Closing the rehabilitation utilization gap of New Zealand’s (Aotearoa) Māori people: Multiple case studies

We aimed to explore personal factors in use of rehabilitation counseling and mental health services by Māori adults. Participants were three Māori adults (females = 2, residing in major urban settings, age range 45–50 years old; male = 1, residing in a rural setting, age range = 25–30 years old). Thematic analysis yielded the following findings: (a) a preference of Māori service providers who understand whānau culture, (b) an understanding of whakapapa or the family structure as an integral source of social support as counselors are planning for treatment, (c) establishing and maintaining trusting relationships within the Māori community by non-Māori counselors, (d) having financial difficulties when attempting to access rehabilitation resources, (e) limited access to health care facilities and services or lack of information about the services available, and (f) a general mistrust of government operated systems. Rehabilitation and mental health services with Māori should address personal cultural and systemic exclusion factors for better service engagement.

Preliminary evidence on combined cognitive behavioral therapy and motivational interviewing intervention efficacy to improve employment motivation for persons with intellectual disability

This study investigated the efficacy of a combined modified cognitive behavioral therapy (CBT) and motivational interviewing (MI) approach on motivating persons with intellectual disabilities (ID) in obtaining employment. The sample consisted of a total of 52 individuals with ID who were clients of an independent vocational-rehabilitation services provider (females = 42%; males = 58%), ranging in age from 19 to 47. They were randomly assigned to an intervention group (n = 26) and a control group (n = 26). The intervention group received a combined modified CBT and MI intervention and the control group a fact sheet on career-dysfunctional thoughts and lack of motivation to obtain employment. Outcome measures comprised a career-dysfunctional thoughts scale and employment seeking action scale. Results indicated that the intervention group reported higher motivation in obtaining employment than the control. Practitioners seeking to improve employment prospects for persons with ID should consider the use of a combined modified CBT and MI intervention for increasing the chances of employment seeking by people with ID.

Correlates of vocational outcomes of youth with co-occurring mental illness and substance use disorders: Evidence from a vocational rehabilitation program

Youth with co-occurring mental illness and substance use disorders are at higher risk for vocational rehabilitation exclusion. This study aimed to (a) explore the personal factors associated with vocational outcomes of youth with co-occurring mental illness and substance use disorders and (b) highlight services that have shown the greatest promise for this population in the state-federal rehabilitation program in the United States. Our analytic sample was extracted from the Rehabilitation Services Administration’s Case Service Report data set for 2013, 2014, and 2015 fiscal years. Multiple regression analyses results identified personal factors such as gender, race/ethnicity, level of education, and severity of disability as predictors of the achievement of competitive employment, hours worked, and income. The receipt of vocational rehabilitation services such as job search support, job placement assistance, vocational training, and on-the-job support are significantly associated with the achievement of competitive employment, higher work hours, and income. These finding have implications for vocational rehabilitation practice as they highlight who is at higher risk for poor outcomes, effective services, and additional factors to consider when working with youth with co-occurring mental illness and substance use disorders.

Factors influencing workplace accommodations requests among employees with visual impairments

People with visual impairments experience various challenges in the workplace such as under-employment, structural, and attitudinal barriers. Workplace accommodations are instrumental in assisting individuals to complete essential functions of their jobs and to increase job tenure and satisfaction. However, workplace accommodations are under-utilized. The current study examined influences of psychosocial and demographic factors on decisions to request accommodations amongst people with visual impairments. Participants included 116 people with visual impairments (e.g., female = 63.9%, Caucasian = 81%) from agencies and organizations serving people with visual impairments within United States. The results following logistic regression show that increased levels of psychosocial factors (i.e., self-efficacy in requesting accommodations and goal setting, non-personal cost related to accommodation, knowledge related to Americans with Disabilities Act (ADA), and accommodation policies and procedures) predicted participants’ decision to request accommodations. In addition, participants aged 55 or more and those with a high school degree or lower were less likely to request accommodations. Rehabilitation interventions for enhancing work participation self-efficacy in employees with visual impairment, as well as knowledge on ADA and accommodation policies and procedures, would create a more inclusive and accepting work environment for employees with visual impairment.

Families of veterans with traumatic brain injury in Australia and the United States: implications for rehabilitation counselors

Starting with World War I, Australia and the United States have been allies in military operations. Since then, both countries have been challenged by meeting the needs of military personnel incurring traumatic brain injury (TBI), especially during recent operations in Iraq and Afghanistan. TBI impacts all members of the veteran’s family. This paper articulates the shared responsibility both countries assume in meeting the support needs faced by families of military veterans with TBI and how TBI in the military is different than in the civilian population. The paper describes how both countries differently address the needs of family caregivers of veterans with TBI and outlines areas for rehabilitation counselor collaborations in research and training.

Physical activity participation among older adults with diabetes: Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) Guidelines

Objective: Physical activity (PA) is a known benefit to older adults with diabetes; however, the determinants of PA are less well studied in this population. Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), a well-established biopsychosocial framework, we explored PA participation among older adult with type 2 diabetes. Method: Using data from the Health and Retirement Study and the RAND Center for the Study of Aging (N = 2,016; mean age = 73.19; SD = 6.16), we conducted hierarchical stepwise regression analysis to evaluate the relative contribution of different biopsychosocial predictors to PA – namely, body functions and structure, activity and participation, personal, and environmental factors. Results: Altogether, biopsychosocial factors accounted for 20% of the variance in PA participation. Of the personal factors, high extraversion and low neuroticism explained approximately 54% of the variance in PA among the older adults – beyond sociodemographics. Low body mass index, reduced pain, reduced depression, and higher cognitive functioning also had good explanatory power (25% of explained variance), whereas activity participation and environment did not (10% each). Conclusion: Aligning care with components of the ICF will help to ensure a focus on person-centric practices and, in turn, optimize participation outcomes such as PA.

A systematic review of systematic reviews of secondary health conditions, health promotion, and employment of people with intellectual disabilities

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.

Racial, ethnic differences in complementary and integrative health use among adults with mental illness: Results from the 2017 National Health Interview Survey

The purpose of this study was to examine the patterns of complementary and integrative health (CIH) use among adults with a racial/ethnic minority background and a mental illness. A secondary data analysis of 2017 National Health Interview Survey (N = 793) was conducted using chi-square, multivariate logistic regression, and multinomial logistic regression. Overall, Black/African Americans and Hispanic/Latinx groups remained the least proportional of CIH therapies utilization. Being a male, Black/African American or Latinx/Hispanic and had work experience were predictors of the least use of the CIH therapies. Research is needed to bridge the gaps on the CIH use among a racial/ethnic minority with mental illness and to enhance the equitable and collaborative mental health care in the community.

Men with adult-onset epilepsy: Their experiences of health care provider relationship qualities following neurosurgery

The success of a lobectomy procedure for adult-onset epileptic seizure (AOES) would depend on the quality of the patient’s relationship with the health care provider. This ethnographic multiple case study explored patient and health professional relationship contexts following surgery for seizure activity reduction treatment. We interviewed five Australian men (aged 34–59) with a history of AOES and neurosurgery regarding the quality of their relationship with health care providers. Interpretive phenomenological analysis (IPA) of the data yielded three interrelated relationship themes of Timeliness (promptness of necessary care), Support (availability, understanding, and empathy), and Responsibility (adaptive communication, self-care, and decision-making ownership). Self-directed relationship resourcing enhanced subjective well-being in the patients.

State-level differences in public vocational rehabilitation closures among transition-aged youth with traumatic brain injury

This study aimed to understand state-level variation in participation in the State/Federal Vocational Rehabilitation (State VR) System in the United States among transition-aged youth (persons under the age of 22 years at application for State VR services) with traumatic brain injury (TBI) in Federal Fiscal Year 2016. A weighted least squares regression analysis was conducted to determine the relationship of state-level population size, unemployment rate, and per-capita income to the number of State VR closures in each state for transition-aged youth with TBI. Population size and per-capita income significantly predicted closures, while there was no relationship between closures and unemployment rate. Research is needed that further explores and explains state-level disparities in participation among transition-aged youth with TBI.