Approximately one in five Americans or roughly 50 million Americans are currently living with a disability (U.S. Department of Education, 2007). Individuals with disabilities and their advocates have worked for more than 40 years to eliminate attitudinal and physical barriers, to be fully included in all aspects of society, and to secure the freedom to choose their own futures (Jaeger & Bowman, 2005; Priestley, 2001; Switzer, 2008). Their efforts facilitated the passage of the Americans with Disabilities Act (ADA) of 1990. Nonetheless, many people with disabilities continue to encounter both blatant and subtle discrimination in employment, housing, education, recreation, childrearing, health care, and mental health services (e.g., Banks & Kaschak, 2003; Kirschbaum & Olkin, 2002; Raphael, 2006; Schriner, 2001; Smart, 2001; Stapleton, Burkhauser, & Houtenville, 2004; Waldrop & Stern, 2003; Woodcock, Rohan, & Campbell, 2007).
Although many persons who have disabilities have experienced discrimination, each individual reacts differently to those experiences. Moreover, each person assigns a unique meaning to disability, depending on the nature of impairment, the quality of social support and life demands (Olkin, 1999b; Olkin & Taliaferro, 2005; Vash & Crewe, 2004). Above and beyond their disability experiences, persons with disabilities have their own life experiences and, like everyone else, their own personal characteristics, histories, and life contexts.
To work effectively with people who have disabilities, psychologists need to become familiar with how disability influences a client’s psychological well being and functioning. Psychologists should also become aware of how their own attitudes, reactions, conceptions of disability, and possible biases may affect their professional relationships with clients who have disabilities. Further, it is important for psychologists to learn the best “barrier-free” psychological practices for clients with disabilities, including provision of reasonable accommodations, and appropriate integration of disability-related issues into assessment and intervention.
Unfortunately, while psychologists receive extensive training in treating mental health disorders, they rarely receive adequate education or training in disability issues (Leigh, Corbett, Gutman, & Morere, 1996; Olkin & Pledger, 2003; Rubino, 2001; Strike, Skovholt, & Hummel, 2004). Few graduate psychology training programs offer disability coursework (Olkin, 2000; Olkin & Pledger, 2003). This paucity of training is a major barrier to providing effective services to clients with disabilities (Leigh, Powers, Vash, & Nettles, 2004; Olkin, 2002). Limited training and experience may leave many psychologists unprepared to provide clients with disabilities with professionally and ethically sound services, including provision of assessments and interventions.
The goal of these Guidelines for Assessment of and Intervention with Persons with Disabilities is to help psychologists conceptualize and implement more effective, fair and ethical psychological assessments and interventions with persons with disabilities. The Guidelines provide suggestions on ways psychologists can make their practices more accessible and disability-sensitive, and how they might enhance their working relationships with clients with disabilities. Additionally, the Guidelines provide information on how psychologists can obtain more education, training and experience with disability-related matters.
The Task Force hopes that the Guidelines will increase discussion, training and awareness about disability across the profession. Such interest might contribute to needed research on disability-related issues in assessments and interventions. In particular, we encourage the development and use of empirically informed treatments and assessments for clients with disabilities (Olkin & Taliaferro, 2005).
The Task Force based the Guidelines on core values in the Ethical Principles of Psychologists and Code of Conduct (APA, 2002; Smart, 2001; Szymanski & Trueba, 1994) with specific reference to Principle D: Justice and Principle E (Respect for People’s Rights and Dignity). The core values include respect for human dignity, recognition that individuals with disabilities have the right to self determination, participation in society, equitable access to the benefits of psychological services, recognition that people with disabilities are diverse and have unique individual characteristics, and recognition that disability is not solely a biological characteristic, but is also a result of the individual’s interaction with the environment.
Disability is a broad concept that encompasses a wide range of impairments, functional limitations, and barriers to participation in community life (World Health Organization, 2001). The Task Force recognizes that psychologists have a firm grasp on treating impairments that arise from issues of emotional disturbance and mental health disability. Accordingly, although our Guidelines apply to persons with all types of disabilities, including mental health, we emphasize issues of disability arising from the impairments which are less known to psychologists, such as mobility, sensory, communication, and neurological impairments. We also focus on environmental factors that influence all disabilities and accommodations that mitigate them.
The Task Force conducted an extensive literature search of psychological, medical, rehabilitation, vocational and educational databases, searching in the areas of professional relationship and communication issues, attitudes, biases and assessment and treatment of persons with disabilities across the developmental trajectory. The literature reviews were broad in scope, covering quantitative and qualitative traditions tied to various specialty areas in disability research (e.g., clinical rehabilitation, neuropsychology, education, psychometrics, counseling and vocational rehabilitation). Much of the identified literature was theoretical and professional, focusing on specific disabling conditions rather than generic disability. The Task Force used the results of those reviews in developing these guidelines.
This document offers guidance on how psychologists assess and treat people with disabilities in their professional capacity. Guidelines are not standards. Standards are generally mandatory and may have an enforcement mechanism. Guidelines are intended to facilitate the profession’s continued systematic development and to ensure that psychologists maintain a high level of professional practice. Guidelines are not exhaustive and may not apply to every professional and clinical situation. They are not definitive and do not take precedence over a psychologist’s well-informed judgment. Applicable federal and state statutes also supersede these Guidelines.
These Guidelines are intended for psychologists who work in various settings with clients who have disabilities. Settings may include outpatient therapy; educational, religious, or correctional facilities; businesses and employment settings; insurance, compensation and legal contexts, and hospital, rehabilitation and community service settings. They are meant to facilitate a psychologist’s work with clients who have disabilities, not to restrict or exclude any psychologist from serving clients with disabilities or to require specialized certification for this work. The Guidelines also recognize that psychologists who specialize in working with clients who have disabilities may seek more extensive disability training consistent with specialized practice.
There are many methods and ways for psychologists to gain expertise and/or training in working with individuals who have disabilities. The Guidelines do not prescribe following specific training methods, but instead offer recommendations on those areas of knowledge and clinical skills considered applicable to this work.
These guidelines were developed by the American Psychological Association (APA) Division 55 (American Society for the Advancement of Pharmacotherapy) Task Force on Practice Guidelines. The task force was chaired by Robert E. McGrath. Task force members included Stanley Berman, Elaine LeVine, Elaine Mantell, Beth Rom–Rymer, Morgan Sammons, and James Quillin. Additional input on the guidelines was provided by Robert Ax, representing Division 18 (Psychologists in Public Service). None of the individuals involved in the development of this document has any personal investment in pharmaceutical products of any kind, nor did the developers receive any financial support for its creation.
The task force anticipates that these guidelines may deserve reconsideration in a relatively brief time frame, given anticipated changes in psychologists’ role in pharmacotherapy as well as changes in the perceptions and use of psychotropic medications. In particular, it is the belief of the members of the task force that future efforts should include consideration of whether some elements of the enclosed guidelines merit elevation to the level of practice standards. Accordingly, this document is scheduled to expire as APA policy in August 2014, five years after the date of its approval and adoption by the APA Council of Representatives. After this date, users are encouraged to contact the APA Practice Directorate to confirm whether this document remains in effect.
Correspondence concerning this article should be addressed to the Practice Directorate, American Psychological Association, 750 First Street, NE, Washington, DC 20002–4242.
There were over 200 emails on this issue in a three week period of time. This resulted in a disruption of the listserv with several members resigning from the listserv. In addition, there has been a rancor expressed toward IPA staff members and volunteer officers of the Association. For example, there have been accusations of secrecy, officers’ dishonest motives, and officers’ unethical behavior. All of this besmirches people’s reputations, integrity and credibility. This is potentially libelous and actionable behavior, which we do not want on our listserv. Below is the relevant paragraph from the APA/IPA Rules of the listserv.
Defamation and libel – In exchanges on the listserv and when referring to others, avoid personal attacks and characterizations that question a person’s motives or qualifications. Sometimes a robust debate about ideas spills over into attacks on the proponents or opponents of the ideas. List members need to be reminded that a false statement that harms someone’s reputation can be actionable as libel. There is a substantial difference between disagreeing with how someone did their research or treated a patient and accusing the person of fraud or incompetence. Because negative statements that impugn someone’s professional qualifications can cause substantial economic and emotional harm, this is an area for careful scrutiny. Keeping criticism on an objective basis that is factually verifiable and skipping personal commentary about character, competence or motive minimizes legal risk.
The following statement defines the action that can be taken if discussion begins to violate the above listserv rule:
It is always appropriate to express dissenting opinions on the listserv. However, the listserv moderator’s job is to ensure that these opinions are expressed in a civil way and that the poster does his or her best to present factual information. If opinions are expressed in a manner that is not civil, then the post is not appropriate on a professional listserv. If in the judgment of the listserv moderator such a posting does occur, he/she will back channel the person and ask that language be toned down. If the person does not post respectfully after that, the moderator has the authority to place the person on a read-only basis for a probationary period. If the person comes back after a read-only probation and continues to be disrespectful, the moderator will have to remove the person from the listserv.
These guidelines are designed to address the developing area of practice known as parenting coordination. In response to the recognition by family courts and substantial evidence in the empirical and clinical literature that divorce does not end patterns of high parental conflict for some families (Garrity & Baris, 1994; Hetherington, 1999; Johnston, 1994; Maccoby & Mnookin, 1992; Wallerstein & Kelly, 1980), parenting coordination interventions began to be developed more than two decades ago. In the past decade, parenting coordination work has expanded across states and jurisdictions (Kirkland, 2008; Kirkland & Sullivan, 2008).
The course of the divorce process is commonly one of heightened anger and conflict, anxiety, diminished communication, and sadness or depression for one or both partners. These negative emotions are often accelerated by the separation and the adversarial nature of the divorce process. Although the majority of parents significantly diminish their anger and conflict in the first two to three years following divorce, between 8% and 15% continue to engage in conflict in the years following divorce, with little reduction in intensity of their feelings (Deutsch & Pruett, 2009; Hetherington, 1999; Hetherington & Kelly, 2002; Johnston, Roseby, & Kuehnle, 2009; Kelly, 2000, 2003; Maccoby & Mnookin, 1992; Wallerstein & Kelly, 1980).
Generally, this relatively small group of parents is not able to settle their child-related disputes in custody mediation, through lawyer-assisted negotiations, or on their own. They turn to litigation in the years following separation and divorce to settle these disputes and utilize disproportionate resources and time of the courts. They are more likely to have significant psychological problems, which may interfere with their parenting, and they more often expose their children to intense conflict and intimate partner violence, also commonly referred to as domestic violence (Johnston et al., 2009). As the negative impacts of continued high conflict on children became well established in the empirical and clinical literature (Clarke-Stewart & Brentano, 2006; Deutsch & Pruett, 2009; Emery, 1999; Grych, 2005; Hetherington, 1999; Johnston et al., 2009), family court judges, divorce intervention researchers, and psychologists practicing in the divorce and family area explored alternative interventions that would diminish the use of the adversarial process to resolve child-related disputes and deal effectively with these parents to reduce the conflict to which children were exposed (e.g., Cookston, Braver, Griffin, deLuse ́, & Miles, 2007; Cowan, Cowan, Pruett, & Pruett, 2007; Emery, Kitzman, & Waldron, 1999; Henry, Fieldstone, & Bohac, 2009; Johnston, 2000; Kelly, 2002, 2004; Pruett & Barker, 2009; Pruett & Johnston, 2004; Sandler, Miles, Cookston, & Braver, 2008; Wolchik, Sandler, Winslow, & Smith-Daniels, 2005).
Parenting coordination began gaining recognition in the 1990s as a result of presentations and trainings first offered at conferences, such as those of the Association of Family and Conciliation Courts (AFCC), and by experienced parenting coordinators (PCs). Initially, there were variations in role, source and degree of authority, and practice in different jurisdictions, and different titles were used to describe this innovative intervention model, including special masters, coparenting facilitators, or mediator/arbitrators. In 2003, AFCC appointed an interdisciplinary task force to develop guidelines for parenting coordination to guide mental health professionals, mediators, and lawyers with respect to training, practice, and ethics (AFCC Task Force on Parenting Coordination, 2006).
The complex and hybrid parenting coordination model continues to be refined in professional deliberations about the role, emerging statutes and case law, and court and local rules and regulations governing parenting coordination practice at the local jurisdictional level. These American Psychological Association (APA) “Guidelines for the Practice of Parenting Coordination” are intended to provide a specific framework and direction for psychologists for professional conduct and decision making in the practice of parenting coordination. Although designed for psychologists, many aspects of these guidelines may be relevant to other professionals as well.
The literature reviewed in drafting these guidelines was selected by the members of the APA Task Force for the Development of Parenting Coordination Guidelines to include the most seminal, relevant, and recent publications