Reeve, D. (2000) Negotiation of Disability and Impairment within Counselling Relationships: A Critical Evaluation from the Perspective of Clients with Spinal Cord Injuries, MA Thesis, Leeds: University of Leeds.
Abstract
This empirical study explores the counselling experiences of clients with spinal cord injury (SCI) with particular reference to the ways in which issues about disability and impairment were discussed by both counsellor and client. The effects of the counsellor’s understanding of disability and impairment on the counselling outcome are also considered together with factors that would improve the quality of counselling for future clients. It builds on a study carried out five years ago which considered the counselling experiences of disabled clients from the perspective of the counsellor; one of the acknowledged omissions from this study was the voice of the disabled client. This research also draws on recent discussions within disability studies about the psycho-emotional dimensions of disability and the complex ways in which the experience of living with disability is intertwined with the experience of living with impairment.
Five participants were involved in the research who all had experience of counselling with one or more different counsellors or psychologists since injury. The research was carried out within the emancipatory research paradigm using qualitative methods. Interviews took place with each participant in which they discussed the ways that disability and impairment issues had been handled within past counselling relationships.
The ways in which these participants described their experiences of disability and impairment were rich and complex and revealed an interdependence not explained by a simple social/biological dualism separating disability from impairment. Participants discussed the emotional effects of incontinence highlighting an aspect of the ‘personal’ experience of impairment that has been neglected within the literature. The structural and emotional effects of disability were also discussed with counsellors and it was found that counsellors who did not understand disability as a social construct, failed to counsel effectively and often further oppressed their disabled clients. Participants also found it helpful if the counsellor themselves had knowledge of SCI and was able to pass on information and advice.
These observations have many implications for counselling practice. I suggest that counsellors working with disabled people need to work within the framework of the social model of disability to avoid further disabling their clients. I propose that in addition to making Disability Equality Training (DET) a mandatory part of all counselling courses, this DET must include reference to the psycho-emotional dimension of disability and the ways in which disabled people internalise the negative prejudices and attitudes held by the society they live in. I also argue that a new counselling approach might be more suitable for disabled people which recognises the multiple effects of disablism and offers a more directive counselling approach to empower disabled clients.
I evaluate my research practice and identify the lessons I have learnt from this research experience. Finally I discuss these problems in the light of recent attempts at participatory research within counselling research and propose that emancipatory research offers a new methodology for counselling research which is highly suitable for researching the counselling experiences of oppressed groups in society – areas which are absent within counselling research to date.