Accommodating clients with disabilities

“Provide adequate accommodations for clients with disabilities” (NBCC, 2027 task 6.14)

Counselors must make their services accessible to clients with disabilities. Under the Americans with Disabilities Act and related laws, this means reasonable modifications, effective communication and physical access, without extra charges to the client. The exam tests the legal requirements and a respectful, practical approach.

Key points

Title III of the ADA covers places of public accommodation, which include private counseling offices; Title II covers state and local government services; Section 504 of the Rehabilitation Act covers federally funded programs.
Effective communication may require qualified sign language interpreters, captioning, large print or accessible electronic documents; the cost generally cannot be passed to the client.
Make reasonable modifications to policies, such as allowing a service animal, adjusting scheduling or extending session format, unless doing so would fundamentally alter the service or impose an undue burden.
Under the ADA, a service animal is a dog (with a separate provision for miniature horses) trained to perform tasks for a person with a disability; emotional support animals are not service animals under the ADA, though other laws such as housing law treat them differently.
Telehealth services should also be accessible, for example through captioning and screen reader compatibility.
Ask clients what they need rather than assuming, and include accessibility in intake.
Consider disability as a cultural identity and avoid ableist assumptions in assessment and treatment.

In practice

A client who is hard of hearing asks for live captioning during video sessions. The counselor enables the platform's captioning, checks its accuracy with the client, and arranges a CART captioner for a session where accuracy is critical.

A client arrives with a dog wearing a vest. The counselor may ask only whether the dog is required because of a disability and what task it has been trained to perform, and the client explains it alerts her to seizures. The dog stays in the session.

Check yourself

Does the ADA apply to a private counseling office?

Yes, private offices are places of public accommodation under Title III.

Can a counselor charge a deaf client for the cost of a sign language interpreter?

Generally no, because the ADA requires effective communication without passing that cost to the client.

Is an emotional support animal a service animal under the ADA?

No, under the ADA a service animal is trained to perform specific tasks related to a disability.

NBCC's knowledge and skills for Domain 6

Knowledge of: State laws (state licensure law, supervision requirements, abuse reporting, license renewal, CAQH); Federal laws (e.g., HIPAA, FERPA, immigration policy, HI-TECH, ADA, NPI); Codes of ethics; Third-party reimbursement, insurance and billing (e.g., CPT codes); Counseling Compact; Emerging technologies in Counseling; Crisis policies and procedures; Recording keeping and reporting requirements and procedures; Appropriate logistics for telemental health services; Scope of practice (e.g., letters of support, working with special populations); Alternative medical-assisted/pharmacological interventions; Accessing state licensure board; Executing voluntary and involuntary commitments.

Skill in: Maintaining confidentiality; Discerning reputable training providers and programs; Troubleshooting technological difficulties during telemental health session (e.g., session disconnects, video not working); Billing and third-party reimbursement.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.