Charles Edmund Degeneffe

Development and validation of the caregiver empowerment scale : a resource for working with family caregivers of persons with traumatic brain injury

OBJECTIVE To use multitrait analysis to determine the measurement structure of the Caregiver Empowerment Scale (CES). PARTICIPANTS An American sample of 87 adult primary family caregivers of persons with traumatic brain injury (TBI). RESULTS A four-factor structure was identified including factor 1 (Advocacy Self-Efficacy), factor 2 (Community Self-Efficacy), factor 3 (Caregiver Self-Efficacy), and factor 4 (Personal Self-Efficacy). CONCLUSIONS The CES provides clinicians and researchers a means to assess self-perceived coping abilities of family caregivers of persons with TBI.

Correlates of Depression in Adult Siblings of Persons with Traumatic Brain Injury.

Using Pearlins stress process model, this study examined correlates of depression in 170 adult siblings of persons with traumatic brain injury (TBI). Approximately 39% of adult sibling participants evinced Center for Epidemiologic Studies—Depression (CES—D; Radloff, 1977) scores indicating clinically significant depressive symptoms. Background characteristics found to be related to higher ratings of depression included being female and history of a pre-TBI depressive episode. In addition, results indicated that perceptions of more restrictions in valued family activities and less accessibility to social support were related to higher ratings of depression. Contrary to study hypotheses, an inverse relationship was found between subjective caregiving burden and depression. Practice and research implications of these findings are discussed.

‘We are the forgotten victims’: Perspectives of adult siblings of persons with traumatic brain injury

Primary objective: This study determined how the lives of a cross-national sample of adult siblings had changed since their brothers and sisters incurred a traumatic brain injury. Research design: A total of 272 participants provided responses to the question, ‘How is your life different since your sibling had a TBI?’ Responses were analysed through the constant comparative method of textual analysis. Methods and procedures: Responses were collected through a mailed-survey. The analysed question appeared at the end of a 243-item quantitatively-based survey containing five open-ended questions. Outcomes and results: Three themes emerged: (1) ‘Family impacts’ such as growing up with a sibling with TBI and impact on family closeness; (2) ‘Caring’ including caring for and about the family member; and (3) ‘Making sense of the experience’ through adjustment and personal development. Conclusions: The study demonstrates that having a sibling with a TBI can result in profound and enduring negative and positive life changes for non-injured siblings. Professionals need to attend to the needs of siblings for support and guidance and should be considered as key informants about their injured family members during intake and service planning.

Overview of Disability Employment Policy and Rehabilitation Practice in Australia: Implications for Rehabilitation Counselor Education

This article provides an overview of the development of disability employment policy and rehabilitation services in Australia. In particular, it focuses on recent legislative and policy changes that attempt to address the high rates of welfare dependency, low employment rates and workplace discrimination experienced by people with disabilities. An overview of rehabilitation counselor training in Australia and identification of factors that have led to curriculum changes over recent years are provided as a basis for a case example of rehabilitation counselor training programs at the University of Sydney. Implications of Australian developments in disability employment policy and practice, and rehabilitation counselor training, are examined in relation to the situation in the United States.

Regaining equilibrium: Understanding the process of sibling adjustment to pediatric acquired brain injury.

Objective: This study developed a comprehensive framework for understanding the process of sibling adjustment to pediatric acquired brain injury (ABI). Participants: Grounded theory methodology was employed to inductively explore the issues siblings perceived to be their main concerns and how they managed these concerns. Fifty-three interviews (N = 28) were conducted recursively with 20 child and adolescent siblings of individuals with an ABI, 4 adult siblings of individuals with an ABI, and 4 child and adolescent siblings of individuals with congenital disability. Observational and secondary data from hospital staff and parents were also analyzed. The framework was developed and verified through simultaneous data collection and analysis that continued to the point of data saturation. Results: The main concern for siblings was the loss of equilibrium in their lives as defined by the concepts of vulnerability and emotional turmoil. Losing equilibrium was enduring and threatened siblings’ sense of security, safety, predictability and control many years post injury. To manage these concerns, siblings employed a variety of interrelated strategies to regain equilibrium. These strategies were conceptualized by the concepts navigating and sacrificing to restore safety, predictability, and control. Like the nonfinite nature of losing equilibrium, regaining equilibrium was an ongoing cyclical process. Conclusions: Rather than focusing on adjustment outcomes only, this study extends previous research by offering a framework for understanding the process of sibling adjustment, and thus providing a set of integrated categories, concepts, hypotheses, and propositions to inform future research and practice.

Community-Based Support and Unmet Needs Among Families of Persons with Brain Injuries: A Mixed Methods Study with the Brain Injury Association of America State Affiliates

This study examined service gaps and post-injury needs for families of persons with brain injuries as perceived by leadership of 28 Brain Injury Association of America state affiliates. Participants report that BIAA affiliates assist families with a variety of information, service referral, and emotional support services. Participants stressed that, while many community-based programs and professionals are available, they do not adequately meet family caregiver needs. Similarly, participant responses to a modified version of the Family Needs Questionnaire indicate that families have a great need for post-injury rehabilitation supports but that these needs are seldom fully met. Finally, participants emphasized a need for enhanced training and knowledge regarding brain injury. Clinical service and research implications are discussed for the general public and for the families of veterans.

Service Use and Satisfaction Following Acquired Brain Injury: A Preliminary Analysis of Family Caregiver Outcomes.

Purpose: The study aimed to understand how use and satisfaction with services following discharge from an acquired brain injury (ABI) acute-care facility related to family caregiver outcomes. Methods: A correlational and descriptive study design was used. Nineteen primary family caregivers of persons recently discharged from an ABI acute-care facility in a large city in the southwestern part of the United States participated. Results: Satisfaction with the services provided during post–acute-care rehabilitation demonstrated medium effect size relationships to family caregiver depression, family dysfunction, and extent of rehabilitation needs met. Service use demonstrated a medium effect size relationship to caregiver family dysfunction. Conclusion: Findings present a call for future research to examine the role of service use and service satisfaction during the continuum of care from acute-care to long-term community integration following ABI.

Searching for the First Faculty Position in Rehabilitation Counselor Education: Results of a National Survey.

Although many doctoral students wish to enter academic life, many lack the necessary understanding of how to prepare for and pursue this objective. Using both quantitative and qualitative analyses, we examined the structure and process of the tenure-track interview process within rehabilitation counselor education programs; how doctoral students can best prepare to secure a tenure-track faculty position; and how hiring committees might better facilitate the application and interview process for a tenure-track faculty position. A comprehensive and multifaceted review of participants’ perceptions of their preparation and experiences in the interview process was undertaken. Results provide information and suggestions for rehabilitation counselor education programs and for individuals pursuing an academic position.

A National Survey of Adjunct Faculty in Rehabilitation Counseling Education Programs.

A national sample of 54 adjunct faculty members in rehabilitation counseling programs were surveyed to ascertain reasons why they chose to teach and how they contributed to their respective programs. Constant comparative analysis revealed a variety of reasons for why adjunct faculty enjoy teaching, including a desire to influence future counselors, engage in professional development, and give back to the rehabilitation counseling profession. The majority of participants believed they influenced the mission and directions of their programs and were engaged in a variety of non-teaching program activities such as attending advisory board meetings, conducting research, and individually advising students. Most adjunct faculty also believed that they influenced programs primarily through teaching and related activities. Implications and recommendations are offered for needed developments in rehabilitation counseling education in response to our findings.

Predictors of Employment Following Postsecondary Education for Vocational Rehabilitation Participants With Traumatic Brain Injury

The purpose of this study was to identify vocational rehabilitation (VR) services associated with employment outcomes of individuals with traumatic brain injury (TBI) who received college training and increased their highest level of postsecondary education completed. The participants were 1,221 individuals with TBI who increased their highest level of postsecondary education while receiving VR services. A logistic regression model containing five demographic and six VR service variables correctly classified 75.4% of cases as competitively employed or not competitively employed. The model explained approximately 10.0% of the variance in competitive employment. Significant predictors associated with competitive employment were the demographic characteristics of ethnicity and age at application. VR service variables that were significant predictors of competitive employment were (a) vocational rehabilitation counseling and guidance, (b) job readiness training, (c) job placement assistance, and (d) personal assistance services. While demographic characteristics and VR services explained a relatively small proportion of the variance in employment outcomes, more robust measurements of the variables have the potential to enhance prediction of outcomes. Provision of job readiness training and personal assistance services should be investigated further to determine the extent to which they serve as indicators of the presence of additional barriers to competitive employment.