Leadership is a critical strategic variable within program management as a process that can motivate employees and influence agency performance. Specifically within the field of vocational rehabilitation (VR), there has been little study of the dynamics of leadership and how these influence the agency, employees, and clients. To date, much of the leadership-related research has focused on clinical supervision, yet there remains a need to continue to build the supervision literature base and to broaden the view of leadership to include the conventional strata found in VR agencies: administration, supervision, and direct service (aspiring leaders) levels. The current study outlines a more comprehensive model of leadership within state VR agencies and then explores administrator’s perceptions of important leadership components, needs for further development, and expected vacancies at each level. The findings reveal expectations of high turnover among senior leader positions over the next 5 years, specify important elements of leadership at each level, and identify numerous needs which are not being adequately addressed through current systems. These results hold value in promoting general understanding of leadership functioning in rehabilitation agencies, informing the design of targeted professional development programs, and establishing improved succession planning across organizations.
The current study identified the longitudinal quality of life (QOL) trajectories of individuals with disabilities as well as the predictors of those trajectories. It examined a secondary data set, the Panel Survey of Employment for the Disabled (PSED), conducted by the Korea Employment Agency for the Disabled (KEAD). Data were gathered over 5 years from individuals with disabilities and analyzed using growth mixture modeling to identify the best QOL trajectory model. Covariates, physical dependence, experience of discrimination, emotional stability, self-esteem, religion, and degenerative type of disability were explored as trajectory predictors. Analysis revealed four latent classes: a high and stable QOL class, a high and varied QOL class, a low and stable QOL class, and a low and varied QOL class. Analysis of predictors indicated degenerative type of disability, physical dependence, discrimination, emotional stability, and self-esteem differentiated the high and stable QOL group from other groups. Significance, limitations, and implications for future practice and research are also discussed.
Sense of community (SOC) refers to feelings of belonging and attachment one has for a community. Despite a growing focus on adjustment and community outcomes following disability, this construct has received little attention in the rehabilitation literature. The primary aim of this study was to examine the extent to which SOC and social identification with one’s town contribute to life satisfaction outcomes among adults with brain injury, controlling for demographic, disability, and other related social constructs (e.g., social support and social integration). Members from brain injury associations across the United States (N = 177) participated in a survey-based study. Results from hierarchical regression analysis indicated that the final model accounted for 45% of the variance in life satisfaction, with SOC variables contributing 11%. Symptom severity, perceived emotional support, and the SOC dimension reinforcement of needs were significant independent predictors of life satisfaction. Findings from this study highlight the importance of examining SOC variables among clients with brain injury to enhance subjective well-being.
Given the high unemployment rates of adults with multiple sclerosis (MS) and the importance of job satisfaction as a predictor of turnover intention and job tenure, this investigation examined the relationship of perceived job satisfaction to social cognitive career theory and ecological model constructs. Highly compatible, the two formulations suggest that extent of job satisfaction is a function of personal or demographic, contextual or extrinsic, disability/health status, and self-perceived vocational situation variables. Based on responses to a national survey by 628 employed adults with MS, a four-block, hierarchical logistic regression analysis examined the extent to which the four variable groupings contributed to the prediction of job satisfaction. The following variables were retained in the regression equation: racial/ethnic status, satisfaction with current financial status, satisfaction with housing accessibility, illness duration, extent of job/person match, appropriateness of current work hours, and self-rated job performance level. Consequently, job satisfaction is influenced by multiple factors that counselors must consider in their rehabilitation planning and service delivery.
The purpose of this study was to document the first-person perspectives of 10 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with posttraumatic stress disorder (PTSD) regarding their efforts to move from homelessness to employment. A qualitative, phenomenological study design was employed through the use of in-depth interviews. Five themes emerged, labeled as (a) fallout from PTSD, (b) motivation to change, (c) family support, (d) rehabilitation counseling, and (e) developing a new work identity. Findings suggest that veterans of this era with PTSD express the values and attitudes needed for work adjustment and successful reintegration into the workforce. It is anticipated that the results of this study will stimulate the rehabilitation counseling profession to continue advancements in training, research, and service provision to better meet the vocational rehabilitation needs of veterans with PTSD.
We analyzed the psychometric properties of two published self-report suicide assessment competency rating scales—the Suicide Competency Inventory (SCI) and the Suicide Competency Assessment Form (SCAF)—in a multistate sample of 223 public-sector vocational rehabilitation counselors. Both measures demonstrated very good to excellent internal consistency in our sample. Exploratory factor analysis indicated the SCI loads on a three-factor model whereas the SCAF loads on a single factor; these are consistent with the theoretical scale structures proposed by the original authors of the scales. In addition, both scales were highly correlated with each other, providing strong initial evidence of construct validity. In sum, our results support the use of these measures as a reliable and valid means of assessing perceived suicide assessment competency in rehabilitation counselors.
The purpose of this study was to identify vocational rehabilitation (VR) services associated with employment outcomes of individuals with traumatic brain injury (TBI) who received college training and increased their highest level of postsecondary education completed. The participants were 1,221 individuals with TBI who increased their highest level of postsecondary education while receiving VR services. A logistic regression model containing five demographic and six VR service variables correctly classified 75.4% of cases as competitively employed or not competitively employed. The model explained approximately 10.0% of the variance in competitive employment. Significant predictors associated with competitive employment were the demographic characteristics of ethnicity and age at application. VR service variables that were significant predictors of competitive employment were (a) vocational rehabilitation counseling and guidance, (b) job readiness training, (c) job placement assistance, and (d) personal assistance services. While demographic characteristics and VR services explained a relatively small proportion of the variance in employment outcomes, more robust measurements of the variables have the potential to enhance prediction of outcomes. Provision of job readiness training and personal assistance services should be investigated further to determine the extent to which they serve as indicators of the presence of additional barriers to competitive employment.
Although the Wellness Recovery Action Plan (WRAP) has been studied in the context of recovery from mental illness, peer-led services, effectiveness, and improving self-advocacy skills of clients, the relationship between employment success and WRAP has not yet been examined. The objective of the study was to explore the impact of WRAP on employment and how individuals with psychiatric disabilities utilized WRAP strategies for employment success. Ten working-age individuals who completed WRAP training and subsequently worked for at least 90 days engaged in semi-structured interviews about their experiences with WRAP and employment. Transcripts of the interviews were analyzed and three themes emerged from the study: (a) Then and Now, (b) Strategies for Wellness, and (c) Toward Employment Success. Findings showed that WRAP strategies facilitated success in employment and that employment was an important component of recovery from mental illness.
The implementation of evidence-based practice (EBP) in rehabilitation counseling has the potential to improve the effectiveness of vocational rehabilitation (VR) services and employment outcomes of people with disabilities. The purpose of this content analysis was to explore certified rehabilitation counselors’ (CRCs) perceptions of the effectiveness of EBP and their preparedness to implement EBP in a variety of rehabilitation counseling settings. Three hundred fourteen CRCs responded to two open-ended questions related to their perceived effectiveness and preparedness to use EBP in VR service delivery practices. Results of this content analysis indicate that CRCs generally recognize the value of EBP and support its use in rehabilitation counseling. However, they identified major individual-level and organizational-level barriers that could hinder the implementation of EBP in the professional practice of rehabilitation counseling. Strong administrative support, adequate funding, time, and continuous training to update skills will be needed to fully implement EBP in rehabilitation counseling.
The construct of resilience is key to understanding adaptation to disability from a strengths-based perspective. The objective of this study was to examine the impact of factors identified in Kumpfer’s resilience model on quality of life (QOL) outcomes for adults with spinal cord injury (SCI), specifically taking into account injury characteristics, self-efficacy, resiliency characteristics, and social support using hierarchical regression analysis. Participants included 255 adults with SCI. Findings revealed that the overall model accounted for 75% of the variance in QOL outcomes. In particular, coexisting pain, participation self-efficacy, core self-evaluation, resiliency characteristics, cognitive strength, general health, and social support independently contributed to the variance in QOL scores. Implications of these findings for developing theory-driven, strengths-based approaches for improving rehabilitation outcomes for individuals with SCI are discussed.
This article describes the development and initial validation of the Participatory Ethics Scale (PES). The PES assesses counselor’s self-reported ethical orientation in relation to consumer participation in the solution of ethical dilemmas. Study 1 includes the results of a Delphi study conducted to develop and assess content validity of PES items. This first study resulted in the creation of 90 potential items to evaluate a participatory ethics orientation. Study 2 reports on the results of a pilot study conducted to assess the usefulness of the PES items measuring an ethical orientation guided by consumer participation. Results indicate that data from this pilot study provide enough evidence of the usefulness of these items in measuring aspects related to ethical knowledge, working alliance, consumer involvement, and consumer empowerment. Discussion, limitations, and implications for future research are presented.
Negative employer attitudes have traditionally been considered one of the major barriers to employment faced by people who are blind or visually impaired. Recent research suggests this continues to be a problem, yet little research has directly measured employer attitudes toward this population. Data were collected from a large sample of hiring managers (N = 382) to provide evidence for the validity of a recently developed instrument, the Employer Attitudes Toward Blind Employees Scale. Confirmatory factor analysis was used to evaluate the instrument, providing evidence for its reliability and validity. Social desirability bias was not found to be a significant problem with the instrument. Self-reported likelihood to hire a person who is blind or visually impaired in the future had a strong association with attitude scores, providing evidence for the scale’s predictive validity.
The purpose of this study is twofold: (a) to examine the relationship between individual factors and rehabilitation outcomes of transition youth with disabilities receiving state vocational rehabilitation services and (b) to determine the contextual effects of state unemployment rate on the employment outcomes of transition youth and its potential interactions with personal and service factors. Hierarchical generalized linear modeling was used to analyze Rehabilitation Services Administration Case Service Report (RSA-911) data for fiscal year 2013. Results show that state unemployment rates were found to moderate the relationships between some demographic and service variables and successful competitive employment. These results indicate the importance of contextual variables, such as state unemployment rates, and their impact on the predictive strength of specific personal and service variables on employment outcomes of youth with disabilities. Implications for vocational rehabilitation services and policy, and future research are discussed.
According to decades of research on secondary transition for individuals with disabilities, cross-agency collaboration with adult service providers is an integral element of positive post-school outcomes. While much has been written about the general functions of vocational rehabilitation (VR) professionals and their part in the transition planning process, limited research has explored the role these professionals play in curriculum decisions, particularly for students with the most significant disabilities. Through the use of semi-structured, face-to-face interviews, the authors explain the work of six transition specialists in a midwestern state who are jointly funded by VR and the respective local education agencies with which they work. Specifically, their influence on the development and implementation of transition-related curricula for students with severe disabilities is addressed. Participating VR transition specialists reported that they influence curricula through a collaborative approach, and focus on resource and knowledge sharing. These professionals also reported delivering several direct-service activities to students inside and outside of the school environment.
The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) in a sample of state vocational rehabilitation (VR) service consumers. A total of 277 individuals with disabilities were recruited from Alaska, Kentucky, Florida, Michigan, New Mexico, Texas, Utah, and Wisconsin. The measurement structure of the VRES was evaluated using exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis results support a one-factor measurement structure of the VRES. Confirmatory factor analysis results also indicated a good model fit for the one-factor measurement model. Internal consistency reliability (Cronbach’s α) for the scores on the VRES was computed to be .94. VR engagement was found to be associated with working alliance, vocational self-efficacy, internal motivation, and VR outcome expectancy in the expected direction. The VRES is a brief, reliable, and valid instrument for assessing VR engagement and contributes to the use of self-determination as a paradigm for improving motivation and engagement of people with disabilities receiving services from state VR agencies.
The purpose of this article is to evaluate the mediation effect of hope on the relationship between attachment and full-time employment for people with spinal cord injury (SCI). Quantitative descriptive research design using logistic regression, multiple regression, and correlational techniques were used. Eighty-four persons with SCI were recruited from several SCI advocacy organizations in Canada, the United Kingdom, and the United States. The results show that secure attachment, anxious attachment, and hope were significantly related to employment. Hope was found to be a significant mediator of the relationship between attachment and full-time employment. Results provide support for the use of hope-based interventions by vocational rehabilitation counselors working with individuals with SCI.
State vocational rehabilitation (VR) agencies are well positioned to assist youth aged 16 to 24 years with disabilities who are transitioning from school to work. Using Rehabilitation Services Administration (RSA)-911 records matched to Social Security Administration (SSA) administrative records, this article adds to the knowledge about state VR agency provision of services to youth with disabilities and differences in outcomes based on SSA benefit receipt status. Although agencies’ statistics varied widely, almost one in six SSA beneficiaries who sought VR services had at least 1 month of benefit suspension due to work within 48 months of their VR applications, and about one in 10 VR applicants without SSA benefits at the time of their VR application received SSA benefits within 48 months. SSA beneficiaries received services from VR agencies at the same level as non-SSA beneficiaries, but the levels at which they were employed when they closed from services were lower. The results have two main policy implications. First, the level of resources to which agencies have access may be important in influencing the outcomes we measured. Second, agency differences in the proportion of SSA beneficiaries who eventually had benefit suspension due to work point to the potential for additional gains by agencies in this area.
Rehabilitation counselor skills, knowledge, and training are significant predictors of quality of employment outcome. In the past decade, vocational rehabilitation (VR) and placement-related work settings in Taiwan have gone through a tremendous amount of change to reflect changing policies, types of disabilities, and global factors. VR professionals’ competencies also need to be addressed to keep pace with this transformation. The purpose of this study was to validate the Taiwanese version of the Systems Approach to Placement: Self-Assessment for Students and Counselors (SAP-SASC), designed to identify critical areas of knowledge, skills, and competencies possessed by practicing VR professionals. A total of 116 participants completed the instrument. The participants represent (a) rehabilitation counseling master’s students from National Changhua University of Education, National Kaohsiung Normal University, and National Taiwan Normal University and (b) job coaches, VR case managers, and other VR professionals from the Council of Labor Affairs in Taichung, Changhua, Nantou, and Taipei counties. Multi-trait scaling analysis revealed eight components of VR professionals’ competence (client, health, education, family, social, employer, placement, and funding). The respondents expressed the highest level of competence in providing job seeking and social skills training, addressing job modification needs, performing job analysis, and referring clients of community-based support services.
Accommodating students with disabilities may influence their academic performance. This study investigates the effects of accommodations on grade point average (GPA) by examining a sample of 1,248 students from the Office of Disability Services at the Pennsylvania State University. The results showed the significant influence that both test accommodation, specifically extension of time and modification of materials, and course accommodation, specifically assignment accommodation, had on overall GPA while controlling demographic variables and types of disability. The authors also discuss the significance, limitations, and implications of such results.
This study explored treatment participation rate as a mediator between individuals’ baseline alcohol use, drug use, and psychiatric issue levels and post-treatment employment status. The study sample included 106 unemployed or underemployed individuals with substance use disorders who were participants in an intensive drug abuse treatment program. Structural equation modeling was applied to examine relationships between study variables. The results showed that (a) the direct effect of individuals’ baseline alcohol use, drug use, and psychiatric issue severities reduced treatment participation rate; (b) the direct effect of treatment participation rate ameliorated post-treatment employment status; and (c) the indirect effect of individuals’ baseline alcohol use, drug use, and psychiatric issue severities on post-treatment employment status was mediated by treatment participation rate, which reduced the negative influence of baseline issue severity on employment. This significant mediating effect has both practical and theoretical importance in that it indicates the need for increased focus on treatment participation in practice and future research.
The primary purpose of the study was to investigate the relationship of Type D personality and perceived career readiness in a group of college students with and without disabilities. The findings of the study revealed no significant differences in levels of career readiness and Type D personality across disability groups. Results also revealed that Type D traits did have a significant relationship with career readiness variables, and that this relationship is particularly significant for college students with disabilities. Results also indicated that for individuals with disabilities, both Type D traits (negative affect and social inhibition) have an effect on different dimensions of career readiness. Implications of the results are discussed within the context of rehabilitation counselors and professionals. Future directions for research are also offered.
The ability to effectively manage social interactions is key to achieving many life goals. A substantial amount of research has been conducted in rehabilitation counseling and rehabilitation psychology that includes a consideration of some aspect of social effectiveness. The purpose of this study was to collect and synthesize the past 30 years of rehabilitation counseling and rehabilitation psychology research addressing aspects of social effectiveness. A total of 13 terms (e.g., interpersonal skills, social competence, social functioning, and soft skills) were used to search six of the most prominent rehabilitation counseling and rehabilitation psychology journals from the period January 1982 to May 2013. A total of 608 articles were identified as including at least one of the search terms, with 175 using a search term prominently and the other 433 only passively. Social skills, social functioning, and social competence were among the most frequently used search terms, accounting for almost 90% of all used terms. It was found that social effectiveness constructs were rarely defined and often used interchangeably. Twenty-nine interventions studies had been published in the 30-year period. Results reflect a substantial and useful body of literature in this area of research while also conveying an opportunity for the development of a more systematic, unified, and theory-driven approach to understanding and addressing aspects of social effectiveness.
African American women are disproportionately affected by HIV/AIDS. As individuals with HIV/AIDS are living longer and healthier lives, research exploring the appropriateness of rehabilitation services has increased. To date, no research has examined the specific use of vocational rehabilitation (VR) services among HIV-positive African American women. The purpose of this study was to apply the behavioral model for vulnerable populations (BMVP) to examine key predisposing, enabling, and need variables related to and predictive of the utilization of VR services among African American women with HIV/AIDS. Survey research methods were used to collect data from a sample of 313 African American women living with HIV/AIDS, recruited from AIDS Service Organizations and national HIV/AIDS networks across the United States, who volunteered to complete the National Working Positive Coalition–Vocational Development and Employment Needs Survey. Hierarchical logistic regression statistical analyses were conducted to identify key factors predictive of use of VR services. Receipt of income benefits and knowledge of VR services were found to be predictive of the utilization of VR services among African American women living with HIV/AIDS.
Community-based rehabilitation organizations (CBRO) play an important role in providing rehabilitation and support services to individuals with disabilities. Increased utilization of CBROs by state vocational rehabilitation (VR) agencies requires a better understanding of how evidence-based practices (EBPs) are used in CBROs. The aim of the study was to examine the readiness of CBRO practitioners to implement EBP, based on social-cognitive predictors of confidence in knowledge and use of EBP, expected benefits of EBP, and perceived barriers and supports to use EBP. A total of 187 CBRO practitioners were surveyed using the Evidence-Based Practice CBRO (EBP-CBRO) survey. Participants were in moderate agreement that they were ready to implement EBP. They were moderately confident in their knowledge about EBP, in high agreement about the expected improvements by using EBP, and perceived low barriers and moderate supports to implementing EBP. The social-cognitive predictors accounted for 55% of the variance in readiness to implement EBP, with knowledge about EBP as the most significant predictor of readiness to use EBP. Social-cognitive theory is a useful framework for exploring CBRO practitioners’ attitudes toward and knowledge of EBP. CBRO practitioners are in moderate agreement about readiness to use EBP. Improving practitioner confidence to use EBP might be the best means of increasing utilization.
The purpose of this study was to examine the structure of active social networks of individuals with visual impairments, the social support they receive from their social networks, and their satisfaction from received support. In addition, we examined these factors as predictors of happiness in people with visual impairments. A total of 96 individuals with visual impairments, who ranged in age from 16 to 50, participated in this study. Three self-constructed questionnaires, which included questions related to demographic data, social networks, social support, and happiness, were used in the study. Participants reported being satisfied with received support, and they also appeared to receive more positive than negative support. Findings also demonstrated the merit of social support for the happiness of individuals with visual impairments.
Vocational rehabilitation (VR) counselors do not always focus on competitive employment for people with severe mental illness (SMI). Based on the Theory of Planned Behavior (TPB), this study examines how three types of VR counselors (i.e., gatekeepers, case managers, and specialists) vary in their underlying beliefs about competitive employment. VR counselors (N = 286) from Belgium completed an online TPB survey measuring behavioral, normative, control, and self-efficacy beliefs. Differences in beliefs were analyzed by one-way ANOVAs and post hoc comparisons using Bonferroni correction. Results indicate that counselors differ in their beliefs regarding competitive employment for people with SMI. Specialized counselors are stronger convinced that competitive employment results in latent benefits (e.g., increased integration and self-confidence). In contrast, gatekeepers consider income as the most recurrent and positive effect. The more specialized VR counselors are, the more often they perceive significant others valuing competitive employment and the more often they may comply with these norms. Finally, specialized counselors experience fewer barriers, more control, and more self-efficacy in dealing with problems compared with less specialized counselors. The differences in beliefs determining the focus on competitive employment may result in a lack of an integrated approach. Training, outcome feedback, and intersectoral communication can enhance consistency between different VR services.
It has long been recognized that people with disabilities usually have less earnings than workers who do not have disabilities. The Rehabilitation Services Administration (RSA)-911 data for 2012 were examined to determine the "true" income of workers with disabilities. The 2012 database included 579,312 cases closed during that year. The benefits and earnings of the whole data set and of 17 disability groups were examined. That is, the amount of earnings (at application for Vocational Rehabilitation [VR] services and at case closure) were combined with the amount of benefits to determine (a) whether total income increased from application for VR services to case closure, (b) the proportion of total income from benefits versus earnings, and (c) how total income for these consumers compared with the poverty level. Overall, those data revealed a 326% increase in total income from application to closure. At application, the proportion of total monthly income from earnings was 42%, whereas at closure, it had shifted to 83% of total income from earnings. Income relative to the poverty threshold was 57% for all clients at application, but had increased to 185% at closure. Results are also provided for each of the 17 disability groups.
The current study surveyed 94 Japanese vocational rehabilitation (VR) professionals to determine their perceived self-efficacy, perceived benefits, perceived barriers, and readiness to use evidence-based practice (EBP). VR counselors in Japan generally see the potential benefits of using EBP to improve psychosocial and employment outcomes of people with disabilities. However, responses related to knowledge and skills were mixed with higher confidence reported in the ability to understand basic concepts of rehabilitation research designs, methods, and statistics but less confidence in the use of research databases to find empirically supported interventions and in their ability to understand the best evidence information from systematic reviews/meta-analyses. Perceived barriers to EBP were identified, including lack of support for the use of EBP from colleagues and senior management in the agency and not having supervisors who are experienced in EBP. As expected, Japanese VR counselors also reported EBP was not effectively used in VR service delivery practices. Implications for practice, education, and professional development are discussed
Disability is associated with low employment rates and earnings. The gap in earnings between people with and without disabilities continues among those who exit vocational rehabilitation (VR) services with an employment outcome. Hypothetical hiring scenarios were presented to undergraduate business students, and the potential influence of social capital on starting wage was examined for both persons with and without disabilities. Results suggest that both direct and indirect social capital have a positive influence on starting wage. Scenarios depicting high levels of social capital resulted in an increase in hourly wage of over US$1,500.00 more per year for a direct relationship and over US$800.00 more per year for an indirect relationship. Social capital, along with human capital, is an important factor in starting wage decisions. A comparison between human and social capital suggests important differences in (a) where the capital is located, (b) potential for indirect use, and (c) resources for investment. Implications for provision of VR services include increased use of a customized, strength-based approach for development and use of social capital for both consumers and counselors.
This article describes the development and pilot testing of an Internet-based abuse and safety awareness program, the Men’s Safer and Stronger Program, for men with diverse disabilities and Deaf men (MWD) using a three-phase community-based, qualitative modified Delphi process. In Phase I, MWD participated in individual interviews (n = 46) and nominal discussion groups (n = 37), identifying key messages to be included in the program and providing guidance concerning program structure and content. In Phase II, the project staff developed the program content and structure with the assistance of an advisory board of MWD. Video narratives by nine male survivors with disabilities were recorded and edited. In Phase III, 14 MWD served as expert reviewers, verbalizing their thoughts, concerns, and suggestions as they used the program. In Phase IV, the program was piloted with 31 MWD and qualitative and quantitative feedback was gathered. The resulting user-guided program contains eight modules including definitions and examples of abuse, risk factors for abuse, survivor narratives, and strategy suggestions designed to increase safety. The program was generally well received by expert reviewers and pilot study participants. Overall, the use of an Internet-based program to increase abuse awareness in MWD appears feasible.
The main study objective was to further evaluate the factorial validity of the Moorong Self-Efficacy Scale (MSES) with 266 Canadians with spinal cord injuries (SCI). Exploratory factor analysis yielded three reliable factors (Interpersonal, Instrumental, and Participation Self-Efficacy) building on earlier studies that extracted two factors. The MSES appears to be a promising rehabilitation assessment tool for individuals with SCI.
Research on vocational rehabilitation in Kuwait is limited, in part, due to the availability of instruments validated for use in Arab countries. The purpose of this study was to adapt the Knowledge Validation Inventory (KVI) for use in Arabic populations and to determine the psychometric characteristics of the adapted inventory for assessing the training needs of vocational rehabilitation service providers in Kuwait. The Knowledge Validation Inventory–Arabic Version (KVI-A) was administered to a convenient sample of 764 service providers from Kuwait special schools. Internal consistency for the three scales of the KVI-A ranged from .94 to .97. Exploratory factor analysis identified six distinct factors: (a) assessment and career counseling; (b) resources and services of rehabilitation; (c) counseling theories, techniques, and applications; (d) medical, environmental, and functional implications of disability; (e) case management; and (f) techniques and strategies of disability prevention and working effectively. Years of experience, job title, and service provider qualifications predicted training needs scores. Significant differences in knowledge domains and training needs were obtained across the identified predictor variables. Evidence suggests that the KVI-A is applicable for use in primarily Arab countries. The knowledge domains identified can be used to develop a training curriculum and certification credentials for Kuwait.
A modified consensual qualitative research approach was taken to determine factors that influence job placement services in selected state Vocational Rehabilitation agencies. Thirty-five counselors, supervisors, and administrators participated in semistructured interviews on job placement and how they determine whether the counselor or another professional (e.g., in-house placement specialist, community rehabilitation provider) provides the direct service. Results indicated that several factors were noted by at least half of the participants, including anticipated intensity of services needed by the client, counselor caseload size/available time, existing employer relationships, availability of a placement service provider, and placement skills. Results highlight the impact of consistently high client volume on placement services, particularly for individuals with the most significant disabilities. Implications related to the current state of policy and practice for placement services, as well as potential future directions, are discussed.
The purpose of this study was to investigate the relationship between various biopsychosocial factors and depressive symptoms in individuals with spinal cord injuries (SCIs). Survey data were collected from 238 individuals with SCIs. The survey measured symptoms of depression, injury level, pain, catastrophizing beliefs, coping skills, perceived stress, and social support. Results indicated that pain (β = .14, p < .05), catastrophizing beliefs (β = .13, p < .05), and perceived stress (β = .50, p < .001) have a positive association with depressive symptoms. Positive coping skills (β = –.16, p < .01) were found to have a negative relationship with depressive symptoms. Injury level (β = .05, ns) and social support (β = –.09, ns) were not found to significantly affect depressive symptoms. The results of the study generally support the biopsychosocial model of depression in individuals with SCIs. Interventions should be aimed at promoting positive coping and ameliorating pain, catastrophizing beliefs, and perceived stress.
We conducted a meta-study of research articles published in Rehabilitation Counseling Bulletin from 2001 to 2012. Variables associated with authors (biological sex, setting, domicile) and study characteristics (sample and research methodology) were coded and analyzed across groups of 4-year publication periods. Our findings and related implications for the rehabilitation counseling profession are discussed.
Evidence-based practice initiatives pertaining to helping people recover from severe mental illnesses have designated certain practices as evidence-based (e.g., supported employment, intensive case management) due to their ability to generate positive outcomes in randomized trials. These practices are often described mostly in terms of their program structures, such as staffing or caseload size. However, evidence-based practice initiatives would benefit from deliberately integrating the factors in the helping process that can occur within each program, and which other mental health research has shown to foster change and growth (i.e., relationship variables, skill teaching strategies, hope-engendering techniques). This article overviews the research underlying those evidence-based helping processes that have often been overlooked in the study of evidence-based practices with respect to interventions for people with severe mental illnesses. Implications for policy and rehabilitation counseling are addressed to expand the evidence base to include evidence-based processes for rehabilitation counseling and research.
General labor market condition is an important contextual factor influencing employment opportunities and outcomes for people with disabilities and is particularly significant given the recent economic recession. Yet, longstanding data analytic strategies have focused only on individual predictors rather than the dynamic interaction among individual level and organizational/environmental level variables, such as considering the role of labor market conditions. This study used the Rehabilitation Services Administration Case Service Report (RSA-911) data for fiscal years 2005 and 2009 to represent two distinct time periods, one before and one during the U.S. economic recession, respectively. Hierarchical linear modeling was used to examine the relationship between state unemployment rate and its interaction with personal factors influencing the employment outcomes of people with disabilities receiving state vocational rehabilitation services. Results found negligible between-state differences, but state unemployment rates were found to moderate the relationships between some demographic variables and successful competitive employment vocational rehabilitation (VR) case closure. Specifically, the significance and magnitude of those effect sizes varied by general economic context. These findings call attention for the need to consider the role of contextual variables, such as state unemployment rates, and their impact on the predictive strength of specific demographic and disability variables on employment outcomes for people with disabilities.
Employers’ characteristics and their policies and practices are workplace environmental factors with important implications for the hiring and retention of employees with disabilities. To explore these factors, a survey was conducted by Cornell University in 2011 focusing on employer policies and practices related to the employment of people with disabilities. The private employer membership of the Society of Human Resource Management (SHRM) was randomly sampled across small, medium, and large employers. In all, 675 SHRM members completed the survey and provided information regarding organizational characteristics; disability-related practices and policies regarding recruitment and hiring, training, accessibility and accommodation, retention and advancement; collection of metrics; and their perception of barriers to the employment and advancement of people with disabilities. Ratings of effectiveness of these practices/policies are examined, as well as the number of policies and practices implemented by organizational size and industry. Comparisons of employer views on employment barriers for persons with disabilities to a previous 1998 Cornell/SHRM study are made.
Although the idea of people with psychiatric disabilities determining their own treatment and rehabilitation goals is increasingly accepted, its relationship to service outcomes has rarely been evaluated programmatically. A statewide, Medicaid-funded psychiatric rehabilitation program incorporated a systematic goal setting procedure conducted by practitioners trained in helping people set their own individual rehabilitation goals. Individuals who successfully set either residential or employment goals were followed for up to 18 months to assess progress on these goals. Participants were grouped by type of goal (residential or employment) and by level of participation in the intervention (enrolled, completed 18 months, or graduated). Residential functioning for those who set residential goals increased significantly, independent of level of participation. For people who had set employment goals, only graduates of the intervention showed significant employment gains. Furthermore, employment functioning changed significantly when a goal was set in the residential area; in contrast, residential functioning did not change significantly when goals were set in the employment area. This study suggests that the programmatic effect of goal setting procedures can be evaluated, even when the person’s goals are tailored to an individual’s unique preference. Implications for rehabilitation counseling will be discussed.
Vocational rehabilitation services have been implemented in a number of countries to facilitate the return to work of sick and injured workers, yet little research has been undertaken to document competencies required to provide services globally. This study compared the job tasks, functions, and knowledge domains deemed important by Australian and German rehabilitation professionals working in vocational rehabilitation settings to identify common practice domains. An online survey comprising items from the Rehabilitation Skills Inventory–Amended and the International Survey of Disability Management was completed by 149 Australian and 217 German rehabilitation professionals. Items from each measure were submitted to factor analysis, using principal axis factoring as the extraction technique. Three common domains were identified: (a) vocational counseling, (b) workplace disability case management, and (c) workplace intervention and program management. Differences in skill and knowledge domains centered on the levels of specialization in vocational rehabilitation practices in each country. Ongoing transnational research is required to ensure that a "global curriculum" covers core competencies, while at the same time allowing for specialization at a local level.
The purpose of this research project was to create an instrument to measure attitudes of employers towards persons who are blind or visually impaired as employees. Items were developed based on prior research with employers that identified their concerns about hiring people with disabilities. A 15-item attitude scale (which was revised based on an expert panel review and results of a pilot test) was administered to a sample of 194 employers in hiring positions located in four states. Psychometric analyses included evaluation of coefficient alpha estimates, item-total correlations, and a common factor analysis procedure (n = 158 for these analyses). Items were hypothesized to load on two factors: productivity of blind/visually impaired people as employees and challenges to employing blind/visually impaired people, which was supported by the data. As a result of the psychometric analyses, four items were removed from the attitude measure, resulting in an 11-item instrument consisting of a five-item productivity subscale and a six-item challenges subscale. Evidence for criterion validity was provided by significant differences in scores of employers based on whether they had ever hired someone with a visual impairment. Overall, results provide good initial evidence for the instrument’s reliability and validity.
This article begins a series of planned annual reviews of rehabilitation doctoral dissertation research. Twenty doctoral dissertations completed in 2011 from recognized doctoral programs in rehabilitation were identified and analyzed. Dissertations were indexed according to their research topic, methodology employed, model, and statistical analysis, and an annotated bibliography was developed. Institutional productivity and employment trends of doctoral graduates were added as baseline data points for future analysis. Results of the current analysis reflect that a majority of the studies consisted of quantitative descriptive research designs. Unlike prior analyses, advanced and basic statistics were utilized equitably. Dissertations focusing on attitudes toward persons with a disability were higher than any of the prior reporting periods. Predictive outcome studies and clinical population research also remain prevalent. Implications for the practice of rehabilitation counseling, education, and future research are discussed.
Based on Moos and Holahan’s "Coping With Chronic Illness and Disability" model, we examined the contribution of medical impairment, illness perception, sense of coherence (SOC), relationship with the professional team, and adherence to treatment to the psychosocial adaptation (social adjustment and life satisfaction) of young adults with cystic fibrosis (CF). We also examined adherence, an important goal in and of itself for patients with CF. Seventy-one participants completed the following questionnaires: Social Adjustment, Life Satisfaction, Perceived Illness Severity, SOC, Relationship With Team, and Compliance. The legal criteria for medical impairment were also examined. Findings indicate that female patients and patients with high SOC reported better psychosocial adaptation. Participants with more severe medical impairments reported higher levels of adherence, and those who perceived their illness to be less severe reported lower levels of adherence and greater satisfaction in life. Relationship with the team was found to contribute to social adjustment. Psychosocial adaptation is associated with internal and external resources, but not necessarily with adherence to treatment. The rehabilitation counselor’s role is, therefore, to help adults with CF bridge between the contrasting dimensions of their lives, namely adherence to strict treatment protocols and psychosocial adaptation.
This study examined the mediating effect of stigma on the link between past and future hiring behavior for individuals with serious psychiatric disabilities. Structural equation modeling of data from a randomized controlled trial of 174 employers in Chicago, Hong Kong, and Beijing regarding stigma and employment-related discrimination toward individuals with behaviorally driven health conditions indicated that, for individuals with serious psychiatric disabilities, the relationship between past and future hiring behavior was fully mediated by stigma. Implications of these findings in terms of psychiatric rehabilitation and suggestions for future research are discussed.
As the number of adults with a diagnosis of autism continues to grow, attention is drawn to whether they receive adequate services and achieve satisfactory employment outcomes, compared with their peers with other disabilities. After examining data from the U.S. state vocational rehabilitation programs from the years 2006–2010, we found that youth with autism received similar levels of services and reported similar employment outcomes compared with their peers with other disabilities. However, these outcomes were modest, declining, and substantially different across states, regardless of the types of disabilities. We recommend continuous monitoring of services and outcomes of people with autism and other disabilities as a means to promote their economic self-sufficiency and inclusion in society.
Leisure may potentially play a key role in rehabilitation counseling, including psychiatric rehabilitation. Based on recovery and positive psychology frameworks in which meaning-making is a central concept, this study examined the role of leisure-generated meanings (LGMs) experienced by culturally diverse individuals with mental illness in potentially helping them better cope with stress, adjust to and recover from mental illness, as well as feel more actively engaged in life. One-on-one survey interviews were conducted with African (n = 35), Hispanic/Latino (n = 28), Caucasian (n = 28), and Asian (n = 8) American adults (aged between 23 and 78) (total n = 101) with mental illness (e.g., bipolar disorder, n = 32; major depression, n = 23; schizophrenia, n = 22) in Philadelphia, Pennsylvania. Using general linear modeling, we found that LGMs significantly predicted the adjustment to and recovery from mental illness, leisure stress-coping, leisure satisfaction, and perceived active living positively, and lower leisure boredom. The findings have implications for psychiatric rehabilitation to better support persons with mental illness from a strengths-based, meaning-centered, and active-living promotion perspective in which leisure seems to play an important role.
Vocational rehabilitation (VR) agencies, as well as other service providers, are under increased pressure to provide evidence of the effectiveness of services. The primary metric for evaluating services in the VR program is short-term employment outcomes. Although employment outcomes are crucial, they may serve as a poor proxy for the ultimate intended goal of services, namely, improved quality of life (QOL). In this study, a comprehensive framework (the International Classification of Functioning [ICF]) is used to assess QOL in two samples of adults with disabilities receiving educational and vocational services. The relationship between difficulty with work and daily living activities with QOL was compared with a more complex assessment based on the ICF framework, including other life areas such as social relationships and inclusion and environmental factors. Results indicated that the additional information provided by the ICF model substantially increases the prediction of QOL relative to the more traditional VR measures. Within-groups analysis provided more information specific to each sample.
As a behavioral science and helping profession, rehabilitation must promote theory building and knowledge utilization through comprehensive and conscientious approaches. This article addresses notable failures to incorporate earlier and significant conceptual developments from rehabilitation into contemporary research. The identified gaps in scholarship acknowledgment concerned omissions of the groundbreaking work of several scholars who were shaped by Kurt Lewin’s mentorship and field theory. These authors advanced two fundamental principles: (a) the ecological perspective that behavior (including that associated with disability) can only be understood as the interaction of the person within an environmental context and (b) a strengths-based approach that rehabilitation assessments and interventions must tap into the assets of the person and the resources in the environment. The nexus and usefulness of these authors’ contributions have gone unrecognized in explanations of two relevant and popular psychosocial research agendas: (a) the new paradigm of disability and (b) the positive psychology movement. This article delineates these gaps in rehabilitation knowledge utilization, offers some interpretations for their occurrence, and recommends strategies to reduce the gaps. It also suggests how developments in theory or practice from rehabilitation research and philosophy could be better marketed to and utilized by our partners in other counseling/psychology specialties, disability studies, and the broader community interested in disability issues.
This study investigated the relationship between supervisory working alliance (SWA) and successful client outcomes in the state/federal vocational rehabilitation counseling system and supervision practices associated with SWA. Rehabilitation counselors (N = 166) from five randomly selected rehabilitation counseling programs participated in an electronic survey. Existence of a supervision contract, regularly scheduled contact with supervisor, and the counselors’ rating of importance of supervision were found to be positively associated with SWA among new counselors. Implications of findings for rehabilitation counselors will be discussed.
Despite legislation promoting youth transition from school to employment, and despite growing knowledge of factors contributing to successful transitions, youth with disabilities continue to work at lower rates compared with their nondisabled peers. Over the past decade, efforts specifically directed toward reducing this intractable employment gap between these two groups of youth have met with relatively little success. Marriott Foundation’s Bridges from School-to-Work Program, a national multisite intervention offering paid competitive employment to high school youth enrolled in special education programs prior to school exit, addresses obstacles to labor market participation confronted by youth with disabilities, with an intensive, time-limited vocational intervention at seven inner-city urban sites across the United States. We found universally high job placement rates of a large sample of youth with disabilities enrolled in high school over several recent years of operation (2006 to 2011) across their sociodemographic and disability characteristics, and across diverse urban areas throughout the United States. Thus, we argue that educational, disability, and rehabilitation professionals should hold high expectations for employment success of these youth, regardless of their disabilities and the local economic conditions of the communities in which they live.