Counseling Clients with Physical Disabilities: Biased and Exemplary Practices

Date of Award


Degree Name

Doctor of Philosophy


Counselor Education and Counseling Psychology

First Advisor

Dr. Robert L. Betz

Second Advisor

Dr. Dennis Simpson

Third Advisor

Dr. James Croteau


There is little substantive research that addresses disability as a diversity issue in generalist counseling practice. This study aims to develop an empirically based conceptualization of the principles and concrete practices that represent biased and exemplary practices (BEPs) in counseling persons who have disabilities.

The purpose of this study was to identify, describe, categorize, and illustrate the widest possible range of BEPs that occur in counseling with clients who have physical disabilities. This study used the BEP research model, which has its roots in past research on the quality of services rendered to clients from socially marginalized groups (Croteau & Lark, 1995; Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991; Leigh, Powers, Nettles, & Vash, 1999; Paul, 2000; Task Force on Sex Bias and Sex-role Stereotyping in Psychotherapeutic Practice, 1975). The BEP research methodology obtains data via mail survey from an expert group of practitioners. In this study, the sixty-two participants (16% of the 406 who were sent research packets) had an average of 19.9 years of experience in serving clients with physical disabilities in a wide variety of practice settings. Most were white (86%), female (71%), heterosexual (81%), doctoral-level (81%) professionals, and 31% of the respondents identified themselves as having disabilities. Responses to 4 open-ended questions captured the participants' views of both specific incidents (75 biased and 73 exemplary) and general characteristics (162 biased and 202 exemplary) of BEP with clients who have physical disabilities.

Rigorous qualitative analysis was used to develop a categorical description of a wide range of BEPs. The 8 broad themes address issues such as ableism (in the environment, internalized by clients, and expressed by counselors), disability-specific knowledge, the importance of a holistic view of disability, individual differences, collaboration and client autonomy, accessibility and accommodation, and generic good practices. These findings have implications for professional practice, training, and clinical supervision in that they provide empirically grounded guidance for increasing practitioners' competence in working with clients who have physical disabilities. The results also point to further areas of research and scholarship regarding disability as diversity within the disciplines of counseling and professional psychology.

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