«Reeve, D. (2002) 'Oppression within the counselling room', Counselling and Psychotherapy Research 2(1): 11-19. This is the corrected version ...»
Counsellors who understand the distinction between impairment (medical condition) and disability (social oppression) would no longer consider the ‘loss’ theories described previously to be applicable - they would lose credibility as a total description of how people respond to disability. In addition, I would hope that these ‘enlightened’ counsellors would take on personal responsibility for making their counselling services more accessible for disabled people.
Donna Reeve Oppression within the counselling room 5 As well as including DET, counselling courses also need to teach counsellors to be more imaginative and flexible when counselling disabled people (Oliver, 1995). Part 3 of the Disability Discrimination Act regarding access to services came into effect in October 1999; this means that counselling agencies will need to make their information available in accessible formats, provide access to a sign language interpreter, as well as overcome the problems posed by inaccessible premises [start page 14] by using home visits or telephone counselling (DN, 1999). This is especially true of specialist agencies such as drug and alcohol projects, which need to be available to disabled and non-disabled people alike. Few counselling services offer home visits because of the issues about the personal safety of the counsellor (Nicholas, 1992).
This problem can be solved by the use of telephone counselling which can be as effective as face-to-face counselling if counsellors are properly trained (Sanders, 1996). However, this solution will not be appropriate for all disabled people and the question of home visits will need to be explored further. Counsellors need to be trained in the use of a minicom for counselling deaf clients over the phone (Corker, 1995). Counsellors who are not fluent in BSL will need to adapt to the particular challenges of working with a Deaf client and sign language interpreter within the counselling session (Corker, 1995). Finally, there are a range of issues that a counsellor needs to be aware of when counselling people with communication difficulties to avoid misunderstandings (Brearley and Birchley, 1994).
Disabled Counsellors The lack of DET provision on counselling courses is one reason why counsellors are unaware of their prejudices about disabled people. A second reason, I would suggest, stems from the fact that there are very few disabled people going through counselling training to become counsellors (Withers, 1996). As a result disability is not present ‘in the room’ as an issue in the same way that race and gender are.
Many disabled people who train as counsellors experience difficulties with tutors (and fellow students) who are prejudiced, and as a result come up against pity, anger, embarrassment and other disabling conditions (Withers, 1996). A revealing article describing the personal experiences of a deafened counselling trainee and her tutor showed how frequently the trainee was excluded from the group by both the tutor and her peer group (Monks and Martin, 1997). During my own training I experienced exclusion, and denial of my difference by tutors and students, which I found very oppressive and frustrating. In addition to these difficulties, counselling training is expensive. This, together with inaccessible course materials and venues for skills practice, means that many disabled people with the potential to become competent counsellors are excluded from counselling courses. Finally, many counselling courses require that the counsellor be receiving counselling themselves. Cost and lack of access can make it very difficult for disabled counselling students to meet this particular course requirement.
The process of oppression of disabled clients by non-disabled counsellors can also be repeated in the supervision relationship between a disabled counsellor and nondisabled supervisor (Corker, 1995). As a disabled counsellor I have also experienced the frustrations of having a supervisor who is unwilling to acknowledge the difficulties which occur when a disabled counsellor experiences oppression from non-disabled clients within the therapeutic relationship. The dearth of professionally trained disabled counsellors means that there are even fewer disabled supervisors especially so for Deaf counsellors who want to work in BSL (Ratna, 1994).
Donna Reeve Oppression within the counselling room 6 There has been some discussion about whether or not disabled counsellors should counsel disabled people. A disabled person may want to request a counsellor who is also disabled, maybe even with the same impairment - it is not unusual for a black client to request a black counsellor or a gay client to feel more comfortable with a gay counsellor. However, because of the scarcity of disabled counsellors, the reality is that disabled people have less choice about whether they see a disabled or nondisabled counsellor. Disabled people may want a disabled counsellor because of the ‘shared’ experience of disability. Many disabled clients, myself included, find that they have to educate their counsellor about their reality of living in a disabling society (Withers, 1996). Alternatively, they may prefer a non-disabled counsellor because of internalised oppression creating the belief that a disabled counsellor could not be as good as a non-disabled one (Ratna, 1994). There are mixed views on whether disabled counsellors should counsel disabled people (Oliver, 1995). I believe that both disabled and non-disabled counsellors can counsel disabled people as long as they are aware of the potential problems such as over-identification and work with these in supervision. It is also vital that both non-disabled and disabled counsellors are aware of their own disablist attitudes and prejudices - being disabled does not automatically exempt someone from oppressing other disabled people.
I have shown how disabled people who do manage to find a counsellor who is accessible, may find the experience to be an oppressive one because of counsellors who are unaware of their own prejudices and attitudes towards disabled people. The addition of DET into counselling courses is one way of reducing oppression in the counselling room for disabled clients. Certainly counsellors (and supervisors) who understand disability as a social construct are most likely to enable their clients towards self-empowerment. I would also like to see more disabled people becoming counsellors so that disability remains a ‘live’ issue on counselling courses.
Unfortunately, I do not believe that this will be sufficient to ensure that the experience of counselling for a disabled person is always one which empowers, rather than oppresses. Whilst DET should be a mandastart page 14]
tory part of all counselling courses, I agree with another counsellor who states:
But I don’t think that in itself is enough. What worries me is that people think, ‘well, I’ve done that therefore I must have the kit’. (S5 in Oliver, 1995: 269).
If DET for counsellors alone is not sufficient to ensure that counselling is a positive experience for disabled people, then what else needs examination? Oliver (1995) states that disabled people do not need different counselling to non-disabled people.
I can only agree with this up to a point because I believe that the counselling relationship itself can oppress disabled clients more than non-disabled clients and that DET alone is not enough to prevent this happening. I now want to look more closely at recently developed counselling approaches that address the needs of other minority groups in society and see if they have anything to offer disabled people.
Future Directions: Naming the Oppression One of the criticisms of counselling has been the way in which counsellors, who are usually white, middle class, heterosexual and non-disabled (McLeod, 1998), have continued to ignore the social injustices experienced by their clients (Masson, 1992).
If counselling is not going to become part of the problem for people who are oppressed then I believe that counsellors need to act as agents of social change because Donna Reeve Oppression within the counselling room 7 counselling is a ‘social enterprise’ and cannot be divorced from the social, economic and political environment in which it is practised. (Woolfe et al., 1989: 11).
Psychodynamic, behavioural and person-centred counselling form what is historically known as the first wave of counselling approaches (McLeod, 1998). These approaches paid little attention to the issue of power or the social role of counselling.
The second wave of counselling approaches including feminist and transcultural counselling do recognise the potentially oppressive aspects of counselling. I now want to look at transcultural counselling to consider if this approach which openly acknowledges oppression within the counselling relationship has anything to offer counsellors working with disabled people.
Recognition of Oppression: Transcultural Counselling Over the last 15 years there has been an increasing awareness of the importance of cultural differences between counsellor and client, and the effect this has on counselling practice (McLeod, 1998). Transcultural counselling actively addresses the issues of cultural difference between counsellor and client, particularly the racial and cultural prejudices of the counsellor, and how they affect the counsellor–client relationship (d’Ardenne and Mahtani, 1989). Corker (1995) explores at length the link between transcultural counselling, and the counselling scenario where the counsellor is hearing and the client deaf. Deaf people are part of a linguistic and cultural minority; like Black people they share common cultural experiences and history of oppression, which makes transcultural counselling a natural choice. Transcultural counsellors also recognise the importance of cultural differences in areas such as non-verbal communication and the expression of strong feelings. These areas cause misunderstandings for deaf clients where emotions may be over-interpreted by a hearing counsellor; for example irritation or annoyance may be incorrectly interpreted as anger (Corker, 1995). Many of the issues which are covered by transcultural counselling, such as the reality of prejudice and discrimination in the life of the client (Lago and Thompson, 1996), are also appropriate issues to consider when working with disabled clients.
The question I now want to consider is whether transcultural counselling can be applied generally to the situation of counsellors working with disabled clients because in the majority of counselling services the counsellor will be non-disabled and, therefore, from a different ‘culture’. This ‘cultural difference’ is particularly true for the scenario when a hearing counsellor is working with a Deaf client; such a client defines themselves as a member of a linguistic and cultural minority group, rather than being disabled (Corker, 1998). Whilst transcultural counselling is applicable to this example, I am not confident that transcultural counselling as it stands would provide the complete solution for counsellors working with disabled clients generally.
Disabled people are not a homogenous group, are likely to be isolated and separated from each other, living within a community or family of non-disabled people. This is quite different to the case for people from different cultures where there will usually be role-models within the family and community who can give support (Shakespeare, 1996).
However, transcultural counselling (unlike person-centred counselling) does at least recognise that counsellors live in a society in which discrimination and prejudice exists, and that it is essential that these people have to acknowledge that their assumptions and beliefs about and attitudes towards those who are culturally and racially different may well be, [start page 16] Donna Reeve Oppression within the counselling room 8 oversimplistic, judgemental and discriminatory. At worst and as a consequence, therapeutic aims may well have anti-therapeutic outcomes.
(Lago and Thompson, 1996: 8).
If the words ‘culturally and racially different’ are replaced with ‘disabled’ then the statement supports my earlier observations on oppression in the counselling room by counsellors who are unaware of their own prejudices towards disabled people. The question I now want to consider is whether it would be possible to develop a new counselling approach based on the ideas of transcultural counselling.
Disability Counselling: A New Approach?
Transcultural and feminist counselling are established counselling approaches with oppression at their root, which were created from within the respective oppressed groups. I am suggesting that maybe it is now time to consider a separate ‘disability counselling’ approach which is developed by disabled people and has the social model of disability as one of the core supports, specifically disability as oppression.
With the social model of disability at the centre, disability counselling, like feminist and transcultural counselling, would be ‘profoundly social and political as well as personal and individual ’ (Chaplin, 1988: 4). This approach would openly challenge disablist prejudices and attitudes in the same way that transcultural counselling challenges institutionalised racism within the counsellor.
Like transcultural counselling, disability counselling will be aware of the connection between social context and personal problems. A disability counsellor would be expected to look at disability from the social model point of view and to help disabled clients move away from blaming themselves for being socially excluded. A study involving disabled and non-disabled counsellors working with disabled clients showed that comments made from a social model perspective were the most
effective ways of enabling clients to empower themselves:
Do you get angry at yourself or do you get angry with other things and other people and say ‘help me change this situation so that I can get out’? (S8 in Oliver, 1995: 274).