BRS Psychosocial Adjustment & Counseling 5 ā Questions and Answers
Question 1: A BRS works with a client who has diabetic retinopathy and is in denial about the progressive nature of their vision loss. The most therapeutically appropriate initial approach is to:
- Provide written materials outlining the prognosis to force acknowledgment
- Meet the client where they are emotionally while gradually introducing realistic planning (Correct answer)
- Involve family members to persuade the client to accept the diagnosis
- Defer all rehabilitation until the client fully accepts their prognosis
Correct answer: Meet the client where they are emotionally while gradually introducing realistic planning
Meeting the client where they are emotionally respects the protective function of denial while gently building toward realistic planning as therapeutic trust develops.
Question 2: According to self-determination theory (Deci & Ryan), which factor is most essential for sustaining a client's intrinsic motivation in vision rehabilitation?
- Frequent external rewards and praise from the BRS
- The client feeling competent, autonomous, and related to others (Correct answer)
- Setting rigid goals with clear consequences for non-compliance
- Emphasizing the competitive outcomes of rehabilitation success
Correct answer: The client feeling competent, autonomous, and related to others
Self-determination theory holds that intrinsic motivation is sustained when three basic psychological needsācompetence, autonomy, and relatednessāare met.
Question 3: A BRS observes that a client's spouse consistently completes tasks the client is capable of doing independently. This pattern is best described as:
- Appropriate caregiver support
- Overprotection that fosters dependency (Correct answer)
- Compensatory behavior by the spouse
- Evidence of the client's regression
Correct answer: Overprotection that fosters dependency
When caregivers consistently do tasks that clients can manage independently, it fosters unnecessary dependency and undermines rehabilitation goals.
Question 4: In crisis intervention with a client who has just received a diagnosis of total vision loss, which initial action is most appropriate for the BRS?
- Begin teaching braille immediately to give the client a sense of progress
- Ensure safety, establish rapport, and assess the client's immediate support resources (Correct answer)
- Provide a detailed orientation to available rehabilitation services
- Schedule a family meeting to discuss care planning
Correct answer: Ensure safety, establish rapport, and assess the client's immediate support resources
Crisis intervention begins with ensuring safety, establishing a supportive relationship, and assessing immediate resourcesāfoundational steps before any problem-solving or skills training.
Question 5: Which model of disability most directly underpins the philosophy of blindness rehabilitation by emphasizing that barriers are societal rather than inherent to the person?
- Medical model
- Social model (Correct answer)
- Biopsychosocial model
- Moral model
Correct answer: Social model
The social model of disability frames barriers as products of inaccessible environments and social attitudes rather than inherent deficits in the individual.
Question 6: A client reports that since losing vision, their sense of identity has fundamentally changed and they no longer know 'who they are.' This experience is best described as:
- Identity foreclosure
- Role conflict
- Disability identity disruption (Correct answer)
- Ego depletion
Correct answer: Disability identity disruption
Disability identity disruption occurs when acquired disability fundamentally challenges a person's established self-concept and sense of personal continuity.
Question 7: When facilitating a peer support group for individuals with vision loss, the BRS's primary role is to:
- Provide expert advice and direct instruction on coping strategies
- Facilitate sharing and interaction among members while maintaining a safe group environment (Correct answer)
- Ensure each session focuses on teaching a specific adaptive skill
- Act as the primary therapist providing individual counseling within the group
Correct answer: Facilitate sharing and interaction among members while maintaining a safe group environment
In peer support groups, the facilitator's primary role is to create conditions for member interaction and mutual support, not to deliver expert instruction or function as a therapist.
BRS Psychosocial Adjustment & Counseling 5
A BRS works with a client who has diabetic retinopathy and is in denial about the progressive nature of their vision loss.
The most therapeutically appropriate initial approach is to: