BRS Psychosocial Adjustment & Counseling 2 — Questions and Answers
Question 1: A client with acquired vision loss repeatedly cancels rehabilitation appointments and says, 'It doesn't matter anyway.' Which stage of grief described by Kübler-Ross does this behavior most likely represent?
- Anger
- Bargaining
- Depression (Correct answer)
- Acceptance
Correct answer: Depression
Withdrawal, hopelessness, and canceling appointments are hallmarks of the depression stage in Kübler-Ross's grief model.
Question 2: According to Livneh's model of adaptation to disability, which phase involves the person beginning to acknowledge the permanence of vision loss and exploring functional alternatives?
- Initial impact
- Realization
- Reintegration
- Acknowledgment (Correct answer)
Correct answer: Acknowledgment
Acknowledgment in Livneh's model is the phase where the individual begins accepting the permanence of the disability and starts seeking adaptive strategies.
Question 3: A BRS uses motivational interviewing with a client resistant to using a white cane. Which technique is most consistent with motivational interviewing?
- Confronting the client about the safety risks of not using a cane
- Asking the client to explore the pros and cons of cane use in their own words (Correct answer)
- Assigning homework to practice cane travel daily
- Providing a pamphlet on white cane benefits
Correct answer: Asking the client to explore the pros and cons of cane use in their own words
Motivational interviewing uses reflective listening and open-ended questions—such as exploring pros and cons—to elicit change talk from the client rather than imposing external arguments.
Question 4: Which of the following best describes 'secondary gain' in the context of vision rehabilitation?
- Improvement in visual acuity through treatment
- Adaptive benefits the client acquires from accepting disability
- Unintentional reinforcement of disability behavior through social rewards (Correct answer)
- Financial compensation received after vision loss
Correct answer: Unintentional reinforcement of disability behavior through social rewards
Secondary gain refers to unintentional social or emotional benefits (e.g., attention, avoidance of responsibilities) that may inadvertently reinforce disability-related behaviors.
Question 5: A client states, 'I feel like I'm a burden to my family since losing my vision.' Which counseling response best demonstrates empathic reflection?
- 'You shouldn't feel that way — your family loves you.'
- 'Have you talked to your family about how they feel?'
- 'It sounds like you're feeling guilty about the support you need right now.' (Correct answer)
- 'Many people with vision loss feel this way initially.'
Correct answer: 'It sounds like you're feeling guilty about the support you need right now.'
Empathic reflection mirrors the emotional content of the client's statement without judgment, validating their feelings while inviting further exploration.
Question 6: In the context of the BRS role, when is it most appropriate to refer a client to a licensed mental health professional?
- When the client expresses frustration about learning braille
- When the client exhibits persistent suicidal ideation (Correct answer)
- When the client declines to use assistive technology
- When the client requests more frequent rehabilitation sessions
Correct answer: When the client exhibits persistent suicidal ideation
Persistent suicidal ideation falls outside the scope of the BRS and requires immediate referral to a licensed mental health professional.
Question 7: Which concept from social learning theory is most relevant when a BRS arranges for a newly blind client to meet a successfully adjusted peer mentor?
- Operant conditioning
- Classical conditioning
- Vicarious reinforcement and modeling (Correct answer)
- Cognitive dissonance
Correct answer: Vicarious reinforcement and modeling
Bandura's vicarious reinforcement and modeling occur when observing a successful peer inspires the client to believe they too can achieve adaptive functioning.
BRS Psychosocial Adjustment & Counseling 2
A client with acquired vision loss repeatedly cancels rehabilitation appointments and says, 'It doesn't matter anyway.' Which stage of grief described by Kübler-Ross does this behavior most likely represent?