This study explores accessibility to public transport facilities and participation in work life experienced by persons with physical and cognitive impairments. Participants were 21 persons with mobility (n = 6), neuropsychiatric (n = 6), hearing (n = 7), or visual impairments (n = 2) (males = 11, females = 10; age range = 16 to 79). Data were collected using focus group discussions and thematically analysed. The findings point to significant physical, social/attitudinal and communication limitations to the access of public transportation and participation in work life. While participants with physical impairments emphasised lack of accessibility in terms of transport accommodations, persons with neuropsychiatric impairments focused on the social and interactional aspects of public transport. Work life participation was mostly impacted by lack of flexibility in work tasks and work organisation, and fear of being misunderstood and perceived as incapable.

This review aims to highlight how the chronic condition self-management support (CCSMS) field might inform and enhance the skills of the disability employment services (DES) workforce, particularly in its interactions with clients with complex disability needs. The approach we have taken involves a consideration of current education and training, recruitment of staff into DES and issues of concern arising from these processes. The main findings of our review are that the current DES workforce may not have the required skills to fully meet the needs of the populations they serve given the growing burden of chronic conditions, generally. We conclude by calling for greater consideration of CCSMS education and training as core required skills for the DES workforce, so that they might integrate their practice more collaboratively alongside other support providers.

Psychometric properties on a newly developed Supervisor Principle Ethics Scale (SPES) are reported. The SPES was created to measure supervisees' perceptions of supervisors' use of ethical principles (Autonomy, Beneficence/Nonmaleficence, Justice, Veracity, Fidelity). Participants were vocational rehabilitation counsellors with a state agency in the United States (US) (Males = 38, Females = 49). They completed the SPES and the Supervisory Working Alliance-Trainee Form (Efstation, Patton, & Kardash, 1990). The five factors of the SPES were significantly correlated with the Supervisory Working Alliance-Trainee Form (SWAI-T), suggesting evidence of construct validity. Potential uses for the SPES in research and training activities are discussed.

This is a systematic review of systematic reviews of secondary health conditions, health promotion interventions, and employment in people with intellectual disabilities. Articles were included if they reported a systematic review of health and employment, secondary health conditions, and health promotion interventions for people with intellectual disabilities. The methodological quality of the included reviews was reviewed using the A MeaSurement Tool to Assess systematic Reviews quality rating system, a measurement tool to assess systematic reviews. Twenty-five systematic reviews were included. There was evidence that people with intellectual disabilities (ID) were at elevated risk for secondary health conditions, health promotion interventions can improve physical and mental health conditions, and employment is associated with better health-related quality of life. Health promotion intervention to help people with ID engage in health promoting behaviors can improve health and their ability to find and maintain employment.

This study investigated the efficacy of a character strengths and gratitude intervention to reduce pain in people with chronic back pain. Eight participants (males = 4, females = 4) took part in a cross-over multi-baseline study over 5‒7 weeks. Comparisons were made for intervention efficacy effects by contrasting a character strengths approach with a comparison condition premised on positive memories. Daily measures were used to assess mood (happiness, sadness, anger) and pain. In addition, measures of happiness, depression, anxiety, pain catastrophising and pain were collected at each phase. The results indicated improved daily happiness and significantly reduced daily anger following the character strengths and gratitude intervention. This provides preliminary evidence that daily focusing on positive aspects of one's emotional experience benefits those with chronic back pain.

Parenting following acquired brain injury (ABI) has received little empirical or clinical investigation. The current study aimed to explore the challenges facing fathers following ABI and identify their needs for support. Interviews were conducted with three men with ABI, two partners and three rehabilitation coordinators. Five themes emerged from the data and a preliminary model of parenting for fathers following injury was developed. The interactive effects of the ABI and associated impairment on family relationships/functioning, perceptions/identity of parenting role, parenting knowledge/skills and confidence/self efficacy are described. Interventions should be flexible, individualised and tailored to address the unique parenting needs of the father within each family.

Competency research in the rehabilitation profession and that of rehabilitation counselling in particular, has an extensive pedigree. This article reviews the significant research in the field and details several of the instruments used in competency research to date. Issues concerning the current use of competency research and the future role of such research are discussed.

This study examined the post-injury rehabilitation needs of 158 adult siblings of persons with traumatic brain injury (TBI) in the United States. The mean age of participants was 37.0 years (SD = 10.0 years), and their ages ranged from 19 to 72 years. A total of 120 (75.9%) of the participants were female. Participants completed the Family Needs Questionnaire (FNQ) (Kreutzer, 1988), which measures the unique needs of families following TBI. The FNQ counts the types of needs rated as important and the frequency in which those needs have been met. Data were analysed via hierarchical multiple regression analysis with the number of met needs set as the outcome variable. A total of 15 predictor variables assessed direct and indirect markers of caregiving related stresses corresponding to position in the Pearlin stress process model. Participants indicated that health information was the most important need while needs for involvement with care were the most often met. Results also indicated that participant feelings of more restrictions in valued family activities and perceptions of greater cognitive-behavioural impairments with their injured siblings were associated with lower number of met rehabilitation needs. Participants reported that the use of effective coping behaviours and access to social support were associated with higher numbers of met rehabilitation needs. Findings suggest adult siblings share similar needs to parents and spouses (i.e., the most common primary caregivers) and require professional attention and support following TBI.

This article uses a descriptive case study design to examine the potential of narrative therapy as a direct intervention for adults with moderate-to-severe intellectual disabilities, autism and/or severe communication limitations. Archival clinical data on four individuals who received a form of social constructionist narrative therapy are examined for goal attainment. The data were analysed qualitatively with specific input from individuals, their families and carers. Findings indicate improvements in quality of life through reductions in situational and environmental anxieties, and in coping with grief and loss. The results suggest that narrative therapy techniques can be beneficial in assisting individuals with severe intellectual disability to achieve meaningful and persistent improvements in their life.

When a family member acquires a brain injury the family as a whole is likely to experience severe emotional stress and strain in coping with and adjusting to the injured family member. Longitudinal studies of family adjustment have shown that families find it increasingly difficult to cope with the brain injured family member as the time (years) since injury increases. The increasing difficulty family members experience in coping with their brain injured relative led several researchers to investigate the needs of family members. Research investigating family needs after brain injury is limited to the first couple of years post trauma despite the finding that stress and burden continue to increase as the years progress. This paper reviews family needs research over the last three decades and provides a discussion of family needs and surrounding issues relevant to rehabilitation professionals.

Scant research has examined health-related quality of life (HRQoL) in family members of patients with severe brain injury, even less has been done in Scandinavian countries, and none has examined this construct longitudinally. The current study therefore used multilevel modelling to investigate the trajectories of HRQoL in 94 Danish family members of patients with severe brain injury at five time points, beginning at the patient's stay in a neuro intensive care unit through one year after injury. The family members’ HRQoL scores significantly and strongly increased over time, and Role Limitations – Emotional scores were higher when patients had high Rancho Los Amigos Scale scores at admission to early intensive rehabilitation in hospital. These results suggest that the acute and sub-acute periods after brain injury are an extremely difficult time psychologically for many families, and family-based mental health interventions during the acute and sub-acute phases are critical, especially for families who have a patient with severe deficits.

Therapeutic intervention usually begins with a detailed description of the presenting problem and its antecedent history. Through the process of communicating their problem the client presents a story, potentially laden with their experiences, attitudes, beliefs and understandings. The topic and manner in which a story is relayed provides direct and indirect sources of information that help the therapist to both understand the client's problem and formulate goals and approaches to therapy. Rather than simply using the client's story as a guide to understanding and treatment, narrative therapy focuses on the client's story or ‘narrative’ as a medium through which change can be effected. During the process of narrative therapy the client is encouraged to deconstruct and critically appraise their story in the search for new meanings (White & Epston, 1990). The client is encouraged to retell their story with new language and new insights. Thus, the implementation of narrative therapy may be construed as a natural extension of taking the client's problem history, where the story told serves as the content foundation for the therapeutic process. The purpose of the present article is to provide a brief overview of narrative therapy techniques and their application in counselling.

Rehabilitation providers were the product of the 1987 Workers' Compensation Act in NSW, Australia. They operate in a complex environment and serve many masters. This paper assesses how rehabilitation providers are faring in the management of workplace injury. Using in depth semi-structured interviews, the self-perceptions of rehabilitation providers are presented. Results indicate that the current practice of rehabilitation providers labours under a heavy load of competing responsibilities, difficult clientele, adversarial stakeholders, economic restraints, and an unwieldy and clumsy workers' compensation system. Specific problems highlighted by rehabilitation providers included the identification of their core business and client group; misconceptions, lack of information and failure of communication among stakeholders; and lack of co-operation and overt and covert obstruction to the rehabilitation process. Rehabilitation providers perceived that they could function most effectively if they developed a genuine, trusting relationship with the injured worker, and educated and supported the treating doctor and employer in the rehabilitation and return to work process. Rehabilitation providers linked employer support of the injured worker to their willingness to provide suitable duties. Early referral was also considered an essential element in successful return to work. It was argued that rehabilitation providers should conceptualise themselves as advocates for the rehabilitation process rather than for any stakeholder group. This conceptualisation allows the provider to move comfortably between groups of stakeholders, addressing their diverse needs while maintaining their focus on their core business.

This study investigated the relationships among stress, intrapersonal resiliency factors (self-esteem, locus of control, and optimism) and quality of life [QOL] (physical health and mental health) among caregivers of children with high functioning autism spectrum disorders (HFASDs). Participants consisted of 113 caregivers of children with HFASDs (males = 38.1%, females = 61.9%; age range = 27–62; 93.6% Caucasians) and 47 caregivers of typically developing children (males = 29.8%; females = 70.2%; age range = 30–56; 93.3% Caucasians). They completed a set of self-rating surveys on perceived locus of control, self-esteem, optimism, and QOL. Within-group inferential statistical analyses were applied. For the HFASD group analyses, two simultaneous regression analyses were used to study the independent effects of the three intrapersonal variables on the physical health and mental health QOL of the caregivers. Intrapersonal factors predicted self-reported mental health QOL but not physical health QOL in caregivers of children with HFASDs.

Background: Self-determination theory (SDT) has increasingly been used as a theoretical framework for evaluating key elements of the recovery paradigm in rehabilitation and mental health services research and policy-making for people living with severe mental illnesses. Purpose: The purpose of this study was to validate the Behavioral Regulation in Work Questionnaire (BRWQ), an adaptation of the Behavioral Regulation in Exercise Questionnaire-2, as a measure of self-determined work motivation for use in psychiatric rehabilitation settings. Methods: One hundred and twenty-four individuals with severe mental illness were recruited from eight Clubhouse programmes in Hawaii. Factorial validity of the BRWQ was evaluated using exploratory factor analysis. Findings: Principal components analysis of the BRWQ yielded four factors (amotivation, external regulation, introjection and autonomous motivation). The autonomous motivation factor was found to be significantly related to other SDT constructs, including competency, relatedness, outcome expectancy and vocational rehabilitation engagement. Conclusions: The BRWQ is a psychometrically sound SDT measure for assessing self-determined work motivation and could contribute to the use of self-determination as a paradigm for improving recovery and employment outcomes of people with severe mental illness in rehabilitation settings.

The high injury rate with in the Australian construction industry necessitates proactive action on the behalf of rehabilitation professionals. Safety culture is a concept that is gaining traction within this sector as a useful concept to further reduce fatalities, injuries and incidents. Ten focus groups were completed with Australia's largest constructors to investigate this concept of safety culture and to further evaluate the skills, knowledge and abilities required by people who hold influential and key roles. Data interpretation revealed three important personal characteristics that underlie a positive safety culture: safety knowledge, user/interpersonal skills and appropriate attitudes and beliefs. These findings are applied to the rehabilitation process and it is concluded that rehabilitation professionals need to contribute to the development of a positive safety culture by enhancing the workforce's understanding of injury management.

Archival data from a cross-sectional survey of two cohorts of community-residing New Zealand adults (n = 157; n = 141) was analysed to examine social attitudes towards people with mental illness in a historical period associated with the establishment of a community mental health facility. Participants completed the Opinions about Mental Illness (OMI; Cohen & Struening, 1959), and the Comfort in Interaction Scale (CI, Beckwith & Mathews, 1994); the latter a measure of level of prior contact with people with mental illness. Across cohorts, the OMI Mental Hygiene subscale and the CI scale had significant variability. Older participants endorsed more Authoritarian, Social Restrictiveness and Interpersonal Ideology attitudes in their perception of people with mental illness than younger participants. Data supported the hypothesis that attitudes towards people with mental illness were influenced by social attitudes, and by opportunities to interact with people with mental illness in work settings.

The current study investigated the ability of CogniScreen to differentiate older adults with mild cognitive impairment (MCI) from those reporting symptoms of depression. Participants included 140 community-based adults (30 MCI, 15 self-rated depressed, and 95 typical older adults) aged 50–89 years. Intergroup comparisons performed using receiver operating characteristic (ROC) analyses suggest tasks within CogniScreen are sensitive to clinically significant memory loss. Data provided partial support for some CogniScreen tasks to also differentiate individuals with MCI from those who are depressed. Results suggest CogniScreen may be potentially useful in screening older adults for early cognitive decline.

There is concern that young people with visual impairment do not leave school adequately prepared for the workplace. Seventy young people from the UK with visual impairment (aged 16–19) took part in semi-structured interviews exploring how they define independence and how they predict they would deal with employment-based problems. Two overarching themes emerged: (1) how active/passive the young people felt they should be in solving problems (active–passive dimension), and (2) to whom (themselves or others) the young person attributed the responsibility for problems and solutions (internaliser–externaliser dimension). The results provide evidence of the importance of teaching young people disability-specific skills at school (an ‘expanded core curriculum’) which aims to maximise young people's independence while giving them a clear understanding of the accommodations to which they are entitled.

The purpose of this study was to validate the Sense of Well-Being Inventory (SWBI), a quality of life measure, for people with spinal cord injury. Four hundred and five participants were recruited from the Canadian Paraplegia Association for this study. The participants were asked to complete a research packet containing a demographic questionnaire, the SWBI, the Rosenberg Self-Esteem Scale, and the Acceptance of Disability Scale. Exploratory and confirmatory factor analyses of the SWBI and correlational analyses of the SWBI factors with other psychosocial variables were conducted. Exploratory and confirmatory factor analyses validated a four-factor structure (financial, family and social, psychological, and physical wellbeing) for the SWBI. SWBI factors are positively related to self-esteem and disability acceptance. With continuing research to document reliability and validity, the SWBI appears to have great potential as a vocational rehabilitation outcome measurement for people with spinal cord injury.