by Anneliese Knop
No re-read what I just wrote. Did your brain substitute “client” for “colleague?” There are two key reasons why we should be working hard to make our mental healthcare professions more welcoming and accessible to people with disabilities. In this article I will largely focus on the issues of blindness and low vision because that’s what I know best. I am blind, and I am a counselor. But the concepts apply to every disability so I hope you’ll read with a broader perspective in mind.
Here’s Reason #1 why we ought to work toward greater disability representation in the healthcare industry:
Aspiration Leads to Age
When I sat down to research this article it took me 10 different key-word searches on google to come up with these two links.
Every other link featured either the need for mental health services for the blind and visually impaired, or resources to meet that need. Blind and visually impaired people are almost universally perceived as patients, not practitioners.
This is how I saw myself.
In the podcast above Dr. Heidi Joshi coins the term “assumption of competence” to describe a truly positive, inclusive mentality that is lacking in the healthcare industry. On my first day of work I was asked “do you need any help?” twelve times in four hours by five different people. And yet, this is the workplace where I have felt the least patronized.
One of the key resiliency factors that play a part in good mental health, or recovery from poor mental health, is a sense of agency or personal power. It is easier to overcome a challenge when you believe you are capable. This belief is not being presented to blind youth or students who have an interest in contributing to their communities. We are told we’re patients, not providers.
We are burdens, and we have no way to balance the drain we place on society’s resources, yet we are expected to be incessantly positive about this to avoid the stigma of bitterness. You can read more about this phenomenon here.
Every day blind and visually impaired people receive multiple messages from multiple channels that claim we don’t have sufficient agency to survive in a sighted world, that we need help. Every day well-intentioned, overly-compassionate people siphon away this resiliency factor, contributing to the high rates of mental illness in the low-vision community. They end up in counseling offices struggling with anxiety, depression, and anger.
No one expects us to be on the other side of the couch.
We don’t even expect ourselves to be on the other side of the couch. I certainly never did. But how much more confidence, stability, and resiliency might I have had if someone told me this was a viable career field, just once?
I didn’t become a therapist to work with blind youth, or help adults with later-onset vision loss cope with their new reality. I didn’t earn a master’s, take the NCE, and sacrifice an entire tree’s worth of paper to ABEC for my ALC application to break this barrier, yet I knew I’d be ramming up against it in this career. So if I’m going to have to fight this battle anyway, I’d like to make it less of a fight for the next blind person. I never had a blind role model telling me I could help others, not just be helped by them. I hope I can fill that role for someone else.
Counselors, if we want to combat the raging mental health epidemic in this underserved, under-resourced population, we need to make counseling a viable, visible career for the blind and visually impaired.
With the transition into electronic health records management systems the profession has sprung wide open in terms of accessibility. But the education, evaluation and testing, and application processes haven’t caught up yet. No one is thinking about developing curriculum adaptations that highlight the strengths of blind practitioners instead of focusing on how we’ll have to adapt to a sighted world.
Reason #2 why we need blind and disabled mental health practitioners:
We the disabled bring traits, skills, and perspectives to the table that are missing from the current body of best practices.
When I go to job interviews I inevitably get a question about how I compensate for not being able to see a client’s clothes or body language. This betrays a narrow definition of assessment because it isn’t asked out of curiosity and a desire to learn, but out of concern that I won’t measure up to professional standards in a way the interviewer understands.
I recognize and acknowledge the concern for client welfare as a good, ethical, and necessary part of a job interview. But no one who asks this question can truly say they genuinely, deeply believe that a blind person has as much competence potential as a sighted person. Why not try asking something like this?
“Obviously you use different assessment tools than a sighted counselor would. I’d love to hear what those are and how you developed them.”
Then you might hear me talk about learning over time how to identify tension in specific muscle groups in the throat, shoulders, neck, face, and chest which are associated with different emotions. You might discover that your own physiological response to a client’s posture can help you infer their habitual fight/flight, freeze/appease, attach/collapse responses. I could talk for hours about how the skin temperature and grip of a handshake speaks volumes about body chemistry, hygiene, and exercise habits.
“What if a client won’t talk to you?” interviewers ask. “If you can’t see their expression…”
Silence speaks volumes. But let me counter this with a question of my own. ‘How many silences might have been avoided if your client didn’t feel pressure to make eye contact with you?”
When I asked Twitter what they’d like about having a blind therapist, the overwhelming response was “I’d feel less judged based on my appearance.”
I’m just now making my first foray into the world as a blind counselor, and already I can share techniques and perspectives that most professionals wouldn’t think of, ideas that should drive powerful questions and inspire new training challenges to improve client care. Imagine if there were a dozen different perspectives coming from different disabilities fueling the creativity of compassionate therapists and social workers and psychologists and psychiatrists.
Imagine what your career might look like after working with me for five years, if you truly saw me as a colleague, not a client. Who else would you invite into your staff meetings? Where might you turn for continuing education?
How would your workplace change if you took a strengths-based approach to inclusive hiring practices?
For more insights on how living on the dark side can change your life, and career, you can read my blog or email me at anneliese@luminouscounseling.org.