Vocational Rehabilitation Professionals Research Articles

Predicting competitive integrated employment outcomes of Asian American vocational rehabilitation Clients: A national study

AbstractPurposeThe current study investigated the relationships between demographic variables, cash benefits, vocational rehabilitation (VR) services, and employment outcomes of Asian Americans VR clients.MethodsThe data were extracted from the most recent Rehabilitation Service Administration database (RSA‐911). Among 17,278 case services records, 5784 clients met the inclusion criteria. Chi‐square automatic interaction detector and logistic regression analyses were employed to investigate the employment outcomes.ResultsThe results indicated that Asian American clients who have completed a bachelor's degree or more do not receive disability‐related benefits, and those who received more VR services were more likely to achieve competitive integrated employment (CIE). In addition, VR counseling and job placement services were significant predictors of employment outcomes.ConclusionsThese findings provide valuable insights into the factors influencing CIE among Asian American VR clients with disabilities. The results further underscore the importance of VR professionals possessing cultural competence to effectively serve a diverse clientele.

Social representations of gender and their influence in Supported Employment: employment specialists’ experiences in Sweden

Purpose Gender differences have been found in the outcomes of vocational rehabilitation (VR) and in Supported Employment (SE), therefore, the purpose of this study was to explore employment specialists’ (ES) social representations of gender in relation to work and VR and how these social representations influence the ES’s work in the VR process according to SE. Methods The qualitative method of focus group discussions was employed. Ten focus groups were held with 39 ESs from four categories of SE organizations in Sweden. Topic analysis was applied to the transcribed material from the focus groups. Results Five themes with different social representations about gender and disability in relation to VR and working life formed in the analysis: (1) differences in personal and health factors among VR-participants, (2) gender norms in society influencing VR, (3) energy-intensive environmental issues influencing VR, (4) gender-specific interactions in VR, and (5) gendered paths in the welfare system. Conclusion Social representations of higher strains on women with disabilities compared to men with disabilities both in private and working life, which reflect the lived experiences of the ESs, is a possible explanation for gender differences in VR and working life for persons with disabilities. IMPLICATIONS FOR REHABILITATION Gender differences in the outcomes of vocational rehabilitation (VR) interventions have been noticed worldwide. In this study, pervasive social representations about gender and disability in relation to VR were found, but also unconsciousness about gender among VR professionals. Therefore, awareness of gender is necessary in VR. Individualized and person-centered approaches to VR like Supported Employment, although considered best practice, might hide structures like gender, which could lead to reproducing discriminating processes and therefore not achieving gender equality in VR. Therefore, knowledge of discrimination is important in VR. Gender-sensitivity in vocational rehabilitation models with a person-centered and individualized approach is needed and there might also be a need to systematically tailor vocational rehabilitation models to reach gender equality in the outcomes of the interventions. Therefore, gender equality indicators are needed for VR models, to evaluate model effectiveness from a gender perspective.

Facilitating self-employment as a competitive integrated employment outcome: Results of a focus group study with vocational rehabilitation professionals

BACKGROUND: Self-employment is defined in the Workforce Innovation and Opportunity Act of 2014 as a competitive integrated employment (CIE) outcome. However, an analysis of the Rehabilitation Services Administration Case Service Report (RSA-911) reveals that a limited number of people with disabilities receiving vocational rehabilitation services exit the State Vocational Rehabilitation Agencies with a self-employment outcome. OBJECTIVE: The purpose of this study was to identify the factors that Vocational Rehabilitation (VR) professionals report as facilitators of self-employment outcomes for people with disabilities. METHOD: A national sample of VR professionals was recruited to participate in a series of focus groups. Using Zoom Meeting, participants discussed their experiences with self-employment when providing services to people with disabilities. The research team used NVivo12 software to conduct primary data analysis of the transcribed focus group sessions with the consent of the participants. RESULTS: Four major themes emerged from the analysis to include 1) resources, 2) practices, 3) experiences, and 4) attitudes. Each of these major themes contained subthemes related to facilitators of self-employment for people with disabilities. CONCLUSION: A key finding was the need for more comprehensive and individualized training and support for VR counselors. Implications for future research, policy, and practice are discussed.

Trauma-Responsive Vocational Rehabilitation Services

Research on the effectiveness of Vocational Rehabilitation (VR) Programs has revealed that VR services are less effective for trauma-affected and Black consumers. For instance, consumers with trauma exposure disengage from services earlier than their non-traumatized counterparts, and Black consumers benefit less from each phase of VR services compared to others. One midwestern state’s VR program sought to address these disparities by offering trauma-informed and trauma-responsive services that emphasize cultural responsiveness, racial equity, and strengths-based practices. To begin this work, the state’s VR program collaborated with an applied research unit in a public university to establish two work groups: a communications group and a training group. The purpose of the communications group was to build a robust referral network within the VR Division and with other community-based agencies and providers, particularly for low-income, Black consumers. The purpose of the training group was to develop and deliver a training program to support VR professionals in providing trauma-informed and trauma-responsive services. Results from an evaluation of the training indicated that each training module generated for staff both reminders and new insights into ways to effectively work with consumers. Staff expressed that they wanted opportunities to further explore and apply the training content and needed additional, ongoing support to implement what they were learning. In response to staff needs, the state’s VR program is continuing to invest in this community–university partnership by establishing communities of practice for staff and evaluating the effectiveness of the training program.

Business Engagement Strategies for Vocational Rehabilitation Professionals: A Scoping Review

The purpose of this scoping review was to identify research-based resources that explore vocational rehabilitation-related business engagement strategies as they relate to three steps: (a) understanding business needs, (b) marketing to businesses, and (c) supporting businesses. In doing so, this review begins to identify strategies that may support vocational rehabilitation agencies and their compliance with the business engagement requirements mandated by the Workforce Innovation and Opportunity Act. The search of several databases and gray literature identified 153 resources with titles and abstracts that met screening criteria, 54 of which met the inclusion criteria after a review of the full text. Because the purpose of a scoping review is to describe the landscape of available literature on a given topic, this review did not vet studies for quality, nor did it exclude studies of interventions that did not lead to successful business engagement outcomes. Given its goal of identifying broadly relevant information available, the review included resources from non–peer-reviewed, practitioner-oriented sources.

A Decision Aid to Support Vocational Rehabilitation Professionals Offering Tailored Care to Benefit Recipients with a Long-Term Work Disability: A Feasibility Study

PurposeThis feasibility study focusses on the implementation and use of a decision aid, which supports vocational rehabilitation (VR) professionals in helping clients with a disability pension return to work in practice. The decision aid shows an overview of the clients’ return to work barriers and suggests suitable VR interventions based on these barriers.MethodsThe study population consisted of VR professionals working at the Dutch Social Security Institute and their clients receiving a (partial) work disability pension. The feasibility was measured with concepts of the Linnan and Steckler framework and the attitude, social norm and self-efficacy model. Data were collected using questionnaires, checklists and qualitative interviews.ResultsTen professionals participated in this study. Fifty-four clients were asked to fill in the questionnaire of the decision aid and 32 clients received VR care based on the decision aid. In general, VR professionals and clients were satisfied with the decision aid and perceived a few barriers for using the decision aid.ConclusionsThis study showed that it is feasible to implement and use the decision aid. To improve the implementation of this decision aid, it should be implemented in digital systems used by professionals to improve efficiency of working with the decision aid.

Effective Teams in Vocational Rehabilitation: An Exploration of Complexities and Practice in Aotearoa-New Zealand.

Vocational rehabilitation (VR) involves complex skills, and often inter-disciplinary teams need to work effectively to meet the needs of stakeholders. Research highlights important influences on effective teamwork, including funding systems, team structure, policies and procedures, and effects of professional hierarchies. This qualitative study aimed to explore these issues in-depth including how factors interact to produce problems and solutions. We focused on identifying challenges and opportunities for VR teams working in the Aotearoa-New Zealand context which may also be transferrable to other settings. Qualitative descriptive instrumental case study involving focus groups and interviews with two VR teams (n = 14). Teams worked in musculoskeletal injury and were geographically diverse. Reflexive thematic analysis was used to analyse the data. Analysis constructed three overarching themes: Having the Power, Being Human, and VR is Not for Everyone. Achieving trusting relationships within the team was paramount. This was achieved through seeing everyone as equal, and as human. Equality within the team was particularly important for professionals that occupied different positions of power in a wider professional hierarchy. VR specialist skills (experience and postgraduate qualifications) were often under-recognised, leading them to have little power in VR decision making processes. VR professionals also experienced competing demands between client needs and business drivers. Findings offer detail of processes teams engage in to create effective team relationships and manage systemic factors to facilitate positive outcomes. Additionally, findings highlight opportunities in decision-making processes for VR medical certification that may increase job satisfaction and better utilize skills and expertise.

Vocational rehabilitation service delivery: Technical assistance needs of vocational rehabilitation professionals

BACKGROUND: Americans with disabilities have historically faced substantial barriers to employment participation. The state-federal vocational rehabilitation (VR) program has played an important role in increasing the employment opportunities of Americans with disabilities through the provision of services and supports designed to lead to high-quality employment, independence, self-sufficiency, and full integration into the community. OBJECTIVE: The Vocational Rehabilitation Technical Assistance Center for Quality Employment (VRTAC–QE) was designed to bring together the broad range of existing quality employment strategies and supporting practices, identify and implement new ones, and incorporate them into an integrated training and technical assistance plan, consistent with the circumstances and priorities of each State VR agency that requests technical assistance. METHOD: In the present paper, we present the results of a needs assessment survey conducted among State VR rehabilitation counselors and professionals in cooperating rehabilitation agencies and services. RESULTS: The purpose of the present study was to determine technical assistance and training needs of State VR counselors in four practice domains: (a) outreach services, (b) pre-employment transition services, (c) vocational rehabilitation services, and (d) employment services. CONCLUSION: Implications and future directions are also discussed.

The Impact of COVID-19 on Persons With Disabilities: A Systematic Review of Literature

The first case of COVID-19 was reported in the United States in January 2020. To date, the U.S. reports more than 87 million confirmed cases and more than 1 million related deaths. In the U.S., published research suggests that COVID-19 transmission and prevention practices presented challenges for people with disabilities regarding job status and access to services. To explore the impact of COVID-19 on employment and service provision for persons with disabilities (PWD), the authors performed a systematic review of published quantitative and qualitative studies conducted in the U.S. from January 2020 through December 2021. From the 19 identified studies, findings were grouped into three themes: employment, quality of life, and coping. The impact of COVID-19 and other adverse events (e.g., global pandemic, supply chain issues, financial recession, hurricanes, flooding, wildfires) on the provision of vocational rehabilitation services and employment outcomes for persons with disabilities should be further explored. Based on review findings, the COVID-19 Lived Experiences Scale for Persons with Disabilities (CLES-PWD) was created to understand the experiences of PWD in terms of their employment, quality of life, and coping. The CLES-PWD can serve as a tool for vocational rehabilitation professionals when providing employment planning to enhance employment outcomes.

Using Research-Based Strategies to Improve Job-Related Social and Communication Skills Among Adults With Autism Spectrum Disorder: A Scoping Review

The purpose of this scoping review was to identify intervention and non-intervention research-based resources that had been applied in vocational rehabilitation (VR) settings, or in collaboration with VR practitioners, to improve job-related social communication skills among adults with autism spectrum disorder (ASD). The search of seven databases, the gray literature, and recommendations from experts identified 290 resources, of which 42 met the review’s inclusion criteria. Since the purpose of a scoping review is to describe the landscape of available literature on a given topic, this review did not vet studies for quality nor exclude studies of interventions that did not lead to successful employment outcomes. Given its goal of identifying broadly relevant information available, the review included systematic reviews and resources from non-peer-reviewed, practitioner-oriented sources. The team developed four topical themes to categorize the publications: On-the-job social skills development, interviewing skills, self-advocacy, and compensatory strategies. Vocational rehabilitation professionals and other service practitioners may find elements of the research summarized here useful in their efforts to increase successful employment outcomes for individuals diagnosed with ASD.

Structural relationships among predictors of employer attitudes toward blind employees

BACKGROUND: Negative employer attitudes are a primary factor associated with low employment rates and high unemployment rates of people with blindness and low vision (B/LV). Research has identified correlates of employer attitudes, but no investigations of the structural relationships between variables have been published. OBJECTIVE: The purpose of this study was to extend the current research regarding employer attitudes toward people with B/LV by assessing the structural relationship between variables associated with employer attitudes. METHODS: Participants were 387 hiring managers employed by organizations across the country who completed an online survey. We utilized structural equation modeling to confirm our measurement model and evaluate structural models of predicted relationships between variables. RESULTS: Five variables significantly predicted employer attitudes: awareness of people with disabilities at the worksite, knowledge, inaccurate belief in knowledge, previous hiring of someone with B/LV, and having a personal relationship with someone with B/LV. Previous communication with vocational rehabilitation (VR), having a company policy about hiring people with disabilities, and personal relationship predicted having hired someone with B/LV. CONCLUSIONS: Findings support the value of VR professionals providing education about how people with B/LV perform work tasks while communicating with employers and providing trial work experiences to encourage hiring.

Return to work factors and vocational rehabilitation interventions for long-term, partially disabled workers: a modified Delphi study among vocational rehabilitation professionals

BackgroundLong-term disability has a great impact on both society and workers with disabilities. Little is known about the barriers which prohibit workers with long-term disabilities from returning to work and which interventions are best suited to counteract these barriers. The main purpose of this study was to obtain consensus among professionals on important return to work (RTW) factors and effective vocational rehabilitation (VR) interventions for long-term (> 2 years), partially disabled workers. Our three research questions were: (1) which factors are associated with RTW for long-term disabled workers?; (2) which factors associated with RTW can be targeted by VR interventions?; and (3) which VR interventions are the most effective to target these factors?MethodsA modified Delphi Study was conducted using a panel of 22 labour experts, caseworkers, and insurance physicians. The study consisted of several rounds of questionnaires and one online meeting.ResultsThe multidisciplinary panel reached consensus that 58 out of 67 factors were important for RTW and that 35 of these factors could be targeted using VR interventions. In five rounds, the expert panel reached consensus that 11 out of 22 VR interventions were effective for at least one of the eight most important RTW factors.ConclusionsConsensus was reached among the expert panel that many factors that are important for the RTW of short-term disabled workers are also important for the RTW of long-term partially disabled workers and that a substantial number of these factors could effectively be targeted using VR interventions. The results of this study will be used to develop a decision aid that supports vocational rehabilitation professionals in profiling clients and in choosing suitable VR interventions.

Changing Employers’ Implicit Attitudes About the Competence of People Who Are Blind

Introduction: Long-held societal beliefs about the incompetence and dependence of people who are blind are thought to contribute to their low employment rates. This experimental study examined the impact of a meeting between a vocational rehabilitation (VR) professional and a hiring manager on these beliefs, or implicit attitudes, about the competence of people who are blind. Method: Participants were 57 hiring managers working for a financial services company in the southern United States who participated in a one-hour meeting with a VR professional. Two VR professionals, one sighted and one blind, conducted the meetings, utilizing one of two approaches, resulting in a 4 (group) × 3 (time) experimental design. Implicit attitudes were measured with the Implicit Association Test-Blind & Visually Impaired (IAT-BVI) at pre-test, post-test, and a 4-month follow-up and data were analyzed using repeated-measures ANOVA. Results: IAT-BVI scores decreased significantly following the meeting, though the size of the change was small. Type of approach and the interaction between approach and the VR professional’s vision status were not significantly associated with IAT-BVI change. Although vision status was not significantly associated with IAT-BVI change, follow-up analyses documented that participants who met with the blind VR professional had a significant decrease in IAT-BVI scores. Discussion: Hiring managers’ implicit attitudes significantly improved following a meeting with a VR professional, providing evidence that a brief interaction can decrease employers’ implicit bias regarding the competence of blind people. In addition, hiring managers who met with the blind VR professional showed significant improvement in their implicit attitudes after the meeting, with a medium-to-large effect. Implications for Practice: VR professionals should communicate with employers as much as possible about the work capabilities of individuals who are blind to help improve their implicit attitudes, and be aware that incorporating exposure to a competent blind person may result in a greater impact.

Workforce Participation as a Differential Indicator of Satisfaction With the Employment Situation Among Latinx With Multiple Sclerosis: Implications for Vocational Rehabilitation Professionals in the COVID-19 Era

PurposeThis study aimed at examining differences in satisfaction with the employment situation between employed and unemployed Latinx with multiple sclerosis (MS) in the United States (N = 148).MethodParticipants in this study responded to a national survey of the employment and community living concerns of people with MS. Multivariate analysis of variance and a follow-up univariate analysis of variance were conducted to compare the group differences.ResultsThe analyses revealed statistically significant between-group differences in satisfaction ratings on items pertaining to personal and environmental resources and fair treatment, but no significant between-group differences in response to items related to legal rights.ConclusionThe findings in this study confirmed our a priori expectation that satisfaction ratings regarding the overall employment situation among Latinx Americans with MS would vary as a function of their workforce participation status. Implications for future research and clinical practice in vocational rehabilitation in the COVID-19 era are discussed.

Examining barriers and strategies for effective professional or interagency collaboration in secondary transition

BACKGROUND: For young adults with disabilities, post-high school outcomes in employment, higher education, and independent living are markedly worse than for peers without disabilities. As a result, legislation and research aimed at supporting transitioning students with disabilities has increased. Further, numerous initiatives that better support youth and families have been implemented at the state and local level. Collaboration within and across service delivery systems has been identified as a critical aspect of transition planning and supports; however, evidence-based research related to the implementation and effects of collaborative partnerships is limited. OBJECTIVE: In the current study, we identify transition professionals’ perceptions of collaborative factors that facilitate and inhibit collaboration. METHOD: This study utilizes a single-state survey research design to examine the viewpoints of people in transition professions, specifically educators, Vocational Rehabilitation professionals, and community supports providers. RESULTS: Variances in perceptions were found among participant role groups. Specifically, educators as a whole report that time and workload barriers affect their ability to collaborate effectively. Further, findings indicate that ensuring individual collaborative team member responsibility is perceived as an effective strategy. CONCLUSIONS: These findings may be applied to technical assistance providers when developing team-level evaluations to monitor current levels and support needs of collaborative transition planning teams.

Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury

Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.

Vocational Rehabilitation Professionals’ Perceptions of Facilitators and Barriers to Return to Work: A Qualitative Descriptive Study

This is a qualitative descriptive study of professionals’ perceptions of facilitators and barriers for returning to work for women on long-term sick leave due to musculoskeletal pain and/or common mental disorder who participated in a vocational rehabilitation project. Data were collected through semi-structured interviews with 13 purposefully selected professionals from the Swedish Social Insurance Agency, the Swedish Public Employment Service, the health care services, and the municipal services. The interviews were analyzed with a manifest content analysis. The main facilitators were the close cooperation between the professionals and the individual support that was offered to the project participants. The main barriers were differences among the stakeholders’ missions and goals, limitations in project duration and within the labor market, and the project participants’ personal factors. These results emphasize the importance of cooperation between the various stakeholder professionals and a focus on the individual’s resources and needs. The study highlights the value of including health care professionals in vocational rehabilitation to benefit from their specific knowledge of the target group and that group’s strengths and needs. Moreover, the study highlights the need to incorporate collaboration with employers and align with the local labor market in the development of vocational rehabilitation interventions.

Translation and validation of Assessment of Work Performance (AWP) into the Icelandic language and culture.

Evidence-based services in vocational rehabilitation call for valid and reliable assessments of work performance for intervention planning and safe return to work for individuals with illness or injuries. Assessments that are easy to use, culturally adapted, and in a language professionals and clients understand is important for their utility. Translation and adaption of assessments to new languages and cultures are of importance to maintain high standards of assessments and the quality of services in the vocational rehabilitation setting. The aim of this study was to translate and adapt the Assessment of Work Performance (AWP), into the Icelandic language and culture. Furthermore, to investigate the content validity and utility of the evaluation instrument. The study was conducted in two phases. The first phase, based on the Dual-Panel translation method, included two expert panels performing translation and cultural adaption of the original Swedish AWP. In the second phase field testing of the translated instrument was followed by an online survey among vocational rehabilitation professionals for content validation and utility. The results of the study showed satisfactory opinions from experienced professionals toward the content validity, translation, cultural adaption, and utility of the Icelandic version of the AWP. The study indicates that the Dual-Panel translation method is a valid method when translating instruments from one language and culture to another. Furthermore, the results of the study imply that the AWP can be regarded as content valid up to an acceptable degree for implementation in vocational rehabilitation services in Iceland.

Personal Characteristics Associated with Working After Disability Onset for People with Visual Impairments

Introduction: This study utilized data from the 2014 Survey of Disability and Employment (SDE) to examine personal characteristics that influenced employment after disability onset for people who are visually impaired (i.e., those who are blind or have low vision). Method: The selected sample from the SDE data set included 131 individuals who are visually impaired, had disability onset after age 14 years, and worked before their disability onset. Logistic regression was used to examine working after disability onset associated with age at disability onset, years since disability onset, gender, race, education, receipt of government disability benefits, self-reported health, encouragement received to work, additional disabilities, and the interaction between age at disability onset and years since disability onset. Results: Persons who were female, received government benefits, and had multiple disabilities were less likely to work after disability onset; persons who had more sources of encouragement were more likely to work after disability onset. Age at disability onset interacted with time since disability onset; as age increased, odds of working after disability onset increased but only for persons who had their disability for at least 4 years. Discussion: Persons with newly acquired disabilities may need time to adjust to their disability and learn new skills that allow them to continue employment. Information about how employment may influence receipt of government benefits would be helpful to persons evaluating their options regarding continuing employment. Implications for practitioners: A person who has not worked after recent disability onset may be adjusting to life with a disability and may return to work in the future. Encouragement to work from both service providers and family members made a meaningful difference in employment retention after disability onset, and this is an area that vocational rehabilitation professionals can influence.

Using a literacy-based behavioral intervention to teach job interviewing skills to adults with intellectual disability

BACKGROUND: Job interviewing serves a key function in the process of gaining employment. To date, no research has evaluated whether a literacy-based behavioral intervention (LBBI) might be used to improve the essential vocational skill of job interviewing. OBJECTIVES: The purpose of this study was to explore the effectiveness of a LBBI for the acquisition of job interviewing skills. METHODS: Using a combined experimental design (non-concurrent multiple probe across participants with an embedded A1B1A2B2 design) three young adults with intellectual disability who received an in-person and remote LBBI were evaluated on their correct and independent performance on a task analysis created for job interviewing. Generalization and maintenance were also assessed. RESULTS: The results showed that all three students mastered job interviewing skills with 100% accuracy and maintained the acquired skills after the intervention was removed. CONCLUSIONS: The study showed that LBBI is an effective tool to teach and practice job interviewing skills, and can be implemented face-to-face and virtually. Educators, vocational rehabilitation professionals, and families can use this tool in a wide range of settings.