Research on managing challenging behaviour in children and young people with disabilities is becoming increasingly complex as a guide to best practice. There continues to be an outpouring of single-case studies conducted in the traditional research methods and conceptual models of applied behaviour analysis. In contrast, there is growing recognition of the importance of context, social systems, and cultural values, not only in understanding the causes of challenging behaviour, but in the design of interventions and the evaluation of rehabilitative treatments. A ‘third wave’ of educative intervention approaches attempts to integrate these two perspectives within concepts of positive behaviour support. We offer practitioners some guidance to the extant empirical literature by bringing together the most promising themes within this rapprochement.

This study of young adults with disabilities in transition explored what factors contributed to young adults with disabilities terminating early from a transition program. Data from 6,227 young adults with disabilities aged 17–22 living in one of eight major metropolitan areas in the United States were utilised (58.7% of the sample were male, 63.1% were African-American, and 71.4% had a learning disability). All participants were enrolled in a school-to-work transition programme in which service providers place students into paid internships. Service providers at the eight sites collected data while working with participants, and then collected follow-up data at three and twelve months post-programme completion or termination. Hierarchical Linear Modelling was used to explore how personal factors impacted early termination, while controlling for variation at the site level. Results showed the three main reasons for early termination from work to be: programme initiated termination, interpersonal conflicts with coworkers or supervisors and transportation issues. Additionally, the multilevel model that controlled for variance at the site level demonstrated that Asian-American young adults with disabilities were less likely to terminate early from work. These results can help individuals who work with young adults with disabilities, provide supplemental services to students who may need additional assistance to succeed in a transition programme.

The relationship between social support, mental health, and posttraumatic stress disorder (PTSD) symptomatology was investigated in a sample of 229 former New Zealand military personnel. It was hypothesised that veterans reporting greater satisfaction with their social support networks would also report better mental health and lower levels of PTSD symptomatology, and that social support would buffer the relationship between trauma and PTSD. The number of social supports was expected to be unrelated to both PTSD and mental health. Among the subsample of combat veterans (N = 166), results from multiple regression analyses revealed that satisfaction with social support was significantly related to PTSD severity but unrelated to general mental health. The moderating model of social support on the relationship between trauma and PTSD was not supported in hierarchical regression analysis in the total sample (N = 229). Methodological limitations and other explanations for these results are discussed.

The use of computer simulations in professional rehabilitation counselling training has received considerable attention in recent years. Most notably, computer-based rehabilitation case management simulations have been developed for teaching and evaluating clinical problem solving skills of rehabilitation counselling trainees. However, a major problem confronting the use of computer simulations in professional rehabilitation training is the lack of quantification procedures for measuring performance on computer simulations. A current approach involves the computation of proficiency and efficiency indices as performance feedback measures. The purpose of this paper, however, is to demonstrate the potential problems with using these two indices as feedback mechanisms in computer simulations and to present an alternative quantification procedure for measuring and providing feedback about trainee performance on computer-based case management simulations.

The Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) are evidence of the progress, in relation to civil rights, made in the disability public policy arena. Similarly, much progress has been made in regard to societal values and attitudes toward persons with disabilities. Although much progress has been made for persons with disabilities, there is much work to be done. An abundance of concerns have recently surfaced regarding whether the Rehabilitation Act of 1973 and the ADA effectively address the rights of persons with disabilities. In light of recent concerns, some social scientist have advocated the minority group model as a catalyst for creating public policy that will effectively address the rights of persons with disabilities. The belief is that this perception of persons with disabilities would further progress society's value of promoting the well being of others, respecting the rights of others and promoting the fair distribution of society's resources. Thus, the purpose of this paper is to support the hypothesis that society's perception of persons with disabilities as a bona fide minority group will change societal values resulting in a more progressive public policy.

This paper presents the results of Phase 3 of The RETURN Project, a European Study which aimed to reduce long term absenteeism in the workplace. Phases 1 and 2 have been described in detail elsewhere. The study adopted an iterative approach that explored LTA from three different perspectives: the System, the Expert and the Employer. This paper describes how the outputs of both the System and the Expert phases in combination with other tools focused on Disability Management (DM) were used to generate an interactive multi-jurisdictional assessment protocol tool for evaluating company based responses in managing employees on long term absence. The RETURN Protocol was field tested in different regulatory contexts using a company case study approach. Results of the field test carried out in six European companies are presented and the future and appropriate use of the protocol tool is discussed.

A series of studies has tested the hypothesis that individuals with chronic pain (especially low back pain) who are receiving compensation respond less satisfactorily to treatment and rehabilitation than those not receiving it, and that symptoms and disability are reinforced and maintained by financial reward. Some examples of evidence for such ‘compensation neurosis’ are reviewed. The impact of socio-economic status, employment and litigation need also to be taken into account. The best response to individuals with chronic pain who are receiving compensation may not be the obvious punitive one of lowering or ceasing benefits. Rather, a compensation system minimising litigation and emphasising co-ordinated rehabilitation is advocated. The author challenges a common clinical — and political — bias against the so-called ‘compensation patient’.

An online survey of adult women living in Australia with an acquired or congenital disability was conducted to explore the needs and challenges experienced by this population. Data for 116 respondents with a primary mobility (n = 92), sensory-related (n = 12), psychiatric (n = 6), or neurocognitive impairment (n = 6) were collected. Word clouds and content analysis were utilised to examine the data. Barriers to achieving vocational, health and relationship goals were identified, including systemic (e.g. financial resources, accessibility issues, societal attitudes), physical (e.g. medical sequalae), and psychological (e.g. self-concept, assertiveness) issues. Strategies to overcome these barriers included increased availability of peer support networks and opportunities for personal development. It follows that disability services require a multi-faceted approach, with a focus on biopsychosocial factors that include, but are not limited to, mobility, self-care and communication needs.

This study examined the efficacy of an evidence-based supportive leadership program to address psychosocial hazards identified in an organisational health review of a government department. Participants were employees identified as having supervisory and management roles (N = 57; males = 30, females = 27; age range 22 to 63). The program was implemented systematically over a 6-month period using 2 × 2 day intensive workshops, interim 360 peer review assessment and 1-day follow-up. The program used a variety of behavioural learning approaches with individual and group feedback from professional, peer and self-review. The results showed a major improvement in organisational health with significant changes in risk status across the domains of Relationship, Manager and Peer Support. Improvements in organisational health made within the leadership group had generalised across the entire workforce and continued to be maintained at the 18-month follow-up.

Vocational rehabilitation provides guidance and support to individuals with disabilities entering the workforce. Employment plans include considerations of goals, the job market, and pre-existing or trainable skills on the part of job seekers. This process also includes an understanding of the social forces that affect employment goals. Current models of disability include the medical, social, and embodiment models. Each is cognitively based and assumes an element of responsibility or blame, that is, respectively, focused on the individual with a disability, the community, or a combination of these two factors. The difference model of disability offers an alternative understanding of disability by providing an affect-based framework that eliminates the premise of blame. This conceptualization of disability provides a new approach to vocational rehabilitation.

The proportion of older adults seeking rehabilitation services are certain to rise as the population ages. Cognitive rehabilitation techniques can be successfully adapted and used with older adults with a range of clinical diagnoses. An understanding of cognitive changes which could be expected as a result of “normal” (non-disease-related) aging is essential for both assessment and treatment planning for this group. Age-related changes in attention, memory and executive functioning are briefly noted. Common cognitive sequelae of head-injury, depression and dementia are discussed, and useful assessment and rehabilitation strategies described. Case illustrations are used to illustrate major points.

Workers' compensation and disability management in the hazardous occupations of mining and construction are ongoing concerns for employers, employees, insurers and governments. Rising insurance costs, options of self-insurance models, highly competitive tendering, legislative rigidities, and escalating costs of compensation, have contributed to industry practices for injured workers that are driven by cost containment strategies rather than benchmarked disability management processes. In this article a critical review of legislation, industry practices, and published reports is undertaken with a view to oudining the adequacy of current and planned services and practices to meet the needs of injured workers in both sectors. Attention is also given to industrial practices that contra-indicate quality disability management processes. The authors detail a number of industrial and organisational operating environments, which have arisen from legislative frameworks, financial constraints, and outdated disability management practices. They comment on the more recendy introduced legislation and offer comment on its potential to drive benchmark changes in the building and coalmining sectors. Finally, suggestions are provided for more contemporary approaches to the insurance framework and return to work facilitation for injured workers.

This article reports on women’s experiences of career change following a breast cancer diagnosis and explores whether their illness represents the driving force to pursue previously unfulfilled career ambitions. The participants were four women who had been diagnosed with breast cancer and had changed career direction after their treatment. Data were conducted through in-depth interviews and were analyzed using Interpretative Phenomenological Analysis (IPA). Four themes prominent throughout each women’s narrative were identified: (i) a pre-diagnosis, unhappiness at work, (ii) a sense of stepping off the treadmill, (iii) a sharp focus upon their “self,” and subsequently (iv) a flourishing “work-life.” Further research is needed to investigate how common these findings are among women with breast cancer.

This study investigated the relationship between functional disability and perceived barriers to physical activity and exercise in persons with Spinal Cord Injury (SCI). Participants were 144 individuals with SCI (mean age was 44 years old; 61% were male participants; 41.3% had spinal cord lesion at the cervical level, 43.7% at the thoracic level, and 14.3% at the lumbar level) from the National Spinal Cord Injury Association in the United States. Data on physical activity and exercise participation were collected using a cross-sectional online survey and analysed using multivariate analysis of variance and hierarchical regression analysis. The primary research findings indicate that level of functional disability was a predictor of perceived barriers to physical activity and exercise. Moreover, health barriers were found to be a partial mediator for functional disability and physical health-related quality of life, suggesting perceived barriers may help to explain the association between functional disability and physical health-related quality of life.

The purposes of this review article are to gather existing evidence on the contributing factors in affecting the psychosocial adjustment among people with chronic pain, and to promote a comprehensive conceptual framework in this topic by adapting Wallander and colleagues' (1989) Risk and Resistance Model of Adjustment. Our intention is to promote future empirical research that will validate this working conceptual framework and will provide and clinical guidelines for rehabilitation professionals who work with people with chronic pain.

A major concern of rehabilitation counselors is the likelihood of work following illness and the purpose of this paper is to determine the work rate of persons with neuromuscular conditions. A review of 38 published reports indicated the capacity for employment, but this varied according to the specific neuromuscular condition. A quantitative summary of previous studies that comprised a total of 2926 participants indicated that 1266 or 43.2% were working. Higher work rates were reported for studies where (a) the focus was on specific disorders rather than neuromuscular conditions in general or (b) where the participation rate was greater than 80%.

Psychological obstacles often impede the unemployed from finding work. The current study was aimed at investigating the effectiveness of a combined cognitive–behavioural therapy (CBT) and lifestyle program when applied to an unemployed population from a Disability Employment Network (DEN) provider. CBT focuses on the relationship between an individual's thoughts, feelings and behaviours. The lifestyle program was developed to assess and provide psycho-education on sleep, diet, exercise and social habits. Eight participants completed a questionnaire and interview prior to and following participation in the lifestyle program. Measures included the Beck Depression Inventory (BDI), Rosenberg Self-Esteem scale (RSES), Life Orientation Test (LOT), Self-Efficacy Rating scale, one-on-one interview and participation in the lifestyle program. Key workers participated in a one-on-one interview and rated their perception of their participants' engagement in the job search process. Results were analysed using quantitative and qualitative methodologies. Levels of depressive symptomatology and optimism were not seen to improve, however, levels of self-esteem and ratings of engagement in the job search process did. Inclusion of the lifestyle component appeared to yield promising results for future studies. Further research into application of qualitative analysis in unemployment research is recommended.

The WHO’s (2001) International Classification of Functioning, Disability, and Health (ICF) model conceptualizes health from an ecological perspective. It has been implemented by many professionals as the standard health classification framework that guides providers’ decisions regarding assessment tools and targeted interventions. Despite this model’s prevalence among many healthcare providers, the ICF framework remains largely underutilized by many in the counseling fields. This conceptual paper provides an overview of the strengths of the ICF model and ICF-based measurements, and demonstrates its clinical, research, and educational value. A case study is presented to guide counselors and counselor educators through application of the ICF model in various contexts to encourage expanded use of the model. Use of the ICF model among counseling professionals, educators, and researchers is recommended as one way to enhance measurement of clinical outcomes.