Alcohol and other drug abuse by the physically impaired: a challenge for rehabilitation educators. (includes related article)

Alcohol and Other Drug Abuse by the Physically Impaired

Alcohol and other drug abuse is a problem among some clients with physical impairments (Anderson 1980-1981; Boros 1980-1981; Greer 1986), although the scope of the problem is not known precisely (Hindman and Widem 1980-1981; Greer 1986). Thurer and Rogers (1984) found that 53 percent of a sample of physically impaired clients rated help with alcohol or other drug problems as a "substantial need" or "great need" among the physically impaired.

The lack of services to meet this need can be traced in part to the training received by rehabilitation counselors, who often are taught to expect that their future clients will have only one disability. When multiple disabilities are discussed in rehabilitation education, they usually are described in terms of such pairings as brain injury with convulsive disorders, cerebral palsy with speech problems, and low back injury with a learning disability. Physically impaired clients with alcohol or other drug problems often are described in training materials as having one primary disability and almost never as having long-term dependence on alcohol or other drugs.

This article examines possible explanations for the lack of discussion of alcohol and other drug problems in most counselor training programs. It also presents some strategies to rectify this omission.

AN APPROPRIATE INTERVENTION ROLE

FOR REHABILITATION COUNSELORS

In the author's view, four general guidelines on the appropriate role of the rehabilitation counselor in intervention for alcohol and other drug abuse can be inferred from the ethical standards and principles of the profession (as discussed in the accompanying sidebar):

1) The rehabilitation counselor

who knows that a client abuses

alcohol or other drugs, and that

the abuse may interfere with the

client's rehabilitation program,

is professionally obligated to

bring this fact to the client's

attention. The counselor should

apprise the client of all available

intervention options. 2) The rehabilitation counselor

should make alcohol or other

drug abuse intervention a part

of the Individual Written Rehabilitation

Plan, if the client

consents. 3) The client has a right to refuse

any suggested intervention. 4) If the client refuses intervention

and if the client's persistent

abuse of alcohol or other drugs

will seriously impair potential …