Vocational Rehabilitation Consumers Research Articles

Customized employment for transition-age youth in state vocational rehabilitation program PY2017 - PY2020: Analysis of service outcomes and related factors

BACKGROUND: Customized employment (CE) is positively correlated with competitive integrated employment (CIE) outcomes and potentially supports transition-age youth in achieving sustainable employment. OBJECTIVE: This study examines the employment outcomes and related factors for transition-age youth with disabilities who received CE services through state vocational rehabilitation agencies (SVRAs) and their vendors from program year 2017 to 2020. METHODS: Employing a combination of descriptive analysis, binary logistic and multiple regression, chi-square tests, and t-tests, the study investigates the demographics, potential barriers, and vocational rehabilitation (VR) services received by the research sample using the RSA-911 dataset. RESULTS: The sample comprised 672 individuals with a mean age of 22.30 years. The most prevalent barrier to employment among CE participants was long-term unemployment, while Supplemental Security Income (SSI) was the most common social security benefit. Furthermore, only 13.2% of transition-age youth achieved CIE status, compared to 30.1% of adults. The key predictors of employment outcomes, including CIE status, weekly earnings, and working hours were identified. CONCLUSION: The research reveals significant differences in employment outcomes between transition-age youth and adult VR consumers. These insights emphasize the necessity for SVRAs to consider a range of factors, including demographics, potential employment barriers, and the effects of various VR services, to increase the CE service effectiveness for transition-age youth.

Unraveling the factors influencing engagement in vocational rehabilitation services among transition-age Hispanic youth: An exploratory study

BACKGROUND: Prior research has investigated the engagement process of vocational rehabilitation (VR) consumers yet limited understanding about transition-age Hispanic youth VR consumers remains. OBJECTIVE: This exploratory cross-sectional study evaluated the factors predicting VR engagement among transition-age Hispanic youth with disabilities who have received pre-employment transition services (pre-ETS). METHOD: Descriptive, bivariate correlation, and stepwise logistic regression analyses were conducted in this study. A total of four categories of independent variables (sociodemographic, contextual, theoretical, and pre-ETS related) were selected to investigate their relationship with VR engagement. RESULTS: Findings revealed that education level, living with family, perceived social support from friends, perceived stigma from others, VR counselors’ ability to speak Spanish, competence, vocational outcome expectancy, and number of pre-ETS received were among the significant predictors of VR engagement, with the final model explaining a total of 87.6% of the variance. CONCLUSION: Findings of this study can help inform practices and policies to bridge the gap surrounding the service delivery and utilization of VR services among transition-age Hispanic youth with disabilities.

Effective Vocational Rehabilitation Services for Transition-Aged Youth: Lessons From the Literature

Objective:The purpose of this study was to provide an overview of the current literature regarding the vocational rehabilitation services found effective in promoting employment among transition-age youth with disabilities as well as identifying factors affecting the effectiveness of those services.Methods:This study utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines to theoretically and methodologically ground the systematic review. Through a three-stage filtering process, 35 studies were identified that helped identify common and effective vocational rehabilitation services for transition-aged youth.Findings:Three major themes were observed in the review of literature: validated vocational rehabilitation services, vocational rehabilitation counselor factors, and demographic variables.Conclusions:Additional research is needed in the role of disability severity as a variable of successful service provision. Further identifying successful vocational services for varying levels of disability severity will provide vocational rehabilitation consumers with more individualized options and has the potential to increase positive case closure rates. Lastly, research indicated a need for continued training of VR counselors to ensure they are meeting the needs of their consumers.

The Impact of the Workforce Innovation and Opportunity Act on Agency-Level Vocational Rehabilitation Outcomes for Adults and Youth With Blindness and Low Vision

The purpose of this study was to evaluate the impact of the U.S. Workforce Innovation and Opportunity Act (WIOA) on outcomes (competitive employment rates and median earnings) for adult and youth vocational rehabilitation consumers with blindness or low vision (B/LV) and to determine whether impacts differed by agency type. We utilized RSA-911 data to create two agency-level longitudinal datasets, one for youth and one for adults, with 6-year pre-WIOA and 3-year post-WIOA periods. Data were analyzed using discontinuous growth modeling to assess longitudinal changes in agency-level outcomes through the inclusion of variables representing WIOA and subsequent change in response to WIOA. After WIOA, both youth and adult agency-level competitive employment rates decreased significantly for consumers with B/LV, with a larger impact on youth, and median earnings increased. Results document that the impact of WIOA on agencies varied widely. Separate agencies had a significant decrease in adult competitive employment rates for consumers with B/LV and a significant increase in median earnings compared with combined agencies. Overall, the influence of WIOA on B/LV consumer outcomes appears to be mixed at best, and the effect is surprisingly similar for youth and adults.

Persons With Disabilities in Self-Employment Served by the Federal/State Vocational Rehabilitation System: Differences Between 2011–2013 and 2017–2019

Persons with disabilities (PWDs) are disproportionately unemployed, underpaid, and underemployed despite their desire and capacity to work. The U.S. federal/state vocational rehabilitation (VR) program, under the supervision of the Rehabilitation Services Administration (RSA), is charged with providing services to assist eligible PWDs (VR consumers) in achieving employment. Despite research showing that VR consumers closed to self-employment (vs. non-self-employment closures) have better outcomes, self-employment is often considered as a last resort. Moreover, some evidence suggests self-employment (like non-self-employment) outcomes are associated with VR consumers’ gender and racial/ethnic identity. The objective of this study was to determine trends of case closures in self-employment among PWDs within the VR program from 2011–2013 to 2017–2019 and to examine the effects of gender and race/ethnicity on self-employment outcomes. Variables of interest were obtained from RSA’s Case Service Report (RSA-911) data set for 2011, 2012, 2013, 2017, 2018, and 2019. Data were recoded and analyzed. The number of closures in self-employment declined significantly. Weekly earnings in self-employment increased. Time from application to closure in self-employment decreased. Differences in VR self-employment outcomes by race/ethnicity and gender were noted. Efforts should be made to increase competency in self-employment of VR counselors and promote self-employment within the VR program.

What Predicts Job Quality of Vocational Rehabilitation Consumers Who Are Blind or Have Low Vision?

The U.S. Workforce Innovation and Opportunity Act emphasizes promoting high-quality, competitive employment for people served by vocational rehabilitation (VR), but few studies have assessed VR consumers’ job quality. The purpose of this study was to investigate job quality and factors that predict the job quality for VR consumers with blindness or low vision (B/LV), taking into consideration their employment status at application. We utilized RSA-911 data of VR consumers with B/LV who were closed in competitive employment during 2015, creating two separate hierarchical linear models to predict job quality for VR consumers (a) who were employed at application and (b) who were not employed at application. We investigated individual-level (consumer personal characteristics and VR services) and state/agency-level predictors. Job quality and some predictors of job quality differed by employment status at application, although the strongest predictors (education level at application, gender, benefit receipt at application, receipt of a bachelor’s or higher degree) were consistent across the models. While several additional individual-level variables were significantly associated with job quality, their effect sizes were very small. With the exception of advancing education to a bachelor’s degree or higher while receiving services, consumer characteristics at application were the primary determinants of their job quality.

Validation of the Perceived Empathic and Social Self-Efficacy Scale: A Brief Report

Perceived empathic and social self-efficacy are required to strengthen interpersonal relationships and receive social support, which are crucial for community participation, employment, and job retention of people with disabilities. This study investigated the factor structure and related psychometric properties of an instrument used to measure these two constructs among people with disabilities. Results confirmed the two-factor measurement structure, the Perceived Empathic Self-Efficacy and the Perceived Social Self-Efficacy factors. This scale can be used by rehabilitation professionals to assess vocational rehabilitation (VR) consumers’ perceived levels of empathic and social self-efficacy. It can also be used by researchers as an outcome measure to evaluate the effectiveness of social skills training interventions for VR consumers.

A conceptual framework to promote career development for vocational rehabilitation consumers with traumatic brain injuries.

The purpose of this article is to describe the Illinois Work and Well-being Model (ILW2M), a multi-domain framework for conceptualizing the employment development of people with traumatic brain injuries (TBIs). The model emphasizes the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A brief discussion of potential implications regarding vocational rehabilitation research and service is offered with the overall goal of reinforcing employment development as the foundation of vocational rehabilitation services for adults with TBIs.

Service factors and personal characteristics associated with employment and job quality for vocational rehabilitation consumers with combined traumatic brain injury and visual impairment

Service factors and personal characteristics associated with employment and job quality for vocational rehabilitation consumers with combined traumatic brain injury and visual impairment

Utilizing the ICF to Enable Evidence-Based Practice Among Vocational Rehabilitation Counselors

The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) provides an appropriate framework for conceptualizing cases within vocational rehabilitation (VR) programs. VR counselors can improve service delivery by using the framework and tools of the ICF, including the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), the ICF Checklist 2.1, and the ICF Core Sets. VR counselors can more readily begin the initial step of evidence-based practice (i.e., formulating well-defined, answerable questions) by using the ICF framework and its tools to identify and categorize common barriers and facilitators among VR consumers. The ICF framework and its tools are described in relation to their potential utilization in VR practice. In addition, specific case examples are given, describing how VR counselors can incorporate ICF perspectives and tools into their practice. The authors briefly describe training resources, future directions, and other considerations for the use of the ICF in VR settings.

Comorbid Traumatic Brain Injury and Visual Impairment: Vocational Rehabilitation Service Provision and Agency-Level Outcomes

Introduction: The purpose of this study was to investigate how services are provided to state–federal vocational rehabilitation consumers with comorbid traumatic brain injury (TBI) and visual impairment and the prevalence of and competitive employment rates for this population. Methods: We utilized a mixed-methods approach by incorporating interview data from 51 vocational rehabilitation agency administrators (to identify strategies used to serve these consumers) and case service data (to identify prevalence and competitive employment rates at the agency level). We combined the data to examine the relationship between strategies used and the prevalence of and employment outcomes for this population. A modified grounded theory approach was used for qualitative data analysis and descriptive statistics, and analyses of variance were used for quantitative data analyses. Results: Strategies used to serve these consumers included collaboration between counselors, involvement of external organizations, specialized TBI units or caseloads, staff training in TBI, and personnel with dual expertise in TBI and visual impairment. Over a third of agency administrators reported that they did not do anything special or different to serve this population. The average percentage of consumers with visual impairments who also had TBIs being served by agencies was 2.1%. Their average competitive employment rate by agency was 43.2%. Employing staff with dual expertise in TBI and visual impairment was associated with serving a greater percentage of consumers and having a higher competitive employment rate. Discussion: No agencies had a unique service delivery program or method to serve this population, perhaps due to its low prevalence. Agencies had substantial variability in the proportion of consumers with TBI and visual impairment served and their competitive employment rates. Implications for practitioners: Training vocational rehabilitation professionals to develop expertise in both TBIs and visual impairments may help agencies better serve these consumers.

Factors Related to Employment Outcomes for Vocational Rehabilitation Consumers with Visual Impairments: A Systematic Review

Introduction: The purpose of this article was to conduct a systematic review of peer-reviewed studies on factors related to employment in consumers who are visually impaired using Rehabilitation Services Administration (RSA-911) Case Service Report data. Methods: We used database, hand, and ancestral search strategies to systematically identify peer-reviewed studies published between 1990 and August 2018 where researchers used RSA-911 data to address the target question. All included articles were coded by two reviewers for study and participant characteristics, quality indicators, and outcomes. Results: Nine articles consisting of 14 analyses were included. Twelve analyses concerned employment outcomes; two concerned earnings. Researchers in most studies used large samples of 3,000 or more consumers and used multivariable analyses, most commonly multilevel logistic regression. Factors that consistently predicted lower employment across studies included presence of a secondary disability and legal blindness; higher education level consistently predicted higher employment, as did earnings and self-support at vocational rehabilitation application. Few analyses included state- or agency-level variables or specific vocational rehabilitation services. Discussion: These results indicate that certain groups of vocational rehabilitation consumers with visual impairments may be at greater risk of unsuccessful closures; researchers should examine specific strategies that may improve outcomes in these groups. These results also highlight the importance of education in securing employment among people with visual impairments. Researchers should examine state- and agency-level variables that may affect outcomes as well as the effects of specific services on outcomes. Additionally, researchers should analyze factors that may affect employment quality as well as employment outcomes. Implications for practitioners: Practitioners who are working with visually impaired people who do not have a postsecondary degree should encourage and assist their clients in obtaining one; practitioners may also wish to provide more targeted support for consumers from potentially high-risk subpopulations.

Validating a Model of Psychological Capital in Vocational Rehabilitation Consumers

Background:Psychological Capital (PsyCap) is a prominent, well-established model of psychosocial strengths in the organizational positive psychology literature. PsyCap is a higher order construct consisting of hope, optimism, resilience, and self-efficacy that has been identified as a powerful predictor of work-related outcomes, with strong potential for application in vocational rehabilitation (VR). However, PysCap has not yet been validated for individuals with disabilities in rehabilitation settings.Objective:The purpose of this study was to explore the relevance of PsyCap for individuals with disabilities in VR.Methods:Confirmatory Factor Analysis was used to validate the structural model of PsyCap in a sample of adults with disabilities who have received public VR services (N= 229).Findings:VR client data supported the hypothesized factor structure of PsyCap. In an initial exploration of the relationship between PsyCap and employment status, individuals who reported employment had a higher mean PsyCap score than those reporting unemployment.Conclusions:These results highlight the potential utility of PsyCap for VR consumers. Additional research is needed to explore this construct as it pertains to VR services.

Employment predictors and outcomes of U.S. state-federal vocational rehabilitation consumers with affective disorders: A CHAID analysis

BackgroundThis study examined the demographic and rehabilitation service variables affecting employment outcomes of people with affective disorders receiving services from U.S. state-federal vocational rehabilitation (VR) agencies. MethodsAn ex post facto design, using data mining as a statistical analysis strategy, was used to analyze the Rehabilitation Services Administration Case Service Report (RSA-911) for the fiscal year 2011. The sample included 44,960 customers with affective disorders who were closed either as successfully employed (Status 26) or not employed (Status 28) by their VR agency. The dependent variable is employment outcome. The predictor variables include a set of personal characteristic variables and rehabilitation service variables. ResultsThe chi-squared automatic interaction detector (CHAID) data mining analysis results indicated that job placement services, on-the-job supports, and job search assistance services were significant predictors of successful employment outcomes for individuals with affective disorders. LimitationsThe study used data from the RSA-911 database. Causality cannot be inferred due to the use of archival data. ConclusionsEmployment should be viewed as a viable treatment outcome for individuals with affective disorders. Rehabilitation professionals should advocate for their clients to receive VR services, including job placement services, on-the-job supports, and job search assistance services in order to maximize their employment and mental health outcomes.

VR Online in Rehabilitation Counseling Preparation: An Integrative Pilot Initiative

This collaboration involves VR Online research at Wright State (WSU) and the Vocational Rehabilitation Counseling (VRC) Long-term Training Project at University of Southern Maine (USM). The NIDILRR-funded VR Online research team developed and piloted online resources for vocational rehabilitation (VR) consumers and counselors using an online portal to meet consumers via videoconference. To address VRC shortages in state VRs and community rehabilitation providers, the Rehabilitation Services Administration (RSA) funded Northern New England VRC project which provides graduate education to VR employees in order to increase the number of qualified VRCs throughout the rural northeast. This article will examine a partnership of these two projects to provide training and technical assistance to VRC students during internships, which includes: use of tele-rehabilitation technology in delivering VR services; integration of video conference technology into rehabilitation counselor education (RCE) graduate level curriculum during internship; trainee supervision and preparation applying HIPPA compliant, webbased, video-conference technology; and assessing benefits and limitations using advanced technologies in internship experiences and process considerations to improve VR Online application in practice.

Employment Outcomes and Job Quality of Vocational Rehabilitation Consumers With Deaf-Blindness

The purpose of this study was to investigate employment outcomes for vocational rehabilitation (VR) consumers with deaf-blindness, a population that has received no attention in the literature. The sample was obtained from Rehabilitation Services Administration Case Service Report (RSA-911) data and included 1,382 consumers with deaf-blindness identified as their primary or secondary disability whose cases were closed during fiscal years 2013, 2014, and 2015. Independent variables consisted of consumer personal characteristics and VR service-related variables. Two measures of employment outcomes were used: obtainment of competitive employment and a composite measure of job quality. Overall, the results indicate that several VR service-related factors are associated with whether deaf-blind consumers obtain competitive employment, but consumers’ personal characteristics are much more important in determining job quality. Implications for improving employment outcomes for consumers who are deaf-blind include providing job-related services, supporting educational advancement, and providing counseling and guidance. Results also support the importance of accounting for employment status at application in RSA-911 analyses and the efficacy of service provision by separate agencies for the blind.

Predictors of employment outcomes for transition-age state-federal vocational rehabilitation consumers with attention-deficit/hyperactivity disorder

Predictors of employment outcomes for transition-age state-federal vocational rehabilitation consumers with attention-deficit/hyperactivity disorder

Toward a successful vocational rehabilitation in adults with disabilities: Does residential arrangement matter?

ABSTRACTThe objective of this study was to assess whether successful vocational rehabilitation (that is, obtaining employment) among people with disabilities was affected by residential arrangement. Five groups of residential placement were considered: individuals living in a private residence, community or group residential, correctional and rehabilitation facilities, nursing home/mental health facilities, and homeless/shelter/other type of residential arrangement. The study involved a total of 46,570 vocational rehabilitation consumers aged 18 to 65 at referral in a Midwestern state. Statistical modeling was performed using quasibinomial logistic regression. It was found that compared to individuals living in private residences, those in correctional or rehabilitation facilities were at increased odds of successful rehabilitation, whereas those living in homeless/shelter/other residential arrangement and those living in nursing homes/mental health facilities were in significantly decreased odds of being rehabilitated. Individuals living in community or group residential, however, had no statistical difference in vocational rehabilitation outcomes compared to individuals living in private residences. The implications for rehabilitation research and practice are discussed.

Personal, environmental, and service-delivery determinants of employment quality for state vocational rehabilitation consumers: A multilevel analysis

Personal, environmental, and service-delivery determinants of employment quality for state vocational rehabilitation consumers: A multilevel analysis

Factors associated with consumer engagement and satisfaction with the Vocational Rehabilitation program

BACKGROUND: The Vocational Rehabilitation (VR) system spends approximately $365 million annually to serve consumers who disengage from services and drop out of the program. OBJECTIVE: Better understanding of the factors leading to premature exit might help VR better organize and deliver services to increase engagement. METHODS: VR consumers provided four waves of longitudinal data at six month intervals about their VR experiences and satisfaction. Almost half of the respondents felt that progression through VR services was too slow. Overall satisfaction with services was associated with the pace of service delivery, rates of contact between the counselor and consumer, and satisfaction with the counselor. Of those exiting the VR program over the study horizon (n = 162), 35% left because they met their goals, 34% because they were dissatisfied with services, and 30% for personal reasons. CONCLUSION: This study sets the stage for further evaluation and model testing of VR practices to reduce premature exit. Practice modifications might include changes to the rates, timing and structure of contacts between counselors and consumers. Even a nominal increase in consumer engagement and retention could have significant outcomes for the VR system and consumers.