Rehabilitation counselling is in need of a conceptual framework that will distinguish it from the medical notion of restoration and will provide a theoretical base from which rehabilitation counsellors can operate. The current paper presents a model of dishabilitation that highlights the processes that occur following acquired disability and that must be considered in designing a rehabilitation programme. The model suggests that the goal of rehabilitation should be the expansion of opportunities rather than the restoration of functions or previous position. By providing rehabilitation counsellors with a suitable “macro”level conceptualisation of rehabilitation, this approach will enable counsellors to implement “micro”level techniques in a manner that will empower individuals. Because intervention is aimed at opportunity expansion rather than the pursuit of specific goals, this approach allows individuals to retain control and to develop positive perceptions of themselves with their disability. The approach is also more sensitive to the impact of acquired disability on social networks and suggests that opportunities for families must also be expanded.

In today’s rapidly changing society, counsellors need to have knowledge and skills to work effectively with a diverse consumer population. A review of rehabilitation counsellor education programs in the United States applying for CORE (Council on Rehabilitation Education) re-accreditation between 1991–1994 revealed that two-thirds of the programs had content deficits in multicultural and gender issues. Australia and other countries besides the United States have experienced increases in the number of cultural minorities entering the workforce. The role of women in the modern workforce also has undergone significant change. These issues need to be considered by rehabilitation counsellors in all countries. The importance of infusing these content areas in graduate training is addressed. The authors offer suggestions for infusion of cultural and gender issues into rehabilitation counselling curricula.

Key stakeholders' perceptions of the role of the treating doctor, including treating doctors themselves, in the management of workplace injury and in occupational rehabilitation of injured workers was assessed via in-depth semi-structured interviews of doctors and via interviews and surveys of other stakeholders (injured workers, employers, rehabilitation co-ordinators, rehabilitation providers and insurers) in the post-injury period. A number of difficulties were identified by both doctors themselves and by other stakeholders in the treating doctors' management of compensable work injury clients. It was argued that these problems were a function of the conflict of interest that arises for various service providers within the current workers' compensation system and the polarised and adversarial nature of relationships between providers. The discussion of the underlying structural and policy problems inherent in the current workers' compensation system at various levels of practice which this study has highlighted provides a first step in attempts to resolve these difficulties in individual practitioner-client relationships.

Recent studies on the rehabilitation of children with hydrocephalus have demonstrated the need for those planning such rehabilitation programmes to have a clear understanding of the neuropsychological and psychosocial aspects of this disorder. In an attempt to provide such information, the neuropsychological and psychosocial functioning of a group of 17 children with hydrocephalus between the ages of eight and fourteen years old was investigated. Performance by the sample with hydrocephalus was compared to that of a ‘normal’ control sample. Participants with hydrocephalus and control participants were matched on the variables of sex, age, years of education, and socio-economic status. Relative to control participants, the participants with hydrocephalus were impaired on measures of intellectual, attention, verbal and visual memory, and visuo-spatial abilities. Language alone was relatively preserved. The children with hydrocephalus also exhibited poorer self-esteem, fewer adaptive competencies, and more problem behaviours than the ‘normal’ controls. For the children with hydrocephalus, the relationship between their impaired intellectual abilities and their psychosocial functioning was investigated.

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.

The main principles and practices of cognitive-behavioural therapies are briefly outlined and discussed in terms of their relevance to counselling individuals with physical disabilities. The cognitive-behavioural therapies of Beck, Ellis, and Nezu to counselling persons with physical disabilities are specifically presented. A case study involving the application of cognitive-behavioural therapies to counselling a person with severe facial and hand burn injuries is also presented. The view is advanced that although cognitive-behavioural therapies have considerable potential in counselling of persons with physical disabilities, lack of conceptual clarity of some central constructs in cognitive-behavioral therapy is a limitation to practice in rehabilitation settings. The paucity of controlled research studies in this area of study is noted, and suggestions are offered for further research.

This paper is an overview of the transition process for students with disability who are exiting from high school programs into adult life in the United States. Information about available adult services and the changing nature of the employment situation is highlighted. Further, practices that are currently considered to be the best by those actively involved in conducting research and articulating models for improving the future for persons with disability are briefly described. Finally issues and barriers that prevent persons with disability from establishing an adult presence through full participation within our communities are discussed and recommendations about service provision offered.

Tourette Syndrome (TS) is an under recognised, often misunderstood condition that is wrongly perceived as a simple habit(s). Due to the hetrogenous nature of the symptoms, severity and effects of TS, this condition is individualised in terms of its impact on people living with TS. This paper reports five case studies of people living with TS, ranging from mild to severe diagnosis and provides an insight into some of the difficulties and successes people living with TS experience in obtaining and maintaining employment. Treatment methods, aetiology issues and implications for rehabilitation counsellors are also 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 estimated 600 people seek hospital and/or medical assistance for recently acquired brain injury each week in New Zealand. Many of these people return to work only to find themselves unable to function at the same level as achieved prior to injury. The reasons for this are frequently not understood either by the individual with the injury, the individual's colleagues or by the various professionals approached for advice. Common deficits identified impact significantly on an individual's work performance indicating comprehensive vocational rehabilitation services are required. Rehabilitation counsellors have a key role to play in the vocational rehabilitation process of people with head injuries. This requires that rehabilitation counsellors possess a knowledge of brain injury sequelae, their effects on everyday functioning and of the recovery process from the injury.

Computer technology is constantly improving the means of people with a disability to access information. From the earliest electronic bulletin board systems, to listserv software on mainframe networks, to gophers, and now world wide web software, access to a vast amount of disability-related information is becoming much easier and affordable. A brief overview of these developments and several resources for disability-related information are presented in this review.