Counselling Clients with Disabilities using the Human Rights Approach to Psychotherapy

By Wesdyne Otto, Director - Positive-Shift Creative Arts

Disability is a heterogeneity and treating it as a homogenous experience is the root of ableism, racism, sexism, homophobism, agism, and all forms of descrimination. In a forest, no tree is disabled, they are all different and equally valuable to the forest’s health and resilience. Society is similar, no two people are alike, they can be similar, but all are equally valuable for creating robust societies. 

My disability is part of who I am. It influences my experiences in every setting, and my relationships. Ableism is being defined by another person’s assumptions of what living with a disability means. It ignores my relationship with my disability, cripples me, and puts a boundary between you and I. People with disabilities are capable of causing harm by assuming their relationship with their disability is the same as another persons.

In 2017, Dainius Pūras, the United Nations special rapporteur wrote, “I am calling on States to move away from traditional practices and thinking, and enable a long overdue shift to a rights-based approach. The status quo is simply unacceptable.” This approach, first adopted in Europe, is ignored in North America, particularly when counseling people with disabilities. Carl Rogers’ humanistic therapy asks therapists to suspend prejudices and preconceived notions while working with populations whose cultural, religious, racial, and language backgrounds differ from the therapist’s to create a therapuetic alliance. I am a therapist, my training used the medical model of disability when conceptualizing life with a physical, learning, and psychological disability. These were problems to be resolved, minimized, and treated. 

Trauma-informed therapy is in danger of treating discrimination as a trauma from which the individual heals. The onus is on the individual to fit into a homogenous, able, Euro-centric, youth-worshipping, English speaking North America. Human rights, being proud of an expression of self that varies from the status quo, and heterogeneity are often omitted from therapy. Disability is invariably treated as inability, a limitation, and an obstacle to be overcome. Is it any wonder that suicide rates and MAID requests amongst people with disabilities continue to climb? 

Statistics Canada reports that there were 12,689 written requests for MAID in 2021, 31.3% more than the 9,664 written requests in 2020. This resulted in 10,029 medically assisted deaths in Canada in 2021, an increase of 34.7% from the 7,446 deaths in 2020 in Canada. Of those deaths, 9 were inmates. Those terrifying figures speak to the lack of awareness of disability rights, appropriate support for independent living, and disability pride in Canada. There are no statistics available on how many of those individuals sought therapy to deal with the stress of ableism, but it is likely that many did. Are we, therapists, willing to continue the largest, intersectional minority to choose death over life with dignity? Stella Young said, “Death is not a treatment, even if it’s medically facilitated.”

Dr. Erin Andrews, an American psychologist, concluded that disability pride has the greatest positive impact on health and wellness than any other intervention. In 1994, a psychologist advised me to be a disability advocate when I became disabled. I asked her, “How do I go about doing that?”, and her reply was a shrug. Referrals to disability advocacy groups, major moments in the American disability civil rights movement, or disability pride resources are still missing from the dialogue. 

By chance in 2021, I wrote a synopsis of the American Disability Rights movement for an American non-profit. This assignment led to reframing disability as a lack of power and ability to my belonging to a powerful and valuable collective. A positive sense of self-worth can take the name of social inclusion, and be seen as the opposite of discrimination, racism and marginalisation (Wainwright and Leone, 2020). Judith Heumann, Ed Roberts, Alice Wong, Sins Invalid, Johnnie Lacy and others paved the way for transformation. Human rights allowed me to say I am disabled and proud. 

Through a human rights lens I was able to percieve and name the incidents of benovent and malevolent ableism I experienced. I rid myself of the guilt that came from not meeting other’s standards or conforming to what they thought my disability meant. Like all humans, I have limitations and abilities. My limitations do not need to be cured, minimized, and never ignored. They are a legitimate part of my identity. Limitations are an invitation to creative problem solving. Solutions are not universal. I am free to choose which ones I adopt. This theory is not strength-based, it is grounded in human rights. 

Belonging to a group who fought successfully for disability civil rights with America’s longest sit-in, a university wide protest, disrupting traffic, and opened the first centre where people with disabilities helped each other live independently is amazing. Knowing that your life is more than an inspiration, a source of pity, the result of karmic punishment, a traumatic childhood, weakness, or a mistake is empowering. Like any other life, there are challenges, physical and psychological pain, failures, accomplishments, and wonderful experiments. As the old crip joke goes, “Rather than praying for my cure, pray for the stairs. They are miserable because they aren’t ramps.”

Brooke Millhouse’s description of her podcast Disabled and Proud is a blueprint for the therapy office.  Whilst we are creating this space for disabled people to be unashamedly themselves, without need to conform for society, this is also not about toxic positivity. This show will be shining a big, bright light on disability without it being “Paralympic or pity”.. Confronting ableist perceptions of disability, gaining awareness of the disability human rights movements, and aligning your therapeutic practice with disability pride will bring about a positive shift in your client’s ability to live a full and satisfying life. Papers, podcasts, and books are available on the human rights approach to psychotherapy. The European Psychotherapy Act is underpinned  by national and international ethical codes which respect the dignity, autonomy and uniqueness of all human beings. It is time that North America adopts a human rights approach to therapy. 

Additional Disability Pride Resources

The American Psychological Association has a standing committee that is attempting to weed out disability discrimination, known as ableism, from psychological practice.

https://www.apa.org/pi/disability/resources/assessment-disabilities

Leah Lakshmi Piepzna-Samarasinha’s book Care Work: Dreaming Disabiity Justice offers an insight into the world of disability rights from a Canadian author with a disability. 

Canadian author, Amanda Leduc’s book Disfigured: On Fairy Tales, Disability, and Making Space explores how fairy tales teach negative views of disability.

Falling for Myself is an autobiography written by Canadian Dorothy Ellen Parker that chronicles her struggles with internalized ableism. 

University of Winnipeg disability studies professor, Dianne Drieger edited Still Living the Edges: A Disabled Women's Reader, a collection of writing from women with disabilities. 

Disability After Dark is Torontonian Andrew Gurza’s podcast on sex and disability. 

British Brooke Millhouse interviews people with disabilties on her podcast Disabled and Proud.

Canadian Joeita Gupta hosts The Pulse, a podcast hosted by AMI that examines issues important to people with disabilities.