Vocational Issues Research Articles

The Prevocational and Early Employment Needs of Adolescents with Juvenile Idiopathic Arthritis: The Occupational Therapy Perspective

The purpose of the study was to explore the prevocational needs of adolescents with juvenile idiopathic arthritis (JIA) from the perspective of occupational therapists and to examine the role of occupational therapy in addressing these. A questionnaire was distributed to members of occupational therapy organisations (n = 494) to assess the perceived importance of addressing prevocational issues for adolescents with JIA and the respondents' knowledge, confidence and perceived role. The questionnaire was completed by 175 (35.4%) individuals. The results showed that although the occupational therapists felt that they were an appropriate profession to address the vocational needs of adolescents, they reported limited knowledge and confidence to do so. Significant unmet training needs were highlighted. This study echoes previous calls for vocational issues to be addressed within adolescent rheumatology and provides evidence that occupational therapy is well placed to coordinate this area of need.

Occupational Therapy and Vocational Rehabilitation: An Audit of an Outpatient Occupational Therapy Service

In response to an increase in requests for vocational interventions to an outpatient occupational therapy department, an audit was carried out over a 6-month period to determine the size and nature of this demand and the outcome of the service provided. The department provided rehabilitation principally to patients aged 16 to 65 years and, of 118 consecutive referrals, 76 (64%) included requests for work-related interventions. By the end of the audit period, 46 had returned to work, 21 were receiving ongoing vocational input and 9 had decided not to pursue employment. The value of addressing vocational issues within a general rehabilitation programme at an early stage after injury or illness is discussed.

Reflections on Reflections

The Major Contribution in the September issue of The Counseling Psychologist provides several points to consider as the field defines the profession and training models for the 21st century. Calls for returning, in part, to our roots in career and vocational issues as well as our presence in the schools and recommendations for increased focus on children and adolescents should enable the retention of, and perhaps the increase in, our relevance in colleges of education. This reaction adds to this list a continued focus on personal adjustment and crucial attention to marriage and family issues, areas that can augment our institutional fit. Interpretations of survey data on outcomes of training models and racial-ethnic representation in our programs are offered. Little evidence exists to indicate advantages in moving counseling psychology away from its exclusive adherence to a scientist-professional training model. Our contributions to broad educational goals can positively impact our movement toward diverse and representative program faculty.

Growing up and moving on in rheumatology: a multicentre cohort of adolescents with juvenile idiopathic arthritis

To define the transitional care workload of a multicentre cohort of adolescents with juvenile idiopathic arthritis (JIA) including disease, self-advocacy and vocational issues prior to the implementation of a transitional care programme. Data were collected using questionnaires completed by senior clinicians, patients and parents in 10 UK paediatric rheumatology centres. Entry criteria for patients included a confirmed diagnosis of JIA for at least 6 months and an age of 11, 14 or 17 yr. Of 359 families invited to participate, 308 (85.79%) adolescents with JIA and 303 parents/guardians accepted. Of these, 19.5% had persistent oligoarthritis. Despite their imminent transfer to adult care, ongoing transitional issues were identified in the 17-yr-old cohort: 55.8% were still seeing the rheumatologists with their parent, 20% were not self-medicating, 68.5% had not had intra-articular injections under local anaesthetic and 14% had received no careers counselling. This age group also had significant disease-related issues; 54.6% had moderate to severe functional disability, 67.5% were still on disease-modifying anti-rheumatic drugs and, as a group, they had significantly greater pain than younger patients. This study has objectively identified the transitional care workload facing paediatric and adult rheumatologists in terms of disease-related, self-advocacy and vocational issues. Outcome data following the implementation of a coordinated transitional care programme are awaited.

The Impact of Criminal Convictions on Calculations of Lost Earnings in Personal Injury and Wrongful Death: Issues for Forensic Economics and Vocational Assessment

Abstract No abstract available.

Back to work: Vocational issues and strategies for Canadians living with HIV/AIDS

Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Canadian health care and social services systems. However, researchers have given limited attention to issues of entry or re-entry to the competitive job market for HIV positive individuals. The emergence of highly active antiretroviral therapies (HAART) has allowed a significant number of persons who are HIV positive to experience a major recovery in health and energy. This increase in physical health has in turn led to a re-examination of the possibility of returning to former types and levels of activity, including the prospect of going back to work or entering the competitive workforce for the first time. The purpose of this paper is to outline some of the issues and concerns that impact HIV positive individuals' attempts to return to or enter the competitive workforce, particularly those relating to disability policies and public insurance. Data from in-depth interviews with a sample of people living with HIV/AIDS (PHAs) are used to help illustrate the disconnect between these policies and the lived experiences of PHAs. Also discussed are the opportunities for Canadian policies and practices to employ a functional definition of disability and a philosophy of early intervention in vocational rehabilitation.

Two Decades of Research on the Problem Solving Inventory

Heppner, Witty, and Dixon's review of 2 decades of research on the Problem Solving Inventory (PSI) provides highlights of more than 120 studies relating problem-solving appraisal to psychological adjustment, physical health, coping, and educational and vocational issues. Although clearly an impressive body of literature, the level of data reported is uneven with attention to effect sizes (e.g., correlations) and sample descriptors (e.g., race/ethnicity, n size, gender). Acknowledging the importance of the PSI and this major review, we provide commentary on the need for a meta-analysis and the continual expansion of research on the PSI with respect to diversity issues (i.e., race/ethnicity, gender).

Problem-Solving Appraisal and Human Adjustment

This article reviews and synthesizes more than 120 studies from 20 years (1982-2002) of research that has examined problem-solving appraisal as measured by the Problem Solving Inventory (PSI). The goals of the article are fourfold: (a) introduce the construct of problem-solving appraisal and the PSI within the applied problem-solving literature, (b) summarize and integrate existing findings using the PSI within and across four major content areas (psychological adjustment, physical health, coping, and educational and vocational issues), (c) identify promising research directions that might stimulate future research and promote theory development, and (d) identify implications for practitioners in the helping professions. We conclude that problem-solving appraisal as measured by the PSI is a useful psychological construct with implications for theory and many applications to build on peoples' strengths to enhance their life satisfaction and well-being.

An Appraisal of the Adult and Non-Formal Vocational Education Programmes in Kano: Implications for Northern Nigeria

This paper examines vocational adult education concepts, issues and problems in the context of Kano State, Nigeria. It has been pointed out by a number of commentators that vocational education practices and problems have some relatively universal commonalities across Europe, the USA and developing countries such as Nigeria. State-sponsored vocational adult education programmes in Kano State, Nigeria can open up opportunities for the current generation of local skilled technicians who can consequently earn more and contribute to the overall effort towards poverty reduction in society. Similar trends in the values, prospects and difficulties faced in Kano's vocational adult education programmes are found in the other 18 northern states of Nigeria. Therefore, the possible solutions recommended for Kano can have wider implications and relevance for all the northern states of Nigeria.

A Rehabilitation Perspective on HIV Disease and AIDS Among Minority Women

Women with HIV/AIOS have specific needs that require specialized approaches to address the effects of this disease on them. Minority women with HIV/AIOS, however, have to deal with the triple challenge of race, class, and gender in addition to HIV/AIOS. The paper examines two groups of minority women, African American and Hispanic women, and discusses factors that place these women at high risk for HIV/AIOS. The interaction of race, class, and gender, and how it relates to the prevalence of high rates of HIV/AIOS in minority women is explored. Medical, economic and vocational issues of minority women living with this disease are discussed, and suggestions for rehabilitation of theses women are made.

The Making of a Modern City: Philanthropy, Civic Culture, and the Baltimore YMCA

Pulling together the threads of philanthropy, religion, race, and the lives of working single men in Baltimore, Jessica Elfenbein examines the powerful role of voluntary organizations in shaping modern America.--Darwin H. Stapleton, Rockefeller Archive CenterA useful study . . . containing a great deal of important material on the Baltimore YMCA, its founders, the work it did for 80 years, and the benefits of that work for the community.--Barry D. Karl, Harvard UniversityThis compelling story of a city and one of its key institutions affords a revealing perspective on urban modernity in the making. It challenges some of today's prevailing views on the nature and relations of America's religious institutions, as well as its public and nonprofit sectors, especially in light of recent initiatives to integrate religious groups into federally funded welfare programs. Combining urban and social history, this study of the Baltimore YMCA explores the relationships among religion, government, business, and nonprofit organizations in the development of an important industrial American city and reveals how race, masculinity, ethnicity, private institutions, and religious sensibility have influenced modern American culture. From the 1850s to the 1930s, the Baltimore YMCA helped to shape a modern city and its approach to social welfare. Motivated by religious faith, civic need, and community service, its leaders set out to address the domestic, educational, recreational, and vocational issues most critical to the well-being of their targeted audience--young Christian men of (or aspiring to) the middle class. The YMCA leadership, black and white, identified and worked to correct community-wide problems in such areas as education, housing, and poverty. Fueled by its ties to Johns Hopkins University, the Baltimore YMCA was an important incubator of people and ideas that shaped charitable activity in the United States in the late 19th and early 20th centuries. Levering Hall, the campus YMCA at Hopkins, in partnership with the Charity Organization Society, nurtured the careers of men like John R. Commons, Richard T. Ely, and the Flexner brothers, greatly influencing the landscape of modern philanthropy and social welfare. Jessica I. Elfenbein is the director of the Center for Baltimore Studies and assistant professor of history at the University of Baltimore. She is the author of Civics, Commerce, and Community: The History of the Greater Washington Board of Trade, 1889-1999, and of a forthcoming study of the role of faith-based organizations in national urban revitalization efforts.

Vocationally Orientated Rehabilitation Service Requests: The Case of Employed Persons Experiencing a Spinal Cord Injury

Traumatic spinal cord injury (SCI) has a dramatic effect on the lives of those affected. As those injured are typically relatively young adults, the interruption to careers and vocational plans is often significant. While return to work following SCI has been well investigated, little is known about the process by which people regain employment post-injury. This investigation aimed to study participants' perceptions regarding the adequacy of the vocational rehabilitation services they received. Data was collected through personal interview with 168 persons with a SCI who were employed at the time of their injury. Participants were asked if they believed they could have been assisted by additional services provided with the aim of facilitating their return-to-work attempts. More than half of the participants believed they would have benefited from additional services. The most commonly requested additional services were: more discussion of vocational options and alternatives, and the timely follow-up of vocational issues. Analysis of subgroup differences indicated that rural-based study participants had clear and precise ideas for how vocational rehabilitation services might be improved.

The Soul of Work

Working from a paradigm that considers work issues as either central or contextual requires a shift in the way many counseling psychologists think about the world. Perhaps the easiest time to implement such a paradigm is while students are in training, when they are confronted daily with new ways to think of the world. The purpose of this article is to examine how the use of case studies during training can serve to locate vocational psychology within counseling psychology, with one result being the enhancement of trainees’ ability and willingness to consider the whole person (when vocational issues are primary) and to consider work as a major contextual issue (when it is not the presenting concern). To accomplish this goal, the authors’ approach is threefold: (a) to offer support for the use of case studies in teaching,(b) to provide a brief discussion of reasons that students struggle with the location of vocational psychology within counseling psychology and how the use of case studies helps address this struggle, and (c) to describe specific ways to integrate cases into courses (vocational as well as nonvocational), including ethical issues in handling cases.

The Reintegration of Vocational Psychology and Counseling Psychology

In the past 20 years, there have been numerous calls for a reinvigoration of vocational psychology. Now, as vocational psychology has grown again within counseling psychology, the authors argue that what is needed is not a reinvigoration but rather a new paradigm that reintegrates vocational psychology and the rest of counseling psychology. The new paradigm conceptualizes vocational issues as an integral part of theory, research, practice, and teaching of counseling psychology. Vocational issues should not over shadow other issues but should be an integrated part of what counseling psychologists do. The articles in this major contribution take steps toward this new paradigm by addressing teaching issues in counseling psychology training programs. If the new paradigm is to be adopted by all counseling psychologists, they must begin in their training programs. These articles give suggestions for how to begin the paradigm shift in this setting, discussing implications for the science and practice of counseling psychology beyond the training programs.

Laryngectomy: beyond loss of voice--caring for the patient as a whole.

For patients with laryngeal cancer, rehabilitation following laryngectomy may be difficult. However, significant variability in coping skills and adaptation of this patient population exists. Healthcare providers commonly perceive disfigurement, alteration in function (i.e., loss of natural voice), and disease control as the most relevant issues in the postoperative period, yet patients and their families may not share these same priorities. Management of physical symptoms, social reintegration, participation in enjoyed activities, and vocational issues following laryngectomy may present significant barriers to achieving optimal quality of life. Comprehensive preoperative counseling that includes patients and their caregivers is an important aspect of preparation for surgery. This review examines dimensions of adaptation, rehabilitation, and quality of life following laryngectomy.

Unemployment rates among patients with long-term mental health problems

Aims and MethodTo examine the vocational status of people with longer-term mental health problems in the inner London Borough of Wandsworth. Data collected over 10 years on 1 April each year as part of an annual census of adults with longer-term mental health problems using community mental health and rehabilitation teams were analysed to examine the vocational status of these groups.ResultsWithin the borough unemployment rates among people with longer-term mental health problems increased steadily during the 1990s, despite a decreasing rate of general unemployment for the majority of that period. Unemployment among people with long-term mental health problems increased from 80% in 1990 to 92% in 1999, and the unemployment rates among those with a diagnosis of schizophrenia increased from 88% in 1990 to 96% in 1999.Clinical ImplicationsWork and employment is important in health as well as social functioning. Greater attention to vocational issues in clinical teams is required: the challenge for mental health services is to make employment interventions of demonstrated effectiveness available to all who need them.

Case management guideline: Alzheimer disease and other dementias.

Case management guidelines are an integration of information obtained from research, observations, clinical experience, and judgments of expert clinicians, scientists, and clients. This guideline integrates information from multiple practice guidelines in order to guide the case manager in managing clients with Alzheimer disease and other dementias. The guideline provides direction in recognition of symptoms or triggers, risk factors, possible complications, case management outcomes, barriers to effective outcomes, goals, providers/practitioners, treatment options, location of treatment, estimated cost of treatment, psychosocial issues, life planning and long-term planning, vocational issues and teaching protocols. In addition, resource contacts and sources for major instruments used in measuring Alzheimer disease and dementia are presented.

Relationship between illness, rehabilitation and work (ZERA)--an training program for medical-vocational rehabilitation of the mentally ill

A training programme for rehabilitation of people with mental illness is presented, designed particularly for schizophrenic patients who need occupational rehabilitation. The training goal is to connect aspects of the schizophrenic disorder with vocational issues. It is aimed at supporting the participants in developing a realistic and appropriate vocational perspective in line with their illness related restrictions and current vocational possibilities, seeking to find out the individual's optimal ability to take stress so as to avoid over- or understimulation in vocational respects. The ZERA training has been developed for implementation in different medical and vocational rehabilitation settings for persons with mental illness. An initial control-group study was carried out to evaluate the effectiveness of this group training approach, and preliminary results have revealed changes in the experimental group in accordance with the objectives of the training and encourage further research.

Challenging barriers to employment, training and education for mental health service users: The service user's perspective

In 1999 the 'Care Programme to Work' project at the Institute for Applied Health and Social Policy undertook a survey of service users in Sheffield. The aim was to identify users' employment, education and training needs, as they perceived them. One hundred and fifty-six interviews were carried out across the city, followed by 11 focus groups to explore vocational issues in more detail and ensure that the views of groups under-represented in the interviews were included. Service users were employed as interviewers and focus group leaders. Open employment was the most frequently identified long-term goal. The study highlighted the need for an integrated approach to vocational guidance and support; for strong links with employment and educational agencies and with projects supporting diverse groups of users; for access to impartial benefits advice; and for mental health services themselves to take a lead in providing and promoting employment opportunities.

A Rehabilitation Counselor Education Program with a Specialization in Vocational Rehabilitation of People with Severe Mental Illness

Because of the need for specific training in the vocational rehabilitation of, people with mental illness, the Rehabilitation Counselor Education Program of the Institute of Psychology at the Illinois Institute of Technology designed and implemented a specialization program in Psychiatric Rehabilitation. A three class track was. developed covering introduction to psychiatric rehabilitation, vocational issues, and use of groups in treatment. Each full time student also participates In a two semester internship at one community agency. The classes and internship are taken as a specialization Within the current 60 credit hour M.S. in Rehabilitation Counseling. In addition, professionals already working full time In the field may take the three courses and earn a certificate.