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.
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.
This study was designed to investigate the relationship between Type 2 diabetes mellitus (T2DM) and musculoskeletal system disorders and kinesiophobia levels. Eighty-four participants (41 diabetics and 43 nondiabetic individuals) self-reported their musculoskeletal problems and levels of kinesiophobia. Data were analyzed using descriptive statistics, nonparametric Pearson’s Chi-Square testing, and Mann–Whitney U test. Results indicated the total Cornell Musculoskeletal Discomfort Questionnaire score was 190.55 ± 261.56 for the patients with T2DM and 98.11 ± 167.31 for the control group (p < 0.05). Moreover, Tampa Kinesiophobia Scale scores were higher for the T2DM group (p < 0.05). We conclude from these findings that T2DM is associated with a higher frequency of musculoskeletal system disorders and higher levels of kinesiophobia.
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.
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.
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.
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.
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.
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.
This paper describes the impact of disability in Australia on earning and learning. The report is based on the official statistics on Disability Ageing and Carers by the Australian Bureau of Statistics. Whilst 67.9% of those aged 15–64 years without a reported disability complete Year 12 only 43.6% of those with a disability complete the highest level of secondary schooling. In the labor market, the participation rate is lower for persons with a disability (53.4%) compared to 84.1% for those without a disability. Even when people with disabilities are ready to work it is accompanied by a higher rate of unemployment (10.3%) compared with 4.6% for those without a disability. Whilst general labor force participation has increased from 2003 to 2018 the labor force participation of persons with a disability has remained stubbornly constant. Furthermore, the unemployment rate for person with a disability has increased markedly from 2009 while that for persons without a disability has decreased. When the influence of all these factors is combined there is an overwhelming landscape of disadvantage within which a person with a disability has to navigate an educational and vocational pathway.
AbstractA visual narrative intervention – Serious Storytelling with Images – was proposed to manage interview anxiety and performance. Its ability to evocate significant incidents and enhance narratives construction was evaluated ideographically in two case studies. The findings suggest varying levels of sophistication in interviewee actions, challenges encountered, and perceived roles of images. Counselors can refer to the hierarchical concepts when tailoring interview training and coaching. Further investigation is highly recommended to confirm and measure intervention effects.
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 case study assessed the role of job burnout as it relates to employee organisational commitment. An interview was carried out with a disability support worker and the variables she perceived as contributing to her job burnout, affecting organisational commitment or turnover intentions. The Job Demands-Resources model was used for understanding job burnout; three areas of focus were identified: role ambiguity, role overload, and perceived supervisor support.
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.
Psychogenic gait disorders in children and adolescents represent a unique neuropediatric and rehabilitative challenge. The inability to walk frequently strikes abruptly. Triggers are not easily identifiable. Patients are commonly admitted to the hospital in an emergency. In view of the dramatic clinical picture, parents are perturbed. They expect rapid diagnostic clarification and therapy. If physical, laboratory, and X-ray examinations do not disclose any significant pathological findings, parents generally insist on consulting diverse specialists and clinics. The pivotal point of the course of treatment is the parent-doctor-patient relationship. This is notably true when child psychologists or psychiatrists have to be consulted. Typical risks and decision conflicts of the rehabilitation dynamics are described - these are augmented by several case vignettes.
A novel inpatient vocational counseling service (named "In-Voc") was developed and evaluated in three Australian spinal cord injury (SCI) rehabilitation hospitals, aiming to improve vocational outcomes after SCI. The program provided a trained Vocational Counseling Coordinator who worked alongside the allied health team, medical, and nursing staff at each hospital. The Coordinators were interviewed to examine the role expectations and role behaviors associated with the introduction of their novel, vocationally focused, occupational role. The Coordinators' descriptions of their role behavior were very similar to those defined by rehabilitation counselors in North America. They reported the novel role to be a productive and satisfying one. Encouragingly, the In-Voc program was associated with significantly higher post-injury employment outcomes.
Recently, the Progressive Goal Attainment Program has grown in popularity as an intervention for injured workers experiencing psychosocial barriers when returning to work. This article provides an outline of the program and explores its implementation by a workplace rehabilitation provider. Data from 20 participants have been pooled to highlight typical presentations. Key features of the program and outcomes are discussed.
Abstract 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.
