Public and Private Rehabilitation Counseling Practices

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Public and Private Rehabilitation Counseling
Practices

• Maki Riggar Ch 9
• Lecture 4
• September 2, 1998

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Last Time Qualified Providers

• Rehabilitation counseling research Roles,
  functions, and competencies
• Ten Knowledge Domains
• 1. Vocational counseling and consultation
  services
• 2. Medical and psychological aspects of
  disability
• 3. Individual and Group Counseling
• 4. Program evaluation and research

3
continued...

• 5. Case management and service coordination
• 6. Family, gender, and multicultural issues
• 7. Foundations of Rehabilitation
• 8. Workers Compensation
• 9. Environmental and attitudinal barriers
• 10. Assessment

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Last time

• Review of credentialling
• Mission, Role, and Competencies of the
  Rehabilitation Counselor
• Roessler Rubin, Chapter 1, Mission, Roles,
  Competency

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History

• Rehabilitation Service System divided into three
  sectors
• Public Sector (greatest growth occurred 1920 to
  1954)
• Private Sector
• Private-for-profit

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Arguments of Role and Function

• Counselor
• Coordinator
• Problem solver
• Case Manager

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Case Management Job Tasks

• Case Management (Table 1.2)
• Intake Interview
• Service Coordination
• Case Recording and Reporting
• Intake interview content
• What the Client is seeking
• Whether the Agency can help the client
• Type of evaluations for eligibility and
  feasibility

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Case Management Job Tasks

• Case Recording and Reporting
• Maintaining Client Case Records
• Reporting on Client Progress
• Summary Reports

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Vocational Assessment and Counseling Job Tasks

• Being able to gather relevant information
• Table 1.3

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Affective Counseling Job Tasks

• Table 1.4
• Clients feelings about disabilities
• Clients concerns about participating in the
  rehabilitation process

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Job-Placement Tasks

• Table 1.5
• Job Placement tasks involve placement-counseling
  and job-development tasks.

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Factors Affecting the Counselors Job
Performance The Problem of Burnout

• Several Factors Affecting Burnout
• Extensive Client Contact, Caseload
  Responsibilities and Negative Case Outcome
  (Payne, 1989)
• Stress produced by making decisions and actions
  without certainty. (Roberts, 1979)

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cont.

• Tension from job demands (Roberts, 1979)
• Large caseload causes exhaustion (Maslach
  Florian, 1988)
• Futility Syndrome were clients have only a
  minimal prospects for long term success and
  counselor may want more.
• Role strain in quantity vs. quality

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How To Deal with Burnout

• How To deal with burnout
• Change work environment
• teach counselors how to handle job stressors
• create diversions from stressful aspects of the
  job that cant be changed.

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Public and Private Rehabilitation

• We have separate lectures ahead for both the
  public and private sectors
• State Federal Rehab Agencies (from 1918)
• Private nonprofit sheltered work shops (from
  1954)
• ....until the mid 80s
• in the 70s, rehab counselors began seeking
  employment in the private sector

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Private sector expansion

• State Workers Compensation
• 1975, statutes that VR counselors offer services
  to eligible injured workers
• These mandates were directed at the insurance
  industry
• Public sector rehabilitation agencies were not
  able to absorb the increased business secondary
  to the new mandates

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Expansion cont.

• Competition and expansion into other
  insurance-based disability systems
• Personal injury claims from auto accidents
• RR Disability Insurance
• Longshore and Harbor Workers Comp
• Occupational Health and Safety
• Employee Assistance Programs
• Legal suits secondary to wrongful termination

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Expansion cont.

• As policy became more inclusive (e.g.
  developmental disabilities in 1973-78), caseloads
  became larger
• Larger caseloads meant less direct service
  provided by state-federal system counselors
• Clients/consumers were referred to external
  providers of rehab services (private sector)
• Serving most severe disabilities first changed
  return on investment funding

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State-Federal System

• Since 1917, Smith-Hughes Act, Smith-Fess Act
• DOT description of the public sector
  rehabilitation counselor position, pp. 141-142
• Vocational rehabilitation consultant position
  in DOT describes the state-federal position as
  well (p. 142)

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Job Requirements

• Expertise in counseling
• Self concepts, personal goals, vocational goals
• Expertise in coordination
• Select and monitor physical, social and
  vocational services
• Expertise in consulting functions
• Working with clients family, service providers,
  and employers

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Worker characteristics

• Above average ability to learn and understand
  theoretical and technical materials, and to
  communicate orally and in writing
• Coordinate, analyze, compile, compute, copy, and
  compare data
• Advise, guide, and counsel with regards to the
  use of legal, scientific, clinical, spiritual, or
  other professional tools to resolve probs

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Other skills

• Mentor, negotiate, instruct, supervise, divert,
  persuade, speak, serve, and take or provide
  instructions
• Personal temperaments tuned to
• directing, controlling, or planning activities of
  others, moving from one task to another using
  different skills, seeing details accurately,
  making decisions that affect others using data
  and facts, taking responsibility for ones
  decisions, and reaching conclusions based on
  objective and subjective material

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Department of Veterans Affairs

• 1992, 588 personnel employed as vocational
  rehabilitation specialists (GS-1715) in four
  federal agencies
• Department of Health and Human Services
• Department of Interior
• Department of Labor
• Department of Veterans Affairs
• 400 of whom were employed in 81 VA medical
  centers and regional offices
• OPM Handbook description, p. 144-5

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VA

• Requires a bachelors degree
• Full professional counseling knowledge is not
  required
• Positions generally filled by Masters degreed
  personnel
• Personal temperaments attuned to
• Working in a medical center environment,
  planning, multitasking, making decisions with
  data and facts, etc.

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Private Sector

• Rehabilitation firms
• Private practitioners (7)
• Employees of private, non-profit rehabilitation
  workshops and facilities (15)
• (Funded through third-party sources or
  individuals purchasing services)

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Private Sector

• 1993, 38 of CRCs were in the private sector
• Research on time allotted to a given activity
  for CIRS, now CDMS, (Matkin, 1995)

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CDMSs

• Case management and human disabilities (20)
• Knowledge of disabling conditions, psychosocial
  aspects of disability
• Job development and vocational assessment (30)
• Assessing vocational ability, analyzing job
  market, conducting job analysis, placing and
  training clients

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CDMSs cont.

• Rehabilitation services and care (20)
• Knowledge of community services (medical,
  psychiatric, psychological), transportation,
  assistive technology
• Disability legislation (15)
• Workers compensation, ADA, labor unions and
  employment practices, legislative developments
• Forensic rehabilitation (15)
• Courtrooms, hearings, depositions, expert
  witness, witness credibility, etc.

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Personality Characteristics

• Most demanding settings
• Higher degree of legal scrutiny
• Cost effectiveness issues
• High degrees of
• perseverance, creativity, tolerance for stress,
  planning activities of others, moving from one
  task to another using different skills, making
  decisions that affect others, and reaching
  conclusions based on data and facts

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Personality Factor Study

• Interpret with caution, as the RIASEC factors
  have lower reliability and some questionable
  validity in terms of making blanket statements
  based upon one administration of an instrument

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