Tag Archives: Intellectually Challenged

Alternative Counselor Roles

The role of the “advocate” is one I believe counselors are naturally aligned to, and should consider.  One example where I currently serve as an advocate is vocational training for intellectually challenged adults.  The reality is that most of us, on or about the age of 16, were able to get a hiring manager to “take a shot in the dark” and hire us with no experience.  The unfortunately truth is that isn’t the case for the developmentally disabled or the intellectually challenged population, thereby necessitating the need for “transition placement” and subsequent advocacy on the behalf of that population.

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Understandably, the business establishment has good reason to be weary of something it does not fully understand… I think that is part of human nature and cannot be faulted to a certain degree.  Every hiring manager should have the reassurance that someone is capable of fulfilling their duties as an employee, and it’s not entirely unreasonable to ask the question of someone who is intellectually challenged (after all, they would ask it of a “normal” applicant).  Vocational training gives people with developmental disabilities the opportunity to prove themselves, and the opportunity to demonstrate that they “have valuable skills” and can make a “lasting contribution to a business.”

For example, I currently work with an individual who only 8 years ago was “pigeon-holed” by the developmental model.  It was assumed that this particular individual would never grow “beyond the capacity of a child” and, as a result, he was largely treated as a child.  Through a rigorous process of cognitive, social and skills training… he has become “one of the most productive people on the line” at a local business.  I recently spoke with his employer, and he “regrets even hesitating to pick him up, as he now considers him among the most competent employees he has.”   Granted, the work is pretty basic, but this particular individual is fiercely loyal, driven to succeed, and competent at most basic assembly tasks.  That kind of independence would not have been possible without our advocacy.

Despite the fact that I am not yet a full time paid therapist, I can play the advocate role today.  Even now, I have clients who are consistently told by family and friends that “they will never be able to do that.”  I endeavor to break as many of those molds as is possible, as I believe in the general premise put forth by Dr. Marc Gold:  “The behaviors our children show are a reflection of our incompetence, not theirs.”  With regard to the training I would need to fulfill that role, I believe it is already underway.  I would be better able to advocate for an individual as a therapist, because I could bring the weight of a DSM-IV diagnosis to bear, and speak with knowledge about “what’s typical” and “what’s realistic” for a specific individual.  I believe the role as an advocate, especially for people whom are intellectually challenged, is key role we as counselors can play in their development of cognitive, social, skills based functioning.

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Reflections on Mental Retardation

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Although it is not the most politically correct term for the condition, mental retardation (MR) is still has significant presence in the populations we counselors intend to serve.  It is well documented that individuals with MR are at higher risk for comorbid mental illness of virtually all flavors…

Despite our best efforts to serve this needy population, interdisciplinary approaches that are considered ideal are still infrequently deployed due to cost and time constraints.   I am surprised and disappointed that this kind of consideration isn’t arranged for everyone dually diagnosed with MR and a comorbid mental illness.  I believe if we engaged TEAMS of psychologists, social workers, teachers, and communities agencies at every level of care and integrated it into a cohesive whole, the individuals we serve would receive a higher level of care for a LOWER COST!

A natural extension of the interdisciplinary approach is the involvement of the family in the decision-making process.  (Netherton, Holmes, & Walker, 1999, p. 19)  The importance of the family can not be overstated… absolutely critical and nothing less. I think this approach is too often implied and too rarely explicit.  Three key tenets to working with families are not to be overlooked:

1)      The team must be receptive to including families in the decision making process.

2)      The team must consider the level of knowledge and understanding of the family related to the disability of the child and/or the service and treatment options.

3)      Once the family has an adequate understanding of the condition and service and treatment alternatives, they may need to be nurtured through the team decision making process.  (Netherton et al., 1999, p. 21)

We, as practicing clinicians and psychotherapists, could take a number of different roles in the team environment.  As facilitators, we should frequently be asking parents what their perspective is, constantly seeking feedback and nurturing their freedom of autonomy.   It is absolutely critical that the family “buys in.”  I believe that if we nurture their ability to participate, that “buy in” is much more likely.  As educators, we can also serve parents by helping them making informed decisions regarding every phase of the plan.

I think every expectant parent comes to the table with hopes, dreams, and expectations of who their child will become.  Because many of these children will never grow up and meet the expectations of their parents, we can play a role in assisting them in coping, or simply modifying or altering those expectations to coincide with the realities of raising a child who may never be cured of mental retardation.

As the plan unfolds, we as councilors can play a role not only in the development of the primary client, but we can play a developmental role in the lives of the family members.  If the family experiences feelings of shame, guilt, or even a certain sense of grief can be dealt with in a variety of different formats; including group therapy, family therapy, individual therapy, or even couples therapy for parents.

In summary, I hope we can come to consensus that psychologists should play a significant role in the planning and execution of any developmental plan involving a child with mental retardation.  I would advocate that, aside from the primary care givers and family, our ability to offer assistance at different points of entry uniquely positions us to fill the much needed gaps in the overall individual treatment plan.


Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.

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