The Invisible Wall (or career counselling clients with invisible disabilities)

By Lisa Trudel, Career Practitioner

In the world of the theatre and live arts there is a term performers call “the invisible wall” or “the fourth wall”. This invisible wall lies between the stage and the audience. When an actor makes eye contact with the audience, or directly brings the audience into the story, it is considered breaking the invisible wall.

As career practitioners we may find ourselves counselling clients or students with invisible disabilities. They might sit in our workshop audiences or our offices asking for assistance with career issues. Until they disclose their disability, or directly bring us into their story, breaking down their invisible wall, we may never value the extraordinary diversity immediately in front of us.

Progressive workplaces strive to incorporate a definition of diversity into their policies, procedures and programs. Employees may have many differences in areas that include race, gender, culture, sexual orientation, language, class, religion, age, and abilities. Employees are often encouraged to promote inclusiveness, value differences, and avoid actions or behaviours that offend, demean or exclude. In the business of career counselling, it is hoped we cultivate diversity and encourage our clients or students to communicate and work together effectively by appreciating their differences. Often we use workshops such as True ColorsÒ or other team building programs to strive toward this goal of appreciation.

An often-neglected but appreciated difference is invisible disabilities. How do we react when a client discloses their invisible disability in a group setting? How can we motivate a client toward career success once that invisible wall has broken down?

Just as an actor learns about the parts of the theatre and the importance of how to stand and speak on stage, career counsellors and trainers need to develop an understanding about invisible disabilities.

An invisible disability refers to any disability that is not obvious in a brief interaction with a person. The range is wide, and includes the following:

• Medical Disabilities:
  • These may be acute or chronic, and the type of support needed is as diverse as the individuals seeking assistance.
  • Chronic illnesses may include fibromyalgia, chronic fatigue syndrome, arthritis, epilepsy, kidney disease, allergies, diabetes, cancer, HIV infections, respiratory disorders, and gastro-intestinal disorders such as Crohn’s or Colitis which may result in permanent ileostomies or colostomies.
• Mental Health Disabilities:
  • Clients who disclose a mental health disability are often participating in some form of treatment intervention, either medication therapy or psychotherapy, or a combination.
  • These hidden disabilities may include anxiety disorders, mood disorders, seasonal affective disorders, personality disorders, obsessive-compulsive disorders, depressive disorders and eating disorders.
• Learning Disabilities:
  • This invisible disability refers to a variety of disorders that affect the acquisition, retention, understanding, organization or use of verbal and/or non-verbal information.
  • They range in severity and invariably interfere with the use of important skills such as oral language, reading, written language and mathematics.
  • Learning disabilities may also cause difficulties with organizational skills, social perception and social interaction.
  • Scientific evidence has shown that this type of invisible disability is neurologically based, permanent in nature and exists across the life span.
• Attention Deficit Hyperactivity Disorder:
  • According to medical research, this invisible disability is neurobiological in origin.
  • ADHD can occur in 3 forms: the inattentive type of attention deficit, the hyperactive-impulsive type of attention deficit, and the combined type, attention deficit hyperactivity disorder.
  • This disability impacts to a significant degree in social, academic and occupational functioning.
  • It often co-exists with other invisible disabilities such as learning disabilities as well as mental health issues including depression and anxiety.
• Acquired Brain Injury:
  • This invisible disability is characterized by moderate changes in one, or all, of an individual’s level of cognitive, emotional, behavioural, or physiological functioning.
  • These changes can take a number of forms, but will most likely include a combination of: impaired memory, difficulty solving problems, trouble expressing thoughts, increased fatigue, decreased tolerance for frustration, poor coordination of movements, lack of emotion, tendency to overreact, inaccurate assessment of ability, impulsivity and poor judgement.
  • Acquired brain injury can be the result of a brain tumor, a stroke, infectious disease, substance abuse, or a traumatic injury from an accident and blow to the head.
  • There is no such thing as a typical brain injury; similar injuries may produce different effects in different people.

The range of invisible disabilities is wide, but clients with these hidden disabilities can bring a unique set of strengths and experiences to your counselling session. While many learn in different ways, their differences do not imply inferior capacities. There is no need to dilute your program or curriculum or to reduce workshop eligibility requirements for clients with invisible disabilities. However, instructional accommodations may be needed, as well as modifications in the way information is presented and in methods of testing and evaluation.

Invisible disabilities may be more or less severe than visible disabilities and they can pose their own set of problems. For example, because a person with an invisible disability does not obviously need assistance or accommodation, that person must be constantly proactive about having their needs met. This can be exhausting. People also have a hard time remembering that someone with a hidden disability has some very real physical or mental limitations. Therefore they may react to the person in a way that suggests that they are lazy, or trying to avoid work.

In order to assist career practitioners who may find themselves counselling a client who breaks the invisible wall by disclosing their disability, the following is a list of 15 specific suggestions. These may help ease the career action plan you are creating with your client, accommodate the client in a workshop setting, or give you ideas for contingency planning:

1. A common problem for clients with medical disabilities is fatigue and pain, thus allow for appropriate breaks as needed for resting or taking medication.
2. Allow for the freedom to walk, sit or stand to relieve pain.
3. Be aware of procedures if there is a medical emergency and become knowledgeable about side effects of medication.
4. Be ready to arrange supportive methods of assisting clients with mental health disabilities, such as pre-arranging a cue to refocus attention in a group workshop.
5. Clearly outline employment action plan assignments or workshop homework to allow clients to plan the workload effectively, thus reducing anxiety.
6. Provide clear time lines and due dates for all tests and assignments in both oral and written form.
7. When working with clients with learning disabilities, introduce a variety of study strategies that will reinforce important concepts.
8. If reading is required in a workshop, provide the reading lists ahead of time.
9. Allow time to review and clarify information on overheads, charts and lecture material.
10. Signal important key words or concepts verbally by writing on the board, by underlining or by highlighting.
11. Read out information you write on the board.
12. For clients with acquired brain injury, summarize information as it is being taught, and use understanding, feedback and assistance with socially inappropriate behaviour such as anger outbursts, impulsive responding and giddiness.
13. Encourage the use of daily planners to record important information such as appointments, assignment due dates, and workshop sessions.
14. Minimize distractions in your counselling and learning environment.
15. When working with clients with invisible disabilities, as with all clients, it is important to encourage, and to accept that skills may be at varying levels.

There are many reasons people with invisible disabilities do or do not disclose their disability. Career Practitioners and trainers can encourage this decision by providing increased opportunities for discussion of diversity issues in comfortable and safe environments. By creating a climate where everyone feels included, valued and accepted, we begin to create respect and provide the framework for working toward career and employment success which is usually the objective of all our clients. By using language that is free of stereotypes, we focus on the person, not the disability.

Career counselling offices and programs have the opportunity to provide a positive, encouraging and welcoming arena for clients with invisible disabilities. As we coach clients toward success, the environment we create can be a place where differences are not viewed as negative impediments but where individual strengths are recognized. If a client chooses to disclose their disability, or break down their invisible wall, we are given the remarkable gift of diversity in front of us. Bringing us directly into their story might be worth it.

For more information visit:

• Canadian Council on Social Development: Disability Research Information Page (DRIP):www.ccsd.ca
• Learning Disabilities Association: www.ldao.on.ca
• Crohn’s & Colitis Foundation of Canada: www.ccfc.ca
• United Ostomy Association: www.uoa.org
• Ostomy International: www.ostomyinternational.org
• Anxiety Disorders Association of Ontario: www.anxietyontario.com
• Ontario Brain Injury Association:www.obia.on.ca
• Canadian Dyslexia Association:www.dyslexiaassociation.ca
• Canadian Mental Health Association:www.cmha.ca
• Neurologically Disabled of Canada: www.and.ca
• Link-Up Employment Services: www.linkup.ca/

Lisa Trudel is an Employment Counsellor with the Office Workers Career Centre in Toronto, Ontario. Along with conducting Monday evening Career Planning and True Colors workshops for continuing education students at George Brown College, Lisa is completing her Bachelor of Adult Education degree through Brock University. She has lived with the invisible disability of an ileostomy since 1996.