Journal of Vocational Rehabilitation - Volume 48, issue 3

Authors: Rumrill Jr, Phillip D. | Koch, Lynn C.

Article Type: Introduction

DOI: 10.3233/JVR-180938

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 295-296, 2018

Authors: McDaniels, Bradley

Article Type: Review Article

Abstract: BACKGROUND: Parkinson’s disease (PD) is a chronic, degenerative, neurologic condition affecting the central nervous system. The increasing prevalence of PD combined with the increasing economic need among older Americans to work later in life make employment an increasingly important topic of investigation. OBJECTIVE: The purpose of this investigation is to examine the prevalence of articles in the literature addressing the association between PD and employment. METHODS: A literature review was conducted on peer-reviewed articles from 2000–2015 on PD and employment issues. RESULTS: Although PD is the second most common neurodegenerative disorder and results in …numerous sequalae that may negatively affect employment, very few articles specifically address this association. Moreover, PD has been and remains largely absent from the rehabilitation counseling literature. One possible explanation for this may that the typical age at diagnosis is 62 years-old. The literature clearly suggests that the number of Americans working past 65 is steadily increasing, which indicates that individuals with PD may still want and/or need to work. Rehabilitation counselors are uniquely qualified to provide holistic services to individuals with disabilities and provide guidance and support to assist them in gaining or maintaining their employment goals. CONCLUSIONS: PD is an increasingly prevalent chronic condition with roughly 60,000 new diagnoses annually, and the time has come that the rehabilitation counseling profession begin to address the challenges and consider opportunities for effective interventions. Show more

Keywords: Parkinson’s disease, employment, neurodegenerative, rehabilitation counseling

DOI: 10.3233/JVR-180939

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 297-303, 2018

Authors: Li, Jian | Roessler, Richard T. | Rumrill Jr, Phillip D. | Li, Hua

Article Type: Research Article

Abstract: BACKGROUND: For too many cases, multiple sclerosis (MS) results in premature exit from the workforce due to both the complexity and unpredictable nature of its symptoms. OBJECTIVE: The purpose of this investigation was to examine differential employment self-efficacy expectations on the part of employed adults with MS. METHODS: Drawn from a larger national survey, the sample for this study (N = 590) consisted of individuals with three types of employment expectations: continue employment for the next 2 to 5 years, decrease work responsibilities or hours in the next 2 to 5 years, and exit employment in the next …2 to 5 years. RESULTS: Findings confirmed the utility of social cognitive theory regarding the relationship between background, physiological and affective states, performance accomplishments, and proximal contextual influences and employment expectancies. Compared to those who expected to retain their employment, those who planned to decrease work responsibilities or exit the workforce were older, more severely disabled from MS, and, in the case of those planning to decrease their job duties, less likely to have access to suitable housing. CONCLUSION: Specific recommendations regarding intervention strategies are provided, including the need to assist minority adults with MS in securing more satisfying employment. Show more

Keywords: Multiple sclerosis, employment expectation, self-efficacy

DOI: 10.3233/JVR-180940

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 305-319, 2018

Authors: Hill, Julie | Koch, Lynn C. | Rumrill, Phillip D.

Article Type: Review Article

Abstract: BACKGROUND: Approximately 100 million Americans live with chronic pain. These individuals are often negatively affected by the many myths, misunderstandings, and stigma associated with chronic pain and its treatment. These negative attitudes and misunderstandings on the part of the general public, significant others, vocational rehabilitation (VR) professionals, and health care providers can exacerbate their pain, preclude them from receiving effective treatment and rehabilitation, and undermine their overall quality of life. OBJECTIVE: The purpose of this article is to examine ethical considerations for providing responsive VR services that validate and appropriately address the needs of individuals with chronic pain. …CONCLUSION: The authors (a) define chronic pain, (b) provide examples of chronic illnesses and disabilities associated with chronic pain, (c) examine the demographic characteristics of individuals with the highest rates of chronic pain, (d) discuss common myths about chronic pain, and (e) discuss sections in the 2017 Code of Professional Ethics for Rehabilitation Counselors that are especially relevant to providing services to this growing VR clientele. Show more

Keywords: Ethics, chronic pain, vocational rehabilitation, code of ethics

DOI: 10.3233/JVR-180941

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 321-330, 2018

Authors: Conyers, Liza M.

Article Type: Review Article

Abstract: BACKGROUND: One of the most challenging questions faced by individuals with emerging or episodic illnesses is how and when to make critical decisions regarding employment. Research indicates that people with disabilities often experience higher rates of career indecision and challenges to their vocational identity development compared to peers without disabilities. To help guide this complex process, Goldblum and Kohlenberg (2005) developed the client-focused considering work model to help guide vocational counseling for people living with HIV (CFCWM PLWH). This model provides a strong foundation for both professionals and clients to better understand this complex decision-making process and to have …a framework to assess key issues and factors that may influence or help to inform the process. OBJECTIVE: The purpose of this article is to (a) provide an overview of the CFCWM PLWH, (b) evaluate the CDCWM PLWH, and (c) apply this model, with revision, to a broader range of individuals with episodic illness. Implications for rehabilitation research, service, program evaluation and policy are discussed. CONCLUSION: Implications for future rehabilitation research and practices are discussed. Show more

Keywords: Career decision-making, episodic disability, HIV, vocational development

DOI: 10.3233/JVR-180942

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 331-343, 2018

Authors: Lusk, Stephanie L. | Stipp, Addyson

Article Type: Review Article

Abstract: BACKGROUND: The rates of opioid use disorders have notably increased over the years. Initially opioid pain medications were reserved for individuals who experienced chronic pain associated with cancer (malignant) or pain post-surgery, but because of their effectiveness in alleviating pain, the widespread use of these medications resulted. In 2014 alone, American pharmacies distributed 245 million opioid prescriptions, and consequently, the United States now accounts for nearly 100% of the world’s hydrocodone and 81% of the world’s oxycodone use. OBJECTIVE: In this article, the authors explore how opioid use disorders develop and those at most risk of developing opioid …use disorders by discussing the unique pharmacology of opioids and how they increase the propensity of addiction. Terms of treatment – such as types of treatment, recovery-oriented services, and alternative or complementary forms of treatment – are discussed as well as considerations for addressing some of the challenges of working with these individuals. CONCLUSION: Implications for vocational rehabilitation professionals, such as suggestions for screening, making referrals to specialists for those with chronic pain conditions, and the need for continuing education are included. Show more

Keywords: Opioid use disorder, rehabilitation counseling, pain medication

DOI: 10.3233/JVR-180943

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 345-358, 2018

Authors: Koch, Lynn C. | Lo, Wen-Juo | Mamiseishvili, Ketevan | Lee, Donghun | Hill, Julie

Article Type: Research Article

Abstract: BACKGROUND: Increasing numbers of children and youths are being diagnosed with learning disabilities, attention deficit hyperactivity disorder, and psychiatric disabilities. These youths are also enrolling in U.S. colleges and universities at increasing rates. In fact, in combination, they represent the largest group of students with disabilities in higher education. OBJECTIVE: The purpose of this investigation was to (a) summarize the demographic characteristics, in-college experiences, and persistence outcomes of students with and without learning disabilities, attention deficit hyperactivity disorder, and psychiatric disabilities and (b) examine the effect of having one of these disabilities on students’ three-year persistence outcomes at …four-year higher education institutions. METHODS: Secondary data analyses were conducted for a sample of 7,750 students who enrolled at four-year institutions utilizing data from the Beginning Postsecondary Students Longitudinal Study (BPS:04/06). Descriptive analyses were used to summarize demographic characteristics, in-college experiences, and persistence outcomes of students with and without learning disabilities, attention deficit hyper activity disorder, and psychiatric disabilities. Univariate and multinomial logistic regression analyses were used to examine the effect of having one of these disabilities on students’ three-year persistence outcomes at four-year higher education institutions. RESULTS: We discovered that students with these disabilities in our sample (a) did not have the background characteristics typically associated with non-persistence and (b) reported being more academically and socially integrated into their institutions than participants without disabilities. However, they still withdrew from college in higher rates both by the end of the first and second years of college. The results from the multinomial logistic regression analysis revealed that when holding students’ demographic and in-college predictors constant, having one of these disabilities still increased the odds of non-persistence. Hierarchical multinomial logistic regression analysis further confirmed that the disability status significantly contributed to the likelihood of non-persistence over and above the combination of both the background characteristics and the in-college experiences factors. CONCLUSION: These findings have several important vocational rehabilitation practice and research implications for better facilitating the academic persistence of these students. Show more

Keywords: Persistence, postsecondary, ADHD, LD, psychiatric disabilities, academic integration, social integration

DOI: 10.3233/JVR-180944

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 359-367, 2018

Authors: Mann, David R. | Croake, Sarah

Article Type: Research Article

Abstract: BACKGROUND: The Workforce Investment and Opportunity Act increased focus on State Vocational Rehabilitation Agency (SVRA) service priorities for several applicant subpopulations, such as transition-age youth, workers receiving subminimum wages, and workers with competitive and integrated employment. OBJECTIVE: This study examines state variation in outcomes for applicants in four different employment statuses at application similar to the subpopulations affected by WIOA, and identifies SVRAs with consistently strong outcomes. METHODS: We used VR administrative data on cases closed during fiscal year 2014 to calculate the percentage of VR applicants who received services and the percentage of VR service …recipients who were employed at program exit. Regression analysis controlled for applicant subpopulation, SVRA, and other characteristics. Results were reported as marginal effects and presented graphically. RESULTS: There was more variation across SVRAs in the share of applicants receiving services than in the share employed at program exit. Variation was particularly large for students not employed at application. Eight SVRAs were in the highest quartile on both outcomes for one or more subpopulations. CONCLUSIONS: The findings are a first step towards better understanding the mechanisms that drive the relative success of some SVRAs and facilitating the sharing of best practices throughout the VR program. Show more

Keywords: Vocational rehabilitation, employment, service receipt, status at application, agency level variation

DOI: 10.3233/JVR-180945

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 369-386, 2018

Authors: Waghorn, Geoffrey | van Veggel, Rhonda | Chant, David | Lockett, Helen

Article Type: Research Article

Abstract: BACKGROUND: Fidelity scales are an important way to control the quality of implementation of psychosocial interventions such as supported employment programs. However, little is known about the utility of item level scores for informing the implementation of supported employment programs. OBJECTIVE: To explore the utility of item level scores from the IPS-25 fidelity scale for developing evidence based practices in supported employment for people with severe mental illnesses in Sussex, United Kingdom (UK). METHODS: Fidelity was assessed in 18 sites representing 34 independent cohorts where IPS was implemented by one organisation. Item-level fidelity scores were examined …descriptively. Nine item level correlations were selected a-priori and examined with respect to two employment milestones and program attrition. RESULTS: Mean total fidelity score was associated with commencing competitive employment (r  = 0.36, p  = 0.04). None of the three items selected as likely to be related to either commencing employment or to employment duration, were correlated as expected. Of the three items selected as likely to influence attrition, only one ‘Rapid commencement of job searching’ was correlated as expected (r  = 0.38, p  = 0.02). CONCLUSIONS: Individual fidelity score items appear useful for improving supported employment programs, in terms of item response characteristics and expected correlations with particular program outcomes. Show more

Keywords: Supported employment, evidence-based practices, fidelity, item level properties, severe mental illness, psychiatric disability

DOI: 10.3233/JVR-180946

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 387-391, 2018

Authors: Henning-Smith, Carrie | Gimm, Gilbert

Article Type: Research Article

Abstract: BACKGROUND: Although prior studies have explored the demographic and health factors that influence the relationship between disability and employment for working-age adults, relatively little is known about how living arrangements and gender affect this relationship. OBJECTIVE: This study addresses that gap in knowledge by examining how employment status varies by gender and living arrangements for working-age adults with disabilities. METHODS: Using 2014 American Community Survey (ACS) data, we used logistic regression analysis to estimate the likelihood of employment by gender and living arrangement in a nationally representative sample of 195,236 adults (18–64 years old) with disabilities. …RESULTS: More than one-third of working-age adults with disabilities were employed (37.7% of men and 31.7% of women, p  <  0.001). Both men and women who lived alone had higher odds of employment, compared with living with a spouse only, but the difference was more pronounced among women (OR for men: 1.5, p  <  0.001; OR for women: 3.3, p  <  0.001). CONCLUSIONS: The amount of support that working-age adults with disabilities need to successfully participate in employment may vary by both gender and living arrangement, and both factors should be taken into account in designing programs and targeting outreach efforts to support individuals with disabilities. Show more

Keywords: Living arrangements, gender, employment, disability

DOI: 10.3233/JVR-180947

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 393-401, 2018

Authors: Reed, Karla S. | Meade, Michelle | Jarnecke, Melinda | Aust, Richard | Krause, James S.

Article Type: Research Article

Abstract: BACKGROUND: Spinal cord injury (SCI) is associated with unacceptably high unemployment rates that are impacted by the environment in which employment and vocational activities take place. To improve employment outcomes, we must continue to gather data allowing us to evaluate the effectiveness of policies and programs associated with successful employment from the perspective of persons with disabling conditions. OBJECTIVE: Identify key components of programs and federal and state level polices which support employment outcomes, as perceived by individuals with SCI who have worked since injury . METHODS: Qualitative approach using six focus groups at two sites. …All participants (N = 44) had been employed at some point since injury. A semi-structured interview format asked questions about policies and program related factors influencing job attainment, maintenance, and advancement following SCI. Narratives were extracted into themes falling into the overlapping categories of policies, programs and awareness. RESULTS: Within programs, five themes emerged characterizing components of programs perceived to be significant in supporting employment: (1) support for education, (2) development of job seeking skills, including skills assessment; (3) job placement; (4) practical experience, and (5) instrumental support. Within policies, two themes were extracted related to policies focused on individuals and policies focused on changing the environment. Finally, within the category of awareness, themes reflect the importance of personal connections and self-advocacy. CONCLUSIONS: Policies and programs are not static factors but change and differ based on how they are understood, implemented, and reacted to in different places and by different groups. Researchers, program developers, and policy makers should consider how persons with SCI from diverse backgrounds and levels of impairment perceive and are supported by the varying programs and policies in their particular institution, region or state. Show more

Keywords: Spinal cord injuries, employment, qualitative research

DOI: 10.3233/JVR-180948

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 403-415, 2018

Authors: Murfitt, Kevin | Crosbie, Jenny | Zammit, Jessica | Williams, Greig

Article Type: Review Article

Abstract: BACKGROUND: There is entrenched exclusion of around half the working age people with disability in Australia and elsewhere. There also appears to be a lack of attention being paid to the ‘demand’ side of efforts to improve the employment of people with disability, particularly in relation to small and medium sized organizations. OBJECTIVE: To identify gaps in disability employment research, policy, and strategies in relation to small to medium employers; and to identify challenges and potential solutions for these employers in becoming disability confident and inclusive organizations. METHODS: A comprehensive search of literature was conducted including …published articles, books, and reports. Searches were also conducted on relevant government and disability employment related web sites. RESULTS: First, although larger employers are contributing to the discussion of ways to increase the employment of people with disability, small to medium employers are largely missing from the discussion. Second, reliance on the broad business case argument alone for employing people with disability, is not enough to change attitudes and organizational cultures that are at the root of the workforce exclusion of people with disability. CONCLUSIONS: The major barrier to employment of people with disability is negative attitudes that result in discriminatory organizational cultures. Current initiatives in this area are not addressing the needs or potential role of small to medium organizations. Solutions to both these issues are described. Show more

Keywords: Disability employment, inclusive organizations, employer engagement

DOI: 10.3233/JVR-180949

Citation: Journal of Vocational Rehabilitation, vol. 48, no. 3, pp. 417-431, 2018