Chapter 5 of 129.3% of exam

Medical and Psychosocial Aspects of Chronic Illness and Disability

This domain asks what common conditions are, how they affect function, and how attitudes and language shape a person's experience of disability. It mirrors the ICF's structure of body functions, activities, and participation.

Neurological conditions

Spinal cord injury, multiple sclerosis, and traumatic brain injury recur throughout the exam. Know the level and completeness vocabulary for SCI, the courses of MS, and the range of TBI severity. The vocabulary often appears in medical reports that a counselor must translate into functional terms. Recognizing an emergency such as autonomic dysreflexia can matter on a job site.

SCI level
Upper cord injuries can affect all four limbs (tetraplegia); lower injuries may affect the legs and lower body (paraplegia).
NINDS, Spinal Cord Injury
Autonomic dysreflexia
A life-threatening reflex reaction, mainly with neck or upper-back injuries, with pounding headache, flushing, and a sudden rise in blood pressure.
NINDS, Spinal Cord Injury
MS courses
Most people are first diagnosed with relapsing-remitting MS; primary-progressive worsens from onset without distinct attacks.
NINDS, Multiple Sclerosis
Concussion
A type of mild TBI that may take minutes to several months to heal.
NINDS, Traumatic Brain Injury

Mental health conditions and medications

Duration criteria separate diagnoses that look similar. Medication side effects can affect work performance and safety, so counselors should recognize the common ones. Stems usually give a duration and a symptom pattern, so read the numbers carefully. Medication items test recognition of side effects rather than prescribing.

Major depression
Depressed mood or loss of interest most of the time for at least 2 weeks.
NIMH, Depression
Persistent depressive disorder
Less severe symptoms lasting at least 2 years.
NIMH, Depression
Tardive dyskinesia
Long-term use of typical antipsychotics can cause uncontrollable muscle movements.
NIMH, Mental Health Medications

Psychosocial adjustment, language, and barriers

Disability is shaped by environment and attitude as much as by diagnosis. The Code asks counselors to confront stereotypes and to use the language clients prefer. Coverage under the ADA is broad and judged without regard to treatment that controls symptoms. Items in this section tend to reward the answer that locates the problem in the environment or in attitudes rather than in the person.

ICF model
Disability results from interaction between a health condition and environmental and personal factors.
WHO, ICF (2001)
Affirming language
Use the person-first or identity-first language the client prefers.
CRCC Code of Professional Ethics (2023), D.3.e
Attitudinal barriers
CRCs recognize and address stigma, stereotyping, and discrimination in employment and community settings.
CRCC Code of Professional Ethics (2023), C.1.a
Mitigating measures
ADA coverage is judged without regard to medication or other mitigating measures; epilepsy substantially limits neurological function.
29 CFR 1630.2(j)(1)(vi), (j)(3)(iii)

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