David A. Rosenthal

Predicting employment outcomes of rehabilitation clients with orthopedic disabilities: A CHAID analysis

Purpose. To examine demographic and service factors affecting employment outcomes of people with orthopedic disabilities in public vocational rehabilitation programs in the United States. Method. The sample included 74,861 persons (55% men and 45% women) with disabilities involving the limbs or spinal column who were closed either as rehabilitated or not rehabilitated by their state-run vocational rehabilitation agencies in the fiscal year 2001. Mean age of participants was 41.4 years (SD = 11.2). The dependent variable is employment outcomes. The predictor variables include a set of personal history variables and rehabilitation service variables. Results. The chi-squared automatic interaction detector (CHAID) analysis indicated that job placement services significantly enhanced competitive employment outcomes but were significantly underutilized (only 25% of the clients received this service). Physical restoration and assistive technology services along with support services such as counseling also contributed to positive employment outcomes. Importantly, clients who received general assistance, supplementary security income, and/or social security disability insurance benefits had a significant lower competitive employment rates (45%) than clients without such work disincentives (60%). Conclusion. The data mining approach (i.e., CHAID analysis) provided detailed information and insight about interactions among demographic variables, service patterns, and competitive employment rates through the segmentation of the sample into mutually exclusive homogeneous subgroups.

The Relationship between Sense of Coherence and Adjustment in Persons with Disabilities.

The concepts of salutogenesis and Antonovskys sense of coherence are introduced. Salutogenesis and sense of coherence are based upon factors (i.e., comprehensibility, manageability, and meaningfulness) that promote health rather than those factors that cause disease. This study investigated the relationship between sense of coherence and adjustment in individuals with a disability (i.e., 89 college students with disabilities). Results indicated a positive correlation between sense of coherence and adjustment (p < .01). The subscales of sense of coherence accounted for 77% of the variance in adjustment, with the meaningfulness subscale accounting for the greatest percentage. The value of these paradigms and implications for rehabilitation counseling are discussed.

Effects of Client Race on Clinical Judgment of Practicing European American Vocational Rehabilitation Counselors

This Web-based study investigated the effects of client race on the clinical judgment of practicing European American vocational rehabilitation counselors, specifically, whether participants demonstrated bias in their general evaluation, perceptions of psychopathology, and estimates of the educational and vocational potential of African American clients. Participants reviewed case materials depicting either an African American or a European American client and rendered judgments (a) once after minimal initial information was provided, when initial impressions could be more vulnerable to racial stereotypes, and (b) once after subsequent information was provided, facilitating more definitive judgments. African American clients were judged more negatively than European American clients, and these differences persisted after reviewing subsequent information. Implications for treatment planning are discussed.

Advanced Methods in Meta-Analytic Research Applications and Implications for Rehabilitation Counseling Research

Over the past 25 years, meta-analysis has assumed a significant role in the synthesis of counseling and psychotherapy research through the evaluation and interpretation of the results of multiple studies. An examination of four widely recognized rehabilitation counseling journals, however, reveals that only one meta-analysis (Bolton & Akridge, 1995) has been published during the past 10 years. This article examines the meta-analysis process as a viable method to aggregate multiple studies, discusses common advantages and criticisms of meta-analysis, and provides suggestions specific to how meta-analyses may be applied to investigate rehabilitation outcomes. In addition, new applications of meta-analysis that have been discovered and refined in recent years are presented through a reanalysis of the Bolton and Akridge (1995) meta-analysis.

Analyzing Vocational Outcomes of Individuals With Psychiatric Disabilities Who Received State Vocational Rehabilitation Services: a Data Mining Approach

This study examines factors affecting vocational outcomes in the vocational rehabilitation process for individuals experiencing psychiatric disabilities who had received state vocational rehabilitation (VR) services. A data mining approach was used to analyze the Rehabilitation Services Administration FY 2001 Case Service Report (RSA-911). Receiving job placement services was found to be the most important variable differentiating individuals who were working from those who were not working. Results regarding vocational outcomes suggest a positive effect for persons receiving job placement services.

An analysis of evidence-based best practices in the public vocational rehabilitation program: Gaps, future directions, and recommended steps to move forward

As an epilogue to this special issue, this article provides a brief overview of the research undertaken by the Rehabilitation Research and Training Center on Evidence-Based Practice in Vocational Rehabilitation (RRTC-EBP VR) in Phase II of their studies, and what was learned from the comprehensive review of the literature (e.g., Fleming, Del Valle, Kim & Leahy, 2013) and multi-state case studies in terms of promising practices in state VR agencies (Leahy et al., 2013). Gaps identified in EBP research that hinders the implementation of efficacious, effective, and efficient services based on the best scientific evidence are discussed, and finally, recommendations for future research directions and knowledge translation initiatives that will improve the effectiveness of VR service delivery practices are provided.

Informed Consumer Choice in Community Rehabilitation Programs

This study investigated consumer and staff member perceptions regarding the extent of consumer choice and participatory planning in community-based rehabilitation programs (CRPs) and the relationship between these elements, satisfaction, and outcomes. Consumers reported moderate to high levels of choice in services and employment goals, and persons with greater functional limitations perceived themselves as significantly less informed. Consumer perceptions of informed choice were significantly related to greater satisfaction with services received and outcomes attained. Those reporting greater perceived choice also received significantly more services. Lastly, significant differences in informed consumer choice were identified by type of disability. Implications for rehabilitation professionals and future research are discussed.

Effects of Client Race on Clinical Judgment of African American Undergraduate Students in Rehabilitation.

Two randomly assigned groups of African American undergraduate students in rehabilitation services were asked to review case materials of a client who was portrayed as African American to one group and as European American to the other. Participants rated the client in terms of their clinical impressions and estimates of future potential. In Rosenthal and Bervens (1999) similar study, European American students rated the European American client as having higher educational and employment potential than the African American client. In our study, African American students rated the African American client as having higher educational potential than the European American client. In addition, across all four of the other independent measures (general evaluation, psychopathology—conduct, psychopathology—substance abuse, and vocational potential), African American participants demonstrated no bias against the African American client or the European American client. The differential findings of these two studies and their implications for education and future research are discussed.

Facilitators and barriers to integrated employment: Results of focus group analysis

The current study examined narrative data from a series of semi-structured focus groups in order to identify and examine the proficiencies and deficiencies in practice competencies specific to job functions in the changing practice environment of vocational rehabilitation (VR). Focus groups were conducted with members of organizations, individual service providers, as well as consumers and their families, and data were gathered to determine the potential barriers to employment and service needs of individuals with the most significant disabilities living in Wisconsin. Three major domains identified by the comprehensive needs assessment are employment knowledge, systems interactions and navigation, and consumer needs. Recommendations are aimed at increasing opportunities for community-based employment for persons with disabilities, increasing communication between consumers and service providers, and most importantly, eliminating financial disincentives that promote facility based employment.

Effects of counsellor race on racial stereotypes of rehabilitation counselling clients

Purpose: This study investigated perceptions of European American, African American, and Asian American rehabilitation graduate students in rehabilitation counselling by assessing their clinical impressions of African American, European American, and Asian American clients. This investigation is a continuation of several studies investigating clinical perceptions and client race. Method: Rehabilitation graduate students in rehabilitation counselling participating in this study were randomly assigned to one of three groups and were asked to review case materials for a client portrayed either as African American, European American, or Asian American. In pursuit of the main effect of client race, three separate MANOVA analyses were conducted: one for African American graduate students in rehabilitation counselling, one for Asian American graduate students in rehabilitation counselling, and one for European American graduate students in rehabilitation counselling. Results: Contrary to previous findings from comparable research, MANOVA results did not reveal a significant main effect of bias by European American, Asian American, and African American graduate students in rehabilitation counselling against any of the three groups. Conclusions: Understanding of the conditions in which racial biases and subsequent judgmental errors are likely to occur (or not occur) should allow clinicians to recognise tendencies for their assessments to be influenced by client characteristics that elicit stereotypes and thereby to make more accurate judgements.