Rehabilitation Counselor Supervisors’ Perceptions of Counselor Professional Dispositions for Rural Service Delivery

Professional dispositions are recognized as a fundamental to counselor professional practice, but this construct remains largely undefined. This qualitative study explored the professional dispositions that rehabilitation counselors should demonstrate for effective service delivery, particularly within rural areas. The researchers conducted semi-structured interviews to gather perspectives on the conceptualization and identification of professional dispositions in the field. Participants for this study were practicing rehabilitation counseling supervisors ( n = 14) from five states and largely represented state/federal vocational rehabilitation agencies ( n= 12). A preliminary, field-driven definition of the term professional disposition is presented, and primary dispositional categories are identified. Findings indicated three major dispositional themes that are necessary and generalizable to rehabilitation service delivery: traditional rehabilitation counseling values, professional attitude and conduct, and ethically principled behavior. A theme discrete to rural rehabilitation is also identified, community oriented. These domains reflect a focus on the client, the agency, and the community. The concept of ethically principled practice was a bridging theme that connects and is interwoven across the three main themes. Implications for practice and future research suggestions are also discussed.

Needle and Syringe Programs in Rural Areas: Addressing the Intravenous Drug Use Epidemic

BackgroundOpioid use has reached epidemic proportions in rural communities in the United States and injection of drugs is commonly used. As a result of shared or reusing needles and syringes, the risk for contracting blood-borne diseases is significantly increased. Rural areas face many social and attitudinal barriers regarding syringe exchange programs (SEPs).ObjectiveThis article describes national trends for drug injection problems in rural areas and discusses effectiveness of needle and SEPs as a harm reduction healthcare policy. Ethical and practical considerations in the implementation of SEPs are also presented.MethodThe rehabilitation literature was reviewed on trends in substance abuse and intravenous (IV) drug use in rural areas to identify the status and need for SEPs to address risk factors of infectious diseases resulting from needle sharing and reusing of needles.FindingsIV drug use in rural communities has reached epidemic proportions with resulting dramatic increases in hepatitis C and B and incidence of HIV. Yet, many rural communities continue to object to the implementation of SEPs due to fears that such programs will increase drug use and crime in the community.ConclusionIV drug use is a critical public health issue for users and non-IV users in rural communities, and is increasingly becoming an issue about which rural rehabilitation counselors will need to be informed. For the sake of public health, SEPs should be recognized as an economical, ethical, and effective factor in the larger response to the epidemic of IV drug use in rural America.

Rehabilitation as the Wage of Starvation: The 1941 Local 313 Sharecropper Strike's Critical Theory of Normativity

This paper examines the 1941 pamphlet “Down with Starvation-Wages!,” written by Local 313 striking sharecroppers in Southeast Missouri, as it both anticipates and places into deep historical tension theories of normativity that would come to be associated with continental European critique after World War Two. The pamphlet's contents are both a local response to and critical theory of New Deal struggles over the meaning and bureaucratic administration of rehabilitation. I first examine the schematic history of federal Rehabilitation programs as they emerged in the biomedical context of the First World War and were then transformed in the agricultural-economic context of the New Deal era. Across these contexts, I demonstrate that their main discursive and procedural function was the cultivation of their white beneficiaries as economic and political self-sovereigns. I then argue that the brief attempt to extend this Agricultural Adjustment Administration-administered form of Rural Rehabilitation programming, ostensibly an index of citizenship, to 1939 striking sharecroppers constituted one attempt to dull the normative force of an organized population, which had long been treated as surplus. I outline the relocation of remaining protesters to the farming cooperative of Cropperville by the St. Louis Committee for the Rehabilitation of Sharecroppers as an intermediary mode of social management that aimed to prevent organized sharecropper protest without extending the promise of full citizenship. The Local's 1941 subsequent “starvation-wage” is thus a relational theory of racist exploitation that allowed the state of starvation to emerge among black persons. In its maintenance of various orders of black persons’ virtual value as perpetually unrealized, its economy is made to run through cycles of starvation, bondage, and debt; as well as nutrition, rehabilitation, and repair. The Local's subsequent endorsement of the 1941 strike and of coalitional organizing with white sharecroppers thus instrumentalizes the very uneven racist distribution of history and life chances by the starvation-wage as a political resource in elaborating potentially novel arrangements of life.