Certified Rehabilitation Counselors Research Articles

Variations of the Traditional Life Care Plan

A staple in assessing and valuing injury and related monetary damages claims, life care plans have traditionally encapsulated damages computations associated with present and anticipated future rehabilitation interventions related to contested events, the most common involving personal injury, medical malpractice, and product liability. The needs and sophistication of the injury claims assessment process have continued to evolve since the inception of life care plans, and accordingly affect the services life care planners contribute to resolve disputes over the need for and value of litigated future rehabilitation interventions. After a brief history and overview of life care planning, this article describes how the discipline evolved to its current state. The authors then discuss how lawyers’ discernments in prosecuting cases have led to the need for three variations/derivatives of the traditional life care plan: the life care plan cost comparison, the interpolated life care plan, and the international life care plan. Standards of practice considerations follow. According to the Commission on Rehabilitation Counselor Certification, life care planning is a career pathway for certified rehabilitation counselors (CRCs). Rehabilitation counselors encounter a myriad of physical and psychosocial factors that affect the rehabilitation process. CRC certification and training prepares counselors to holistically address complex areas of rehabilitation following a catastrophic illness or injury. According to the Commission on Rehabilitation Counselor Certification (CRCC) Code of Ethics, CRCs have a responsibility to the public to engage in practices that are based on accepted research methodologies and evidence-based practices. They need to remain current with developments in evidence-based practice. Notably, the three variations/derivatives of the traditional life care plan presented in this article address pertinent standards of practice considerations.

Disability Adjustment Counseling: Experiences and Perspectives of Certified Rehabilitation Counselors

Background Disability adjustment counseling (DAC) focuses on the diverse process of adjusting to chronic illness or disability, including responding to the initial diagnosis or the onset and adjusting to changes and barriers that arise from living with a disability. Although DAC is a primary role and function of rehabilitation counselors, there have been limited efforts to explore the use of DAC in the field. Objective The purpose of this study was to survey certified rehabilitation counselors (CRCs) about the extent of DAC utilization and its focus, the theoretical basis for DAC, and professional preparation. Methods A cross-sectional survey was completed with 109 CRCs recruited through the Commission on Rehabilitation Counselor Certification (CRCC). The research team developed a 35-item survey questionnaire for this study. Most respondents identified as white women with master’s degrees (mean age = 51.41 years). Results Approximately two-thirds of the respondents (67.78%) reported engaging in DAC for approximately a third (31.15%) of their professional time. Many respondents reported wanting to spend more of their professional time providing DAC. Most respondents (75%) indicated they do not operate from a specific model of psychosocial adjustment to chronic illness or disability. Nearly half (48.6%) of the respondents reported that there were not adequate options for DAC counseling. Conclusions The survey results confirm that DAC is an important role and function for rehabilitation counselors. Although the sample was too small to permit broad generalizations, the results imply that further exploration of the research questions among a larger sample is warranted.

장애인재활상담사 근로환경 실태조사 연구

The purpose of this study is to investigate the working environment of certified rehabilitation counselors for the people with disabilities (CRC). This study explored the working environment of CRC using a questionnaire in order to take a step toward becoming an expert who provides direct services based on the development and expertise in the field of rehabilitation counseling. Based on literature review, the questionnaire including demographic status, working conditions, value of work, relationship between users and coworkers, burnout, legal obligations, continuing education, and rehabilitation practice was developed. The survey was collected in June 2023, and the final analyzed number of participations in the survey was 308, which was found to be representative of 5,400 CRC in S. Korea based on G*Power. The results of the study showed that there was a high rate of women, university (college) graduates, level 1 CRC, majoring in rehabilitation counseling, and working at community rehabilitation facilities. Based on the research results, for CRC, it was proposed to improve the labor condition for practitioners, support continuous education and training, and improve social awareness.

Importance of Clinical Judgment Skill Competencies Across Practice Settings: Certified Rehabilitation Counselors’ Perceptions

Accurate clinical judgments are critically important for counselors in their work with clients. To date, there are no studies that have assessed rehabilitation counselors’ knowledge of clinical judgment and its importance to implement in practice. In this internet-based study, a random sample of certified rehabilitation counselors (CRCs;n= 579) were surveyed using the clinical judgment skill inventory (CJSI). The CJSI measures clinical judgment skills across seven clinical judgment skill areas (scientific attitude, cognitive complexity, cultural bias, confirmatory bias, memory bias, negative bias, and evidence-based practice). CRC participants overall rated clinical judgment skills to be important. Significant multivariate analysis of variance (MANOVA) test indicated significant mean differences between practice settings (Wilks’ LambdaF= 3.31,pvalue <.01) in “scientific attitude” (F-statistic = 3.91,pvalue <.01), “cultural bias” (F-statistic = 3.71,pvalue <.01), “confirmatory bias” (F-statistic = 3.02,pvalue = .01), and “evidence-based practice” (F-statistic = 5.62,pvalue <.01). Specifically, CRCs working for a college or university perceived clinical judgment skill areas to be more important than CRCs working in other practice settings. Implications for rehabilitation counseling practice are discussed.

Forensic and Business Ethics

Now in its fifth edition, the Code of Professional Ethics for Rehabilitation Counselors continues to clarify and expand behavioral guidelines and practice for those in the rehabilitation counseling profession. Specific to Certified Rehabilitation Counselors (CRC) in the private sector, this article details changes in the revised Code specific to Forensic Services (Section F) and Business Services (Section K). It also briefly describes the historical development of these sections of the Code and explores its implications.

Embracing the Future: Updating and Revising the Code of Professional Ethics for Rehabilitation Counselors

The Commission on Rehabilitation Counselor Certification (CRCC) certifies qualified candidates as certified rehabilitation counselors in the United States (CRCs) and as Canadian certified rehabilitation counselors (CCRCs) in Canada. Those professionals who are certified as CRCs/CCRCs are expected to adhere to the CRCC Code of Professional Ethics. The CRCC Code of Ethics is updated from time to time. With the completion of the recent revision process, a revised Code of Professional Ethics for CRCs/CCRCs is now being distributed and implemented by the CRCC. Given the changes and updates to the Code of Professional Ethics, this article and subsequent articles in this special issue help to outline the process and rationale that framed the recent revision process. Although some specific changes are highlighted through this special issue, practitioners are encouraged to familiarize themselves with the entire code.

Ethics of Technology Practice: Beliefs and Behaviors of Certified Rehabilitation Counselors During the COVID-19 Pandemic.

The coronavirus (COVID-19) pandemic represented a critical moment for technology use within rehabilitation counseling. This study explored trends in the beliefs and behaviors of certified rehabilitation counselors (CRCs) regarding the ethical use of technology before and during the pandemic. Specifically, this study compared two groups of CRCs regarding the degree to which they engaged in 59 technology behaviors and whether they viewed each behavior to be ethical. Overall, group comparisons suggested an increased use of telephone, videoconferencing, and email to deliver counseling, assessment, and supervision services during the pandemic. Furthermore, supervision via videoconferencing and email in the pandemic were rated as more ethically appropriate than before the pandemic. As a general trend, synchronous modes of communication such as the telephone and video conferencing were rated as more ethically appropriate than asynchronous modes such as social networking and text messaging. Indicating a high degree of congruence between beliefs and behaviors, the technology practices viewed as most ethical were used the most often. Implications address the revisions to the Code of Professional Ethics for Rehabilitation Counselors regarding the ethical use of technology in rehabilitation counseling.

Rehabilitation Counselors and Technology, Social Media, and Distance Counseling: Contemporary Considerations

The use of technology in rehabilitation counseling including the delivery of rehabilitation services via virtual counseling is occurring at greater rates than ever before. At the same time, views about the utility of social media have evolved, necessitating increased consideration of social media benefits while at the same time highlighting a need for more detailed guidance regarding its usage and risks. As a standard of ethical practice, certified rehabilitation counselors (CRCs) are required to be aware of guidelines that govern the ethical use of technology in the provision of rehabilitation services, including revisions to the Code of Professional Ethics for CRCs. The 2023 revisions to the Technology, Social Media, and Virtual Counseling section of the Code of Professional Ethics for CRCs specify expanded guidance for CRCs integrating apps, relevant social media, and the provision of virtual counseling. To assist CRCs to meet their standard of ethical practice, this article reviews the historical evolution of technology within the Code, the changes and expansions to Section K of the Code and discusses ethical consideration and revised guidance in the critical technology areas of virtual counseling and social media.

Ethical Dilemmas: Current and Projected Concerns Reported by Certified Rehabilitation Counselors

The purpose of this study was to investigate ethical dilemmas faced by certified rehabilitation counselors. Using a mixed-method survey approach, both quantitative and qualitative data were collected and analyzed. Thematic analysis was used to identify common themes among responses including the ethically challenging incident, additional resources to clarify the situation or reach resolution, projecting future ethical issues, approach to resolution for current ethical issues, and additional issues to address or consider in the code of ethics. Results indicated that participants most frequently encountered ethical dilemmas related to Section B. Confidentiality, Privileged Communication and Privacy of the Commission on Rehabilitation Counselor (CRC) Certification Code of Professional Ethics, followed by Section A. The Counseling Relationship. When addressing recognized ethical dilemmas, participants also identified consideration of the counseling relationship and maintaining confidentiality, privileged communication and privacy as the most important sections of the code to consider. Implications include topics identifying current and projected ethical dilemmas faced by CRCs, as well as the need for a variety of topics to be addressed or considered in the new revisions of the CRC Code of Ethics.

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 returning to work from the perspectives of rehabilitation professionals. In this study, four certified rehabilitation counselors and four rehabilitation physicians in U.S. 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.

The Impact of Human Trafficking on Veterans: Increasing Awareness among Veterans and Employees through Education

Background Health care systems serve an essential role in identifying and treating individuals impacted by human trafficking. The Department of Veterans Affairs (VA) Veterans Health Administration recognizes that human trafficking is a public safety concern and has intentionally increased awareness of human trafficking and how it relates to Veteran care. In 2020, the VA National Social Work Program Office, Care Management and Social Work launched a national Human Trafficking Tiger Team to understand the impact of human trafficking within the Veteran community. Methods Initial Human Trafficking Tiger Team efforts focused on qualitative reviews of existing VA health care services data to identify trends and themes. A series of three trainings for VA staff including Social Workers, Licensed Marriage and Family Therapists (LMFT), Licensed Professional Counselors (LPC), Psychologists (PsyD/PhD), Registered Nurses (RN), and Certified Rehabilitation Counselors (CRC) were completed. A pre and post-test was administered to assess VA staff’s knowledge about human trafficking and the impact on the Veteran community. Results Upon examination of qualitative review of evidence, formal study is needed to develop programming to address human trafficking in the Veteran community. Discussion Further study is needed to understand the prevalence of human trafficking among the Veteran population. While the VA’s human trafficking initiatives are integral initial steps, additional research remains necessary to identify treatment needs and services gaps. Conclusion Human Trafficking Tiger Team Knowledge Needs Assessment trainings revealed that VA staff had contact with survivors of human trafficking, suspected victims, as well as traffickers. 38% of staff acknowledged missed opportunities to assess and intervene with potential trafficking victims. This revealed a clear need for standardized screening, protocols, and implementing routine training to Veterans impacted by human trafficking.

Preliminary Establishment of the Dispositional Development Scale: Incorporating the Working Alliance in Professional Disposition Assessment

This article discusses the initial development of an instrument which was designed to aid educators in assessing professional dispositions in rehabilitation counselor education students, in accordance with the 2016 Council for Accreditation of Counseling and Related Educational Programs (CACREP) Standards. Furthermore, the development of the instrument was embedded with the concept of the working alliance (Bordin, 1979). The current study leads to the introduction of the Dispositional Development Scale (DDS), which was created using a two-phase approach, including content validation by Certified Rehabilitation Counselors (n = 148). The implications for using DDS in rehabilitation counselor education are significant and include a systematic, more transparent method of evaluating students' nonacademic competencies.

Empirically Derived Test Specifications for the Certified Rehabilitation Counselor Examination: Revisiting the Essential Competencies of Rehabilitation Counselors

The purpose of this article is to examine the results of the certified rehabilitation counselor (CRC) knowledge validation study conducted in collaboration with the Commission on Rehabilitation Counselor Certification (CRCC). The research design for the present study includes both descriptive and ex post facto approaches. Three hundred ninety-four CRCs completed the Knowledge Validation Inventory–Revised (KVI-R) survey. Factor analysis results revealed six knowledge domains: (a) rehabilitation and mental health counseling, (b) employer engagement and job placement, (c) case management, (d) medical and psychosocial aspects of chronic illness and disability, (e) research methodology and evidence-based practice, and (f) group and family counseling. The findings of this study provide important information for CRCC to examine and develop test and item specifications that will guide future versions of the CRC examination. The findings also inform the description of the knowledge base underlying the practice of rehabilitation counseling and contribute further empirical evidence regarding the knowledge domains identified in this replication and extension of the previous study completed in 2012.

Ethical Considerations for Working with Transition aged youth and Students with Disabilities Given the implications of WIOA

Purpose: For decades vocational rehabilitation counselors (VRC) have worked to serve transition aged students and youth with disabilities with the consideration of federal mandates such as the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990. With the implementation of the newly authorized Workforce Innovations and Opportunity Act (WIOA) VRC find themselves with greater responsibilities when working with transition aged youth. This article explores the relevant codes set forth in the Certified Rehabilitation Counselor (CRC) Code of Ethics that relate to the implementation of the WIOA as it applies to the provision of transition services. Implications for ethical obligations are presented as well as recommendations for best practice according to the CRC Code of Ethics.

Evaluating Student Performance and Qualifications in Rehabilitation Counseling

Purpose: To determine methods of student learning assessment and clinical training in rehabilitation counseling programs. With many shifts occurring in postsecondary education and in rehabilitation counseling, it is critical to understand these current practices.Method: The authors used an Internet-based survey design to solicit program approaches to student learning assessment and clinical training. Respondents (n = 34) provided description of assessments, perceived effectiveness, satisfaction, and brief comments on the strengths and weaknesses of the approaches employed by the program.Results: Programs reported various assessments used during and at the completion of the training program. Programs also reported varied frequency and intensity of involvement with clinical placement, although most seek certified rehabilitation counselors as supervisors along with other professionals.Conclusion: Strengthening assessment methods to be able to show that students possess the clinical skills and knowledge necessary to become effective counselors is a high priority for our field and will become increasingly necessary within the context of changing credentialing standards.

Rehabilitation Counselor Preparation to Work With LGBTQ Persons Living With Chronic Illness/Disability: A Qualitative Content Analysis

Purpose:To identify meaningful educative experiences that contributed to the development of rehabilitation counselors’ abilities to provide effective rehabilitation counseling services to lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons living with chronic illness/disabilities (CID).Method:This was a secondary analysis of a larger qualitative data set that examined the educational experiences and practices of 12 certified rehabilitation counselors working with LGBTQ persons.Results:Using a qualitative content analysis methodology, 5 categories were identified: (a) formal didactic education, (b) affirmative supervision and consultation during practica/internship, (c) extracurricular-related training, (d) identification, and (e) family of origin.Conclusion:To help facilitate future counselors’ self-perceived abilities to provide effective services to LGBTQ persons living with CID, rehabilitation counselor educators should place more emphasis on LGBTQ-related issues in their curriculum and provide practical (experiential) learning opportunities for their students.

Perceived Preparedness to Implement Evidence-Based Practice by Certified Rehabilitation Counselors: A Qualitative Content Analysis

The implementation of evidence-based practice (EBP) in rehabilitation counseling has the potential to improve the effectiveness of vocational rehabilitation (VR) services and employment outcomes of people with disabilities. The purpose of this content analysis was to explore certified rehabilitation counselors’ (CRCs) perceptions of the effectiveness of EBP and their preparedness to implement EBP in a variety of rehabilitation counseling settings. Three hundred fourteen CRCs responded to two open-ended questions related to their perceived effectiveness and preparedness to use EBP in VR service delivery practices. Results of this content analysis indicate that CRCs generally recognize the value of EBP and support its use in rehabilitation counseling. However, they identified major individual-level and organizational-level barriers that could hinder the implementation of EBP in the professional practice of rehabilitation counseling. Strong administrative support, adequate funding, time, and continuous training to update skills will be needed to fully implement EBP in rehabilitation counseling.

Certified Rehabilitation Counselors Role in the Acceptance of Disability of Returning Afghanistan and Iraq Military Veterans With Disabilities

Purpose:To understand the level of acceptance of disability by veterans and rehabilitation counselor’s role in that acceptance.Method:The Acceptance of Disability Scale-Revised was given to 117 veterans from the wars in Afghanistan and Iraq who acquired disabilities. Their experiences working with certified rehabilitation counselors was also examined.Results:Results indicate that veterans overall are at a lower acceptance of their disability than other groups. Veterans with the most severe disabilities and lower acceptance scores are more likely to seek assistance from certified rehabilitation counselors.Conclusion:Veterans with disabilities need to have early and proper interventions from qualified counselors to best transition into civilian life. Knowledge of the stages of disability and steps to acceptance by counselors can aid veterans navigating this process.

Application of the KVI-R to Assess Current Training Needs of Private Rehabilitation Counselors

The primary purpose of this mixed-methods study was to identify the current training needs of rehabilitation counselors in the private sector. Four hundred twenty-six participants completed the Knowledge Validation Inventory–Revised. The self-reported needs for training are reported across the 10 knowledge domains of rehabilitation counseling. The overall training needs (TN) score for the sample was moderate. For the broader knowledge domains, respondents reported the highest mean TN scores for Case Management and Utilization of Community Resources, Disability Management, Vocational Consultation, and Services for Employers. A secondary purpose was to compare the self-perceived training needs of rehabilitation counselors who are certified rehabilitation counselors (CRCs) with those of counselors who do not possess a CRC. Higher reported training needs were indicated for individuals without CRCs. A third purpose was to examine the relationship between counselor demographic variables and training needs. Gender and years of experiences were significant predictors of perceived training needs. Finally, the following areas were identified as the most significant training needs for private rehabilitation counselors in the field today: multicultural competence, private vocational rehabilitation, labor market research skills, ethics, and forensic case management.

A Model of Affirmative Intersectional Rehabilitation Counseling With Sexual Minorities

Sexual minority persons (i.e., lesbian, gay, bisexual, queer [LGBQ]) are at risk for developing chronic illness(es) and/or disabilities (CID); however, there is a dearth of information regarding the practices used by rehabilitation counselors working with this population. This modified grounded theory study aimed to understand the effective practices that rehabilitation counselors reported exhibiting when working with sexual minority persons living with CID. A total of 12 certified rehabilitation counselors were individually interviewed. Interviews were transcribed and recursively analyzed with a research team. Trustworthiness and credibility were ensured via in-depth member checking, researcher triangulation, and collection of rich descriptions from participants. A substantive model of rehabilitation counseling was constructed from the interviews, with Affirmative Intersectionality as the core category. Four supporting categories were also constructed, including professional attributes, alliance, intersectional sensitivity, and intersectional interventions. Details regarding the model are provided, as well as discussion on educational and supervision implications, study’s limitations, and future research implications.