BRS Psychosocial Adjustment & Counseling 3 — Questions and Answers
Question 1: A client who was blind from birth reports feeling dismissed when sighted people speak only to their companion instead of to them. Which psychosocial concept does this scenario best illustrate?
- Internalized ableism
- Spread phenomenon
- Stigma and othering (Correct answer)
- Role ambiguity
Correct answer: Stigma and othering
Stigma and othering occur when social interactions exclude or marginalize the person with a disability, treating them as less capable of communication or decision-making.
Question 2: According to the stress-appraisal-coping model (Lazarus & Folkman), which type of appraisal involves a client evaluating whether vision loss poses a threat to their goals or well-being?
- Secondary appraisal
- Primary appraisal (Correct answer)
- Reappraisal
- Tertiary appraisal
Correct answer: Primary appraisal
Primary appraisal is the initial evaluation of whether a stressor (vision loss) is harmful, threatening, or irrelevant to one's goals.
Question 3: Which coping strategy would be classified as emotion-focused coping in the context of vision loss?
- Learning to use a screen reader to continue working
- Attending a support group to process feelings about blindness (Correct answer)
- Hiring a driver to replace independent transportation
- Rearranging the home for safety
Correct answer: Attending a support group to process feelings about blindness
Attending a support group to process emotions is emotion-focused coping, which aims to manage the emotional response to stress rather than changing the stressor itself.
Question 4: A BRS notices a client from a collectivist cultural background defers all rehabilitation decisions to their eldest son. The most culturally responsive approach is to:
- Insist on speaking only with the client to preserve autonomy
- Recognize and work within the family decision-making structure while ensuring the client's wishes are understood (Correct answer)
- Document the son as the primary contact and proceed with his preferences
- Refer the client to a culturally specific agency only
Correct answer: Recognize and work within the family decision-making structure while ensuring the client's wishes are understood
Culturally responsive practice means respecting collectivist values around family decision-making while still ensuring the client's voice and preferences are incorporated in the process.
Question 5: Which of the following is an example of the 'spread effect' in attitudes toward people with visual impairment?
- Assuming a person who is blind also has cognitive impairments (Correct answer)
- A blind person developing strong auditory memory skills
- Providing large-print materials to all clients over age 60
- Using audio description during museum tours
Correct answer: Assuming a person who is blind also has cognitive impairments
The spread effect is the tendency to assume that a known disability spreads to affect other, unrelated abilities or attributes.
Question 6: A client with adventitious blindness expresses anger at medical staff for not 'fixing' their vision. The BRS should primarily:
- Explain the medical limitations so the client develops realistic expectations
- Validate the anger as a normal response to loss and explore underlying feelings (Correct answer)
- Suggest the client file a complaint with the medical facility
- Redirect the client's focus immediately to adaptive skills training
Correct answer: Validate the anger as a normal response to loss and explore underlying feelings
Validating anger as a normal grief response creates therapeutic alliance and opens space for deeper emotional processing before focusing on practical skills.
Question 7: In group counseling for adults with vision loss, which therapeutic factor described by Yalom is most directly demonstrated when group members realize they are not alone in their struggles?
- Altruism
- Universality (Correct answer)
- Instillation of hope
- Cohesiveness
Correct answer: Universality
Universality is Yalom's therapeutic factor referring to the relief clients feel when they discover that others share similar experiences and feelings.
BRS Psychosocial Adjustment & Counseling 3
A client who was blind from birth reports feeling dismissed when sighted people speak only to their companion instead of to them.
Which psychosocial concept does this scenario best illustrate?