The Influence of State-Level Contextual Factors on State/Federal System Vocational Rehabilitation Employment Outcomes for Persons With Traumatic Brain Injury

The purpose of this exploratory study was to develop a preliminary understanding of the influence of state-level contextual factors predictive of employment outcomes for State/Federal Vocational Rehabilitation System (State VR) participants with traumatic brain injury (TBI). Participants were 5,213 individuals with TBI with Individualized Plans for Employment closed during Federal Fiscal Year 2016. A four-step hierarchical logistic regression model (5.6% explained variance) containing five demographic, three state-level economic, six state TBI service climate, and nine State VR service variable expenditures correctly classified 57.0% of cases as attaining or not attaining an employment outcome at closure. Significant predictors associated with an employment closure were (a) education, veteran status, and presence of a secondary area of disability impairment; (b) state-level per-capita income; (c) State VR specialized acquired brain injury (ABI)/TBI service and state TBI Implementation Partnership grant funding; and (d) State VR service expenditures on diagnosis and treatment, occupational or vocational training, on-the-job training, job readiness training, transportation, maintenance support, and benefits counseling. The practice, policy, and research implications of these findings are presented.

Psychometric Validation of the Wisconsin Community Participation Scale in a Sample of People with Chronic Health Conditions and Disabilities Living in the Community

Increasing community participation can reduce the risk for functional disabilities; participation is influenced by person and environment contextual factors. Development and validation of a brief community participation assessment can advance and support evidence-based assessment in clinical rehabilitation counseling practice. It will be an invaluable rehabilitation and public health surveillance tool that can be used to gauge the health conditions and participation of people with disabilities. The current study evaluated and validated the Wisconsin Community Participation Scale (WCPS) in 982 individuals with chronic health conditions and disabilities. Participants indicated five most meaningful life roles: (a) being able to get around with or without help, (b) live independently with or without help, (c) live a healthy lifestyle, (d) work, and (e) leisure and recreation activities. The WCPS scores were positively associated with physical health, mental health, and life satisfaction and negatively related to functional disability in the theoretically expected directions. The WCPS can help rehabilitation counselors assess their clients’ current level of participation in meaningful life roles that are important to them. Rehabilitation counselors can use the WCPS assessment data to guide treatment planning and empower clients to build confidence and self-efficacy to participate in personally meaningful activities in the community.

Lessons Learned by Rehabilitation Counselors and Physicians in Services to COVID-19 Long-Haulers: A Qualitative Study

Coronavirus disease (COVID-19) may cause long-lasting adverse consequences after acute recovery, including functional limitations and reduced work capacity. Individuals with long-lasting complications of COVID-19 are known as long-haulers. There is a knowledge gap on how COVID-19 complications affect return-to-work (RTW) efforts. We aimed to describe the challenges that long-haulers encounter when RTW from the perspectives of rehabilitation professionals. In this study, four certified rehabilitation counselors and four rehabilitation physicians in outpatient rehabilitation centers participated in focus groups. Participants discussed challenges in working with long-haulers, including personal attributes, post-COVID-19 symptoms and complications, uncertain recovery and unpredictable outcomes, limited health care accessibility and support, and unsupportive work environments. Participants provide individualized services to meet long-haulers’ diverse needs as they do for all persons with disabilities, although they expressed uncertainty due to the variable disease course and risk of infection. Modifying workplace policies, especially gradual RTW, were frequently mentioned accommodations. The findings highlight the RTW issues of long-haulers. We provide recommendations on increasing awareness of the challenges and job accommodations of long-haulers.

Disability Content in the Journal of Counseling and Development and Social Work: A Comparative Analysis

The purpose of this study was to provide an understanding of how disability is addressed in the Journal of Counseling and Development ( JCD), the flagship journal of the American Counseling Association. A review of disability content in JCD was compared with a review of disability in Social Work ( SW), the flagship journal of the National Association of Social Workers. A series of between and within analyses for JCD and SW addressed the frequency, focus areas, and trends concerning how both journals addressed disability content over their histories. Overall, SW published a higher rate of disability content articles. Mental health was the most common disability domain addressed in both journals; however, JCD has published most of its disability content articles on mental health over the past two decades. The findings of the present study are discussed concerning prior research, historical events, and implications for accreditation.

Vocational Rehabilitation Professionals’ Perceptions of Facilitators and Barriers to Return to Work: A Qualitative Descriptive Study

This is a qualitative descriptive study of professionals’ perceptions of facilitators and barriers for returning to work for women on long-term sick leave due to musculoskeletal pain and/or common mental disorder who participated in a vocational rehabilitation project. Data were collected through semi-structured interviews with 13 purposefully selected professionals from the Swedish Social Insurance Agency, the Swedish Public Employment Service, the health care services, and the municipal services. The interviews were analyzed with a manifest content analysis. The main facilitators were the close cooperation between the professionals and the individual support that was offered to the project participants. The main barriers were differences among the stakeholders’ missions and goals, limitation in project duration and within the labor market, and the project participants’ personal factors. These results emphasize the importance of cooperation between the professionals from the various stakeholders and focus on the individual’s resources and needs. The study highlights the value of including health care professionals in vocational rehabilitation to benefit from their specific knowledge of the target group and their strengths and needs. Moreover, the study highlights the need to incorporate collaboration with employers and align with the local labor market in the development of vocational rehabilitation interventions.

What Predicts Job Quality of Vocational Rehabilitation Consumers Who Are Blind or Have Low Vision?

The Workforce Innovation and Opportunity Act emphasizes promoting high-quality, competitive employment for people served by vocational rehabilitation (VR), but few studies have assessed VR consumers’ job quality. The purpose of this study was to investigate job quality and factors that predict the job quality of VR consumers with blindness or low vision (B/LV), taking into consideration their employment status at application. We utilized RSA-911 data of VR consumers with B/LV who were closed in competitive employment during 2015, creating two separate hierarchical linear models to predict job quality for VR consumers (a) who were employed at application and (b) who were not employed at application. We investigated individual-level (consumer personal characteristics and VR services) and state/agency-level predictors. Job quality and some predictors of job quality differed by employment status at application, although the strongest predictors (education level at application, gender, benefit receipt at application, receipt of a bachelor’s or higher degree) were consistent across the models. While several additional individual-level variables were significantly associated with job quality, their effect sizes were very small. With the exception of advancing education to a bachelor’s degree or higher while receiving services, consumer characteristics at application were the primary determinants of their job quality.

Identifying Racial Differences in Vocational Rehabilitation Services

The literature on racial differences in vocational rehabilitation (VR) services has not been updated for over a decade. Using the 2017 individual-level national RSA-911 data, supplemented with the 2017 American Community Survey and publicly available information from Kaiser Family Foundation, we investigate racial differences at each step of the VR process—application, eligibility, service provision, and employment outcomes at closure. At the first step, application, White individuals with disabilities are less likely to apply than their African American, American Indian/Alaska Native, and Hispanic counterparts, and more likely to apply than their Asian counterparts. For the remaining three steps, the results are inverted: the White subgroup has higher eligibility rates, service rates, and employment rates than the African American, American Indian/Alaska Native, and Hispanic subgroups, and lower rates than the Asian subgroup. These findings suggest that racial and ethnic differences continue to exist in the VR process despite several legislative acts and policy efforts. Within each racial and ethnic minority group, we also find large variation in application rates and employment rates across states, which indicates a need for developing performance measures and standardized guidelines for state VR agencies to better serve individuals with disabilities from racial and ethnic minorities.

Demographic, Transition, and Vocational Rehabilitation Service Variables’ Association With High School Completion Outcomes of Youth With Disabilities Receiving SSI

Completing high school expands career prospects for young adults with disabilities, increasing their likelihood for gainful employment. Those who graduate from high school are more likely to have higher salaries and longer job tenure than those who do not have high school diplomas. As such, graduating from high school is a significant milestone for students with disabilities. Yet, the specific predictors of high school completion among youth with disabilities are not well understood. This study used three multiple logistic regression analyses and a hierarchical logistic regression analysis to evaluate demographic, PROMISE transition services, and vocational rehabilitation (VR) services as predictors of high school completion in a sample of 350 transition-age youth receiving Supplemental Security Income. Among the demographic variables examined, race, disability type, parent education, and family income were significant predictors of completion. For transition services, social skills training and self-advocacy training were independently associated with high school completion, while miscellaneous training was the only independent significant VR service predictor. Findings support the importance of pre-employment transition services, especially in the areas of social skills training, self-advocacy training, and VR services in the areas of miscellaneous training that can be used to promote completion of high school.