This study explored the consumer-reported communication patterns between rehabilitation professionals and ethnically diverse clients who are parents of children with developmental disabilities. Informants were Korean American mothers (n = 10) of children with developmental disabilities (n = 10) who were receiving services from a community rehabilitation agency. Interview data were collected and thematically analysed. The findings suggest that Korean American mothers were not likely to openly discuss possible options for their children with their rehabilitation counsellor. About 60% of participants stated that they worked with at least one counsellor whose communication they felt was ineffective. The findings of this study are congruent with the previous research findings that Koreans emphasize e harmonious relationships. Multicultural competences are important for counsellors with culturally and linguistically diverse clients.

This article discusses multicultural competency education options for early career rehabilitation counsellor supervisors. It specifically addresses the importance of the cultural awareness and competencies in supervised supervision. Multicultural counsellor competencies in clinical supervision are considered in the context of rehabilitation counsellor professional preparation programs in the United States. Diversity considerations are important to operationalising the construct of the working alliance in the context of clinical supervision training for early career rehabilitation counsellor supervisors. Acquiring, retaining and cultivating multicultural clinical supervision competencies in self and others is a lifelong process.

The advent of managed care as a system driving purchasing in the health sector has brought with it an emphasis on purchasing outcomes rather than inputs. Although any change in purchasing schemes will have an effect on service providers, it should not prove to be too disruptive for those of us in rehabilitation since rehabilitation as a service system has always been outcome driven. In fact, our entire system is driven by needs based assessment and directed toward the meeting individually identified goals for service. These goals reflect the desired outcome of the service we provide for each individual served. The challenge we face, then, is translating our emphasis on goal directed, outcome driven services to meet the language, understanding and expectations of our funding agents as they begin to adopt a regime of outcome based contracts. The purpose of this paper is to argue the validity of individually determined outcomes as opposed to institutionally determined measures and to propose one method of measuring those outcomes in a manner that is applicable to the needs of the purchaser.

The effects of transferring 28 long-stay chronically mentally ill patients from a psychiatric hospital to community placements was evaluated. The Rehabilitation Evaluation Hall and Baker (REHAB; Baker & Hall, 1983) scale was used to assess clients' adaptive and maladaptive behavioural functioning at 12, 18 and 24 month intervals following the hospital baseline. Social contacts and inpatient readmissions were also assessed. The results showed that clients' general adaptive functioning and maladaptive behaviour, on average, remained stable across the hospital baseline and two year follow-up period. Clients with frequent social contacts were found to have significantly better adjustment on a number of the REHAB subscales and those who exhibited more maladaptive behaviour were more likely to be readmitted to a psychiatric inpatient unit. Overall the results were encouraging with relatively low readmission rates, however, approximately 10% of clients showed significant difficulty adjusting in the community. The implications of the findings for chronically mentally ill people and suggestions for community programmes are discussed.

Rehabilitation Counsellors utilise comprehensive skills that have strong parallels with the Human Resources environment. As facilitators of development, improvement and goal achievement, Rehabilitation Counsellors are best equipped to deal with the ever changing face of people and organisations. There are key competencies in both fields that allow for the link between the two to be established, therefore creating an alternative career option for Rehabilitation Counsellors. The Human Resources field provides opportunities for Rehabilitation Counsellors to access large organisations with potential for higher remuneration and career development. Furthermore, the Human Resources field allows rehabilitation counsellors the platform to showcase their range of skills in order to achieve an organisations goals and objectives.

This study investigated the relationship between cognitive, psychological and physical symptoms of multiple sclerosis (MS) and independent living optimism among a sample of 5,082 adults with MS (females = 77.8%; Whites = 96.1%, age range 20 to 91 years). Data on physical, cognitive and psychological function were collected utilising standardised clinical measures including the Multiple Sclerosis Impact Scale-29, Perceived Deficits Questionnaire-5-Item version, and the Independent Living Optimism scale. Multiple regression analysis indicated that specific physical, psychological and cognitive factors contributed to the overall prediction model. The combined variables explained approximately 33% of the variance in independent living optimism. This study enables a specific, item-level understanding of the relationship between MS-related symptoms and independent living optimism, and provides important information for the development of targeted rehabilitation interventions.

This idiographic study explored the value of six vocational interest types (realistic, investigative, artistic, social, enterprising and conventional) for guiding a person's occupational choices. To that end, five rehabilitation clients who attended for vocational assessment following a personal injury (e.g., motor vehicle or general accident or work injury) reported on their vocational interests. Participants indicated their preferences (like or dislike) for 77 occupations. Altogether, they made from 5 to 27 choices. A profiling procedure indicated that clients reported more occupational dislikes rather than likes. Of the vocational interest types the choices in realistic, investigative, artistic and enterprising domains were endorsed more than those in social or conventional domains. It was not clear that the six vocational interest types determined occupational choice following an injury. Instead, occupational dislikes may provide more useful data for vocational counselling.

The purpose of this study was to test the usefulness of the attribution model (Corrigan, Markowitz, Watson, Rowan & Kubiak, 2003; Weiner, 1995) in a Chinese cultural context to explain Chinese college students’ perceptions of discrimination toward people with mental illness. A total of 293 college students (male = 142; female = 151; age from 18 to 22) completed an Attribution Questionnaire (AQ) after reading vignettes, consisting of a male who either used illicit drugs or had a traumatic brain injury. Data were analysed using a hierarchical regression to determine the amount of variance accounted for in discriminatory behaviours by the attribution model. The results showed, when controlling for all other factors, that controllability and the three emotions (pity, anger, and fear) were found to be significant predictors of discrimination. The relationship between controllability, responsibility, and discrimination was not consistent with the attribution model since responsibility did not mediate the controllability of cause. These results provide support for the idea that disability attributions are culturally influenced.

We provide a comparative case study of rehabilitation counselling across the U.S., Japan and Taiwan focusing on the common challenges facing international constituents in the field. Through interviews with students, faculty and administrators from each of the respective countries, we use thematic coding analysis to identify key points of tension. Emergent themes comprise (a) systemic challenges, (b) student and faculty mobility, (c) cultural and linguistic differences and (d) lack of sustainable international leadership. We further discuss mitigation of these recurrent challenges and conclude collaborative research, student exchange and institutional partnerships may advance teaching, research and service scholarship of rehabilitation counselling programs, and, in turn, enhance the lives of people with chronic illness and disability worldwide.

The purpose of this paper is to explore the context of injury and its consequences for the vocational rehabilitation of Australian workers. This report was derived from a secondary analysis of the seventh national survey of Work-Related Injuries by the Australian Bureau of Statistics. This is a stratified, random, multiple household survey of 42,100 private dwellings. Work-related injury affects 1 in every 25 of those who had worked at some time in the last 12 months. There were high probabilities of a workplace injury for those in labouring-type jobs and workers who exceeded 35–39 hours per week. Occupational injury is heterogeneous in nature and but there is clearly a restriction in the range of clientele encountered in rehabilitation. A second implication for professional rehabilitation arises from the type of injury. Work-related injuries in Australia are dominated overwhelmingly by musculoskeletal conditions. Work-related injury is a major cause of disability and there are consistently large numbers of people each year that will be requiring some vocational rehabilitation services.

The prevalence of substance abuse among people with disabilities is a major concern in the field of rehabilitation. Recent research has indicated that substance abuse increases incidents that lead to disability and undermines rehabilitation gain. However, most rehabilitation counsellors lack sophistication concerning the dual problems of substance abuse and disability because of their unfamiliarity with and inadequate training for substance abuse and disability issues. This paper provides an overview of (a) important issues related to substance abuse and disability, (b) procedures and techniques for identifying, assessing, counselling and referring clients with substance abuse problems for treatment, and (c) implications for rehabilitation counselling training and practices.

Volunteer programs have been used to alter attitudes, provide long-term knowledge towards mental illness and increase the quality of life of consumers receiving volunteer services. Sixteen volunteers completed an 18-hour training program and in pairs worked with 11 consumers over 4 months. Sixteen volunteers completed training measures of knowledge and attitudes scales. Pre and post program quality of life and behavioural functioning measures were taken on 5 consumers. Volunteers maintained their knowledge of mental illness over 6 months and had significant increases in their comfort in interactions with people who have mental illness. Case managers, consumers and volunteers all reported high levels of satisfaction with the program but there were no significant changes in behavioural functioning or quality of life for consumers over 4 months of receiving volunteer support. High levels of client disability and the need for longer term follow-up were identified as factors needing to be addressed in future studies.

Psychiatric nursing is a stressful profession associated with high levels of burnout. Previous research has demonstrated that burnout in psychiatric nurses can be reduced via training that improves behaviour modification skills. However, the minimum amount of training required to demonstrate a beneficial effect is unclear. We evaluated the impact of a 4-day behaviour modification training program on stress, burnout, and therapeutic attitudes in nurses who were in frequent daily inpatient contact with patients with severe mental illnesses. Nurses working in the same wards served as a control group. Training improved therapeutic attitudes but did not alter self ratings of job-stress and burnout. The need for multi-pronged approaches to the prevention and treatment of burnout in psychiatric nurses is discussed.

The use of the EUROHIS as a brief measure of quality of life (QOL) in applied settings is increasingly commonplace, including in rehabilitation assessment contexts. However, there are concerns about the validity of data produced by the measure, chief amongst which is the latent structure underlying scores. This article reports on research conducted to investigate the dimensionality of scores derived from the EUROHIS. In addition, the factorial invariance of the retained model across gender as well as latent mean differences in QOL over age, employment status, and psychiatric severity were examined. Based on 251 responses to the EUROHIS by compensable accident victims, support was found for a complex one-factor model, which was found to be partially replicable across gender. Some evidence for differential item functioning across gender, age, and employment status was found. Finally, a U-shaped effect of age on QOL, characterized by a mid-life nadir, as well as effects of psychiatric severity on QOL, and a marginally significant effect of employment status were evident. Collectively, though the results of the present study yield validation data for the EUROHIS, they also raise concerns about the measure. We offer some tentative guidelines for working with the measure for both researchers and practitioners.

The purpose of this study was to: (1) Establish whether or not specific rehabilitation for mild brain injury is effective for return to work; and (2) compare the efficacy of an impairment-focused model of treatment versus an early education approach in respect to ability to return to work. Two different approaches to intervention and treatment for those with a suspected concussion from a work-related injury were utilised by an urban, interdisciplinary, outpatient rehabilitation facility. The first approach, Group Treatment (GT), provided minimal early education at time of initial intake, emphasising an extensive group-focused interdisciplinary assessment and treatment. The second approach, Individualized Education and Treatment, (IET) emphasised early education, instead coupled with specific individualised services. Both groups received employment services. Post-discharge, GT (N = 26) resulted in 46% (n = 12) of individuals returning to competitive employment, while IET (N = 23) resulted in 78% (n = 18) of individuals returning to competitive employment. An asset-oriented early individualised educational approach appears to be a more effective for employment re-engagement.

This study aimed to understand the coping strategies used by men with Adult Onset Epileptic Seizures (AOES) following elective neurosurgery, and in particular, how those adaptive skills relate to their subjective wellbeing (SWB). Open-ended qualitative interviews were conducted with five men with a history of neurosurgery for AOES (aged 34–59). The interview data was thematically analysed utilising interpretive phenomenological analysis. The findings indicated that the men experienced significant role marginalisation by family and co-workers, and also poor communication provided by health care professionals. They reported a higher sense of SWB with the use of ego-buffering strategies, such as positive reframing, threat minimisation, emotional self-acceptance and engaging in wish-fulfilling fantasies. Self-blame led to lower SWB. Findings imply that agentic behaviour is important to successful living with AOES following neurosurgery.

The main objective of this study was to investigate the relationships between motivation and readiness levels for physical activity and exercise behaviour among persons with chronic musculoskeletal pain. Participants were 211 U.S. adults with chronic musculoskeletal pain from online support groups as well as specialty and primary care clinics (females = 86.7%; mean age = 43.4 years, SD = 14.4 years). The participants completed an online survey on their engagement in physical activity and exercise behaviour. Multiple one-way analyses of variance with post-hoc comparisons using the Tukey HSD test revealed significant differences between the readiness stages of change groups of preintenders, intenders, and actors in their motivation for physical activity and exercise behaviour. Specifically, the actor group of behavioural change reported higher levels of motivation beliefs for physical activity and exercise behaviour compared to preintenders and intenders. These findings suggest that people with chronic musculoskeletal pain experiencing increased motivation for physical activity and exercise behaviour are more engaged in desired behaviours than the persons with chronic pain reporting varying degrees of behavioural intentions.

The global community is experiencing widespread and rapid changes to labour-force participation with increasing expectations of flexible and highly adaptable skill sets. Workers can expect demands to acquire new, and augment existing, competencies as an integral part of the labour contract. Continuing education, professional development, augmentation of competencies and lifelong learning are the occupational mantras of the millennium. If these are the expectations of those already in the workforce, what then do support professionals expect for their clients, such as rehabilitation counsellors who have considerable skills in facilitating the re-entry of clients to the work-force? This paper examines several questions of continuing skilling and provides a set of recommendations with relevance to contemporary professional practice.