Sexuality and CRC's: Knowledge, Attitude and Comfort

When a counselor, especially a rehabilitation counselor, examines a client it is important to examine all aspects of the client in order to effect a complete treatment. A person's sexuality is an integral part of their being and can be a serious issue during any treatment. Kazukauskas and Lam (2010) discovered numerous studies showing that while over 90 percent of rehabilitation professionals agreed sexuality needed to be discussed as a part of any holistic model of practice, only 32 percent had ever initiated a discussion about sexuality with their patients. Was there a negative attitude towards sexuality in the rehabilitation counseling field?

In the literary review, Kazukauskas and Lam (2010) found that there were high levels of discomfort among many topics involving sexuality and rehabilitation that led to neglect of this important topic in the field. The literary review includes numerous works by Booth et. al. in 2003. The results showed that some felt sexuality issues were outside their boundaries of care, not appropriate for discussion with their patients, lacked the training to deal with such issues or had negative, conservative views about sexuality and disability. They also found high levels of discomfort relating to sexuality issues such as body image, sexual preference, masturbation, sexual acts or being approached by a client for a personal date.

Kazukauskas and Lam (2010) pointed out that there was very limited research on the topic of disability and sexuality competency among professionals. Second, there was also little research on the direct effect of disability and sexual competency on level of comfort. Most importantly, they found no research conducted on the disability and sexuality competency and comfort among Certified Rehabilitation Counselors (CRC's). Any research focused on specific samples of rehabilitation professionals like therapists or direst care staff or focused on a specific disability population. Kazukauskas and Lam (2010) concluded that CRC knowledge, attitudes, comfort and skills in dealing with disability and sexuality was a relatively unknown area needing to be studied.

They determined that this was a major problem needing to be studied; not only due to the sheer number and complexity of sexuality issues important to know for CRC's who often follow a consumer throughout the entire rehabilitation process, but found it to be core part of CRC's responsibility according to the Commission on Rehabilitation Counselor Certification (CRCC) and the Council on Rehabilitation Education (CORE). They noted that current accreditation standards include knowledge of sexual orientation and issues of human sexuality as requirements. As a result, Kazukauskas and Lam (2010) conducted this study to investigate CRC knowledge, skills and attitudes and gauge the effect of these on the level of comfort in dealing with disability and sexuality on consumers. They also attempted to determine the effects of demographic information on the level of comfort.

Using 192 P's taking the Knowledge, Comfort, Approach and Attitudes toward Sexuality Scale (KCAASS), they attempted to answer these questions. Significant results included that there was a low discomfort level among CRC's when related to sexuality questions and had an average level of knowledge regarding issues of sexuality and disability. Those issues included assistive devices, fertility and teenage sexuality. There was an overall suggestion of a positive attitude towards disability and sexuality. However, there was a higher level of discomfort when related to issues of approach. Such issues included finding a client in a sexual situation or being propositioned by a client. This study confirmed results of some previous studies by showing consistence in discomfort levels regarding issues of education and counseling versus issues of approach.

Overall support was found for the hypothesis that increased knowledge of disability and sexuality leads to increased levels of comfort in dealing with consumers during the rehabilitation process. They found support showing that attitudes towards disability and sexuality is indicative of comfort level of CRC's during approach-related situations.

However, the study revealed more areas of study to research. There is a lack of information on the effect of diversity among the CRC's would have on knowledge, attitudes and comfort due to the homogeneity of the sample used. Also, while level of knowledge was a significant factor, there was not enough data to address the perceived skill level of the P's into account which may be a factor in comfort levels. Finally, there was not enough data to draw conclusive results regarding the effect of attitude on comfort levels and they believe it may play a larger role than the results indicated in this study. Kazukauskas and Lam (2010) concluded that more research was needed to better determine how CRC's attitudes and perception of their skill level affect comfort levels in disability and sexuality issues with clients.

This article really brought home to me the comprehensive nature of the role of rehabilitation counselors and disability. There were so many factors I had either not realized were issues or had taken for granted by seeing the issues from my own perspective. Reading this article opened my eyes and hopefully will lead to increased competence on my part in dealing with these issues as a professional and others as well.

SOURCE:

Kazukauskas, K. and Lam, C. (2010). Disability and sexuality: Knowledge, attitudes, and level of comfort among certified rehabilitation counselors. Rehabilitation Counseling Bulletin, 15-25.