BRS Psychosocial Adjustment & Counseling 4 — Questions and Answers
Question 1: A veteran who lost vision in combat describes hypervigilance, nightmares, and avoidance of crowded places. Beyond adjustment to vision loss, the BRS should prioritize:
- Intensifying orientation and mobility training immediately
- Screening for post-traumatic stress disorder and coordinating with mental health services (Correct answer)
- Focusing exclusively on assistive technology training
- Encouraging the client to return to active social activities
Correct answer: Screening for post-traumatic stress disorder and coordinating with mental health services
Symptoms of hypervigilance, nightmares, and avoidance strongly suggest PTSD, which requires screening and mental health coordination before or alongside rehabilitation.
Question 2: According to the World Health Organization's International Classification of Functioning (ICF), which domain addresses the social and environmental barriers that affect a blind person's participation?
- Body functions and structures
- Activities
- Participation
- Contextual factors (Correct answer)
Correct answer: Contextual factors
In the ICF framework, contextual factors (environmental and personal) address barriers and facilitators that affect functioning and participation.
Question 3: A client states their religious faith helps them accept vision loss as 'God's will.' The BRS's most appropriate response is to:
- Challenge this belief as a form of denial
- Respect the belief and explore how faith-based coping supports the client's adjustment (Correct answer)
- Avoid discussing religion entirely to maintain professional boundaries
- Refer the client to a chaplain only
Correct answer: Respect the belief and explore how faith-based coping supports the client's adjustment
Spiritual and religious coping are legitimate adaptive resources; the BRS should respect and explore these beliefs as potential strengths in the rehabilitation process.
Question 4: Which of the following best illustrates the concept of 'internalized ableism' in a client with visual impairment?
- Refusing to use a white cane because 'blind people are helpless' (Correct answer)
- Advocating for accessible crosswalk signals in their neighborhood
- Joining a blindness sports organization
- Requesting braille menus at restaurants
Correct answer: Refusing to use a white cane because 'blind people are helpless'
Internalized ableism occurs when a person with a disability adopts negative societal stereotypes about disability as self-referential beliefs, leading to self-limiting behaviors.
Question 5: When conducting a psychosocial assessment of a client with vision loss, the BRS should assess which of the following as a key protective factor for adjustment?
- Level of remaining visual acuity
- Strength of social support network (Correct answer)
- Age at onset of vision loss
- Type of eye condition causing the impairment
Correct answer: Strength of social support network
Social support is a well-established protective factor that buffers the psychological impact of disability and promotes resilience in rehabilitation.
Question 6: A BRS is working with an elderly client who is newly blind and reports feeling 'useless.' Which theoretical framework would guide the BRS to focus on the client's remaining strengths and abilities?
- Psychoanalytic theory
- Strengths-based perspective (Correct answer)
- Behavioral conditioning model
- Biomedical model
Correct answer: Strengths-based perspective
The strengths-based perspective focuses on identifying and building upon the client's existing capacities, resilience, and resources rather than deficits.
Question 7: A client with low vision reports withdrawing from hobbies they previously enjoyed because they fear embarrassment from performing poorly. This pattern is most consistent with which psychological phenomenon?
- Learned helplessness
- Activity avoidance due to anticipatory shame (Correct answer)
- Regression
- Sublimation
Correct answer: Activity avoidance due to anticipatory shame
Withdrawing from valued activities due to fear of public failure or embarrassment reflects activity avoidance driven by anticipatory shame, a common psychosocial consequence of acquired disability.
BRS Psychosocial Adjustment & Counseling 4
A veteran who lost vision in combat describes hypervigilance, nightmares, and avoidance of crowded places.
Beyond adjustment to vision loss, the BRS should prioritize: