Who Is The Least of These?

Who Is The Least of These?


Sandy Egle, M.S.

The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ – Matthew 25:40

egleI want to challenge us to think about who is the “least of these”.  I believe that the answer to this question is relative.  We may have very different definitions based on how God has opened our individual eyes to the needs/needy in our world.  Some would answer that children are the least of these, some would say the homeless, others might say orphans, and still others might say the poor.  Every answer is correct based on the awareness of needs that God has placed on each of our hearts.

I want to challenge those of us in the mental health arena to consider this question through the lens of who is the most underserved by mental health services.  I propose that individuals with developmental/physical disabilities are greatly underserved by the mental health community.  These folks have mental health struggles like anyone else.  They experience grief and loss, trauma, abuse, abandonment, depression, anxiety, fear, aging and health issues, and the list goes on.  Anything that you and I struggle with, they do too.

I am a Qualified Mental Retardation Professional (QMRP).   I serve individuals who have developmental or severe physical disabilities.  Many of my clients within this group live in residential facilities/group homes.  Serving this group of people presents many unique challenges for the mental health professional.  Traditional therapy/counseling techniques are less than effective simply because of the disabilities themselves.  Communication is often a major challenge for the counselor/counselee to overcome.  Developing trust is yet another major challenge that must be addressed.  It is also important to have an understanding of who the client’s support people are and in what capacity they serve, i.e. family, facility staff, or friends.  Developing and maintaining effective communication with these support people can be very beneficial to the counseling process.

There are initial steps that must be taken in any counseling situation; however the very first step that must be taken by the practitioner who is serving an individual with disabilities is to gain insight as to what the client’s specific disabilities are.   Most individuals have multiple presenting disabilities to be aware of.  If a client has mental retardation, we must understand the developmental age of functioning so that we can communicate at a level that will be easily understood and yet be respectful of the client’s chronological age as well.  If the client has delayed mental processing, it will be important to speak slowly and allow the time necessary for the client to mentally process the information and respond.  If the client is deaf, the practitioner must be mindful to face the client directly and make sure that lighting is adequate so that the client has opportunity to see and read lips.  The use of adaptive equipment/techniques such as using sign language or a sign interpreter, communication devices, or things as simple as pen and paper may be necessary to aid in the counseling the process.

Being aware of the client’s comfort level is yet another aspect of the counseling experience that must be considered.  People with disabilities of any kind may have sensitivities that need to be considered.  Some people are very sensitive to their environment such as room temperature, light intensity, noise levels, etc.  If the client is physically uncomfortable in any way, the counseling effectiveness may be hindered.   When the client feels safe and comfortable, they will more actively engage in the counseling experience and will develop trust in the therapist because of the fact that the therapist is taking good care of them and being aware of their specific needs.

Having an awareness of the client’s living situation is also very important.  If the client is living in a group home or facility, it is important to realize that there are many support people involved in the life of the client.  There will be people that the client likes and dislikes.  Who is on duty the day of the session may have a direct impact on how the session goes.  Also, consistency in attendance may be impacted by availability of staff to transport the client to scheduled sessions, or in the busyness of the unit’s activities, sessions may be overlooked altogether.

Staff turnover is yet another issue to be aware of.  Clients may be reluctant to develop a meaningful relationship with the therapist due to fear that the therapist will leave.  Most staff turnover in agencies happen somewhat quickly and clients are often not given information such as when and why regarding staff departure, thus  leaving the client with feelings of abandonment and sometimes even guilt if the client believes that they are in some way to blame for the staff’s leaving.

These are but a few of the challenges/considerations that must be made when counseling people with disabilities.  It is my observation that there are very few counselors/therapists who are serving these dear people.  I want to challenge us all to follow Christ’s example and equip ourselves to reach out to the blind, deaf, dumb. . . . those who Christ  identified as the least of these.  Let’s follow Christ’s example!  When we minister to them, scripture says that we are ministering to God Himself.



Sandy Egle has been in the mental health profession since 1980 and has served God in many capacities over the years.  She has a Master’s degree in Sociology, specializing in Juvenile Delinquency.  She is a Board Certified Christian Counselor through the International Board of Christian Counselors.  She is recognized as a Qualified Mental Health Professional (QMHP) and a Qualified Mental Retardation Professional (QMRP).  Sandy is the founder, executive director and clinical staff supervisor at Heart To Heart Support Services, N.F.P. in Flanagan, IL.