People with multiple sclerosis (MS) often have to cope with high levels of stress. Lazarus and Folkman’s (1984) stress–appraisal–coping theory emphasizes the relationship between the individual and the environment, suggesting that a stress response is highly influenced by individual appraisal processes. This study aimed to evaluate constructs of Lazarus and Folkman’s stress–appraisal–coping theory and positive human traits as predictors of perceived stress in a sample of 477 adults with MS. Hierarchical regression analysis was used to determine the incremental variance in perceived stress accounted for by demographic covariates, functional disabilities, challenge appraisal, and positive human traits. Core self-evaluations, challenge appraisal, limitations in social/cognitive functioning, agency hope, and age were significant predictors in the final model, accounting for 68% of the variance in perceived stress scores (R2= .68,f2= 2.13; large effect size). Core self-evaluations and challenge appraisal were the strongest predictors of perceived stress. The findings from this study will help rehabilitation professionals develop empirically supported stress management and well-being interventions, enabling people with MS to cope effectively with stressors and challenges and improve their health and well-being.

Certified peer specialists refer to a category of trained mental health professionals who self-disclose serious mental illness to support the rehabilitation and recovery goals of others with serious mental illnesses. The purpose of the current study was to better understand certified peer specialists' perceptions of: (a) the role of self-determination in vocational rehabilitation programs, (b) experiences with vocational rehabilitation services, and (c) the conceptualization of mental health and vocational recovery. A total of 12 participants completed the qualitative interviews in-person or over the phone. This study utilized a Consensual Qualitative Research approach. Study participants described self-determination as an important component in attaining work, as well as overall mental health and vocational recovery. Overall, our findings indicated that certified peer specialists have unique descriptions for self-determination and recovery, as well as diverse experiences with vocational rehabilitation services.

Diabetes mellitus is a group of metabolic disorders characterized by impaired blood glucose regulation. For most individuals with diabetes, the condition is chronic, and it can lead to severe health complications if not managed effectively. This chapter begins with a review of the biological, psychological, and social aspects of diabetes. The chapter then describes the key facets of comprehensive diabetes self-management, providing a review of current literature on health promotion and self-care behaviors for individuals with diabetes. Unique considerations for type 1 diabetes mellitus and type 2 diabetes mellitus are described when relevant. The chapter then concludes with a discussion of existing research on diabetes self-management interventions.

n Purpose: The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) for use in the Clubhouse Model of Psychosocial Rehabilitation.Method: There were 124 individuals with serious mental illness recruited from 8 Clubhouse programs in Hawaii. Measurement structure of the VRES was evaluated using exploratory factor analysis.Results: Exploratory factor analysis of the Clubhouse version of the VRES yielded 2 reliable factors (cognitive-affective engagement and behavioral engagement). Both the cognitive-affective engagement and behavioral engagement factors were found to correlate with other self-determination theory constructs including autonomy support, relatedness, and outcome expectancy.Conclusions: The Clubhouse version of the VRES is a brief, reliable, and valid instrument for assessing vocational rehabilitation (VR) engagement and contributes to the use of self-determination as a paradigm for improving recovery outcomes in psychiatric rehabilitation.

BACKGROUND: Individuals with disabilities continue to be underrepresented in STEM education and employment, despite the strong group of STEM occupations in recent years.OBJECTIVE: The purpose of this study was to gain a better understanding of SPR/nAblement's unique efforts to assist people with physical disabilities to find employment in IT occupations.METHODS: The Consensual Qualitative Research (CQR) approach was used to gain a rich understanding of employment services provided to people with sensory and physical disabilities by the nAblement division of SPR Consulting, a medium-sized information technology (IT) company in Chicago. Interviews were conducted with six SPR/nAblement staff and administrators, six people with physical disabilities served by SPR/nAblement, and five employers who had hired people with physical disabilities from the SPR/nAblement's candidate pool.RESULTS: Results suggest multiple opportunities for IT companies that include a focus on disability in their workforce diversity and inclusion programs. Results also highlight some of the unique opportunities and challenges for people with physical disabilities that may arise from receiving in-house, occupation-specific employment and training services.CONCLUSION: Implications for rehabilitation counseling practice and research are provided, including suggestions for facilitating other companies in their profit-driven goals for hiring people with physical disabilities.

INTRODUCTIONThe great majority of smokers relapse when they make quit attempts. Therefore, understanding the process of relapse may guide the development of more effective smoking cessation or relapse prevention treatments. The goal of this research is to extend our understanding of the context of initial lapses that occur within 8 weeks of quitting by using more comprehensive assessments of context, a contemporary sample, and sophisticated analytic techniques.METHODSParticipants from a randomized controlled smoking cessation trial completed baseline assessments of demographics and tobacco dependence, a daily smoking calendar to determine latency to lapse and relapse (7 consecutive days of smoking), and an assessment of initial lapse context (affect, location, activity, interpersonal, smoke exposure, and cigarette availability). Latent class analysis (LCA) was used to analyze the 6 early lapse (within the first 8 weeks; N = 551) context dimensions; logistic regression and Cox regression were used to relate context to cessation outcomes.RESULTSLCA revealed 5 distinct initial lapse context classes (talking, with friends, angry; social; alone; with spouse, angry; and with smoking spouse) that were differentially related to cessation outcome. The easy availability of cigarettes characterized almost 75% of lapses, but being with friends, drinking, and not being at home were associated with a lower likelihood of progression to relapse.CONCLUSIONSEarly lapsing is highly related to ultimate relapse, and lapsing in frequently experienced contexts seemed most strongly linked with progression to full relapse.