Intro to Rehab Counseling Final Exam

Microaggressions

- "Brief and commonplace daily verbal or behavioral indignities whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults that potentially have harmful or unpleasant psychological impact on the target person or group" ((D. W. Sue, Bucceri, Lin, Nadal, & Torino, 2007, p. 72) ‒The intent is to make the person or group to feel unwelcomed, unsafe, isolated, and alienated

Disability in a Global Context

- Approximately 15% of the world's population, or over one billion people, lives with some form of disability - About 80% of all people with disabilities reside in low-resource countries - Disability is considered both a cause and a consequence of poverty - The majority of the world's people with disabilities who live in low- income countries have "little or no access to basic health services, including rehabilitation facilities" - Throughout the world, people with disabilities who live in poverty struggle with daily life activities, without the advantage of any state-sponsored assistance

ICF Components

- Body Structure and Function - Activity - Participation - Environment - Personal Factors

Structure of the ICF

- Disability involves dysfunction at one or more of these levels: biological impairments, activity limitations, and participation restrictions - Data on both the medical aspects (impairment-oriented) and social aspects (environment-oriented) of disability are important for successful living with disability - Biopsychosocial model of disability that emphasizes functioning and proposes a view of "health" and "disability" in which every human being can experience a decrement in health and thereby experience some level of disability

Super's Life Span, Life Space Theory of Career Development

- Each occupation requires a characteristic pattern of ability and personality characteristics The vocational preferences, competencies, and environments in which people live and work change with time and experience - "Life Career Rainbow" combines situational and personal determinants with life roles and life stages The nature of an individual's career pattern is determined by the individual's parental socioeconomic level, mental ability, education, skills, personalities, career maturity, and by the opportunities to which he or she is exposed.

what makes a "qualified provider?"

- Have completed graduate degree training in rehabilitation counseling or a closely related program at the masters level; have attained national certification - Have acquired the appropriate state licensure in those states that require this level of credential for counseling practice - Practice within the guidelines and standards of the Code of Professional Ethics for Rehabilitation Counselors - Maintain ongoing professional development through relevant continuing education - Are members of a professional association and contribute through professional advocacy to the advancement of the discipline

Hershenson's Theory of Work Adjustment Development

- In the person's environment, organizational culture and behavioral expectations, job demands and skill requirements, and the rewards and opportunities are available to the worker - The product of the interaction of the person's subsystems and work environment is work adjustment * Work role behavior * Task performance * Work satisfaction

ICF Framework Applications to Life Design With Disability

- Individual and Environmental Supports - Enablers - Person-Centric Assessments * Yield data on the person's capabilities (what a person can do) and performance (what a person does) * Provide data on the utility of specific environmental supports with disability including on environmental modifications and adaptations to bridge the gap between the person's abilities (capacities and performance) and the personal learning required for successful living with disability - Human Functioning - Life Design * Appropriate person-centric outcome measures for life design would include those that are for prioritized choices (autonomy), personal values and salient identities (relational worth, possible selves), and aspirations for present and future living (competencies) and satisfaction with life * Autonomy * Competence * Relatedness

Holland's Theory of Vocational Personalities and Work Environments

- Individuals exhibit aspects of the following six work personalities: Realistic (R), Investigate (I), Artistic (A), Social (S), Enterprising (E), and Conventional (C). The work environment consists of the same six traits - Matching of the individuals and environment leads to the increased prediction of vocational and educational outcomes - Rehabilitation counselors should be aware of the potential impact of disability in limiting expressed interests because they may believe that they cannot perform the required tasks due to physical and cognitive limitations

It Is All About Rapport

- Professionals who provide counseling services to people with disabilities must be competent not only in the foundational process skills of counseling but must also pay particular attention to the cultural differences of disability - Building client rapport and maintaining a strong working alliance can be a prime determinant of a positive outcome during therapeutic interactions

Minority Stress

- Refers to chronically high levels of tension experienced by individuals of stigmatized minority groups - Stressors include stigma, expectations of rejection, acute events and chronic everyday discrimination and mistreatment, internalized negative beliefs about one's social identities, and stressors related to concealment or management of stigmatized identity

10 Factors of RESPECTFUL Counseling

- Religious/spiritual identity - Economic class background - Sexual identity - Psychological maturity - Ethnic/racial identity - Chronological/developmental challenges - Trauma and other threats to one's well-being - Family background and history - Unique physical characteristics - Location of residence and language differences

Guidelines for the Counseling Professions

- Society's attitude towards people with disabilities may actually be more disabling than the disability itself - People with disabilities are not members of one cultural group. Rather, these individuals comprise multiple roles, identities, attributes, and capabilities - Counselors who exhibit honest, direct, and empathic therapeutic relationships in a cultural-centered manner can offer clients a very good beginning point for counseling

Paradigmatic Factors Influencing Counseling and Case Management

- The importance of organizational auspices (Bureaucratic versus community-based organization) - Case management in community counseling (Broad-based assessment of the quality of life) - Importance of an environmental focus (An appraisal and understanding of multiple features of the environment) - Criteria guiding adoption of consumer-driven case management - Community-based/alternative support/well-being of people whose status is diminished - Variation in advocacy

Current Practice Issues in Rehabilitation Counseling

- Third-party reimbursement - Mental health and disability legislation - The ability to diagnose and treat mental health and substance use conditions - The expanding specialty areas in counseling that require certification and/or a license to practice

Private Sector VR

- delivery system is insurance driven; the goal is almost exclusively singular: return to work. There are rarely, if ever, any psychological adjustment or independent living objectives in a rehabilitation plan. - less severe disabilities among our clientele - smaller caseloads, typically in a 20 to 30-client caseload range - service delivery system that is job placement oriented

CACREP standards

- what are the missions and objectives of the department of rehabilitation counseling - how does it evaluate its services - what is its curriculum - what clinical experiences does it offer its students in the way of practicum and internship - what are the educational outcomes or what types of employment do graduates secure - what is the makeup and composition and accomplishments of the faculty and of the administration - what types of support and resources are available for the faculty and the students

The Vocational Rehabilitation Process

1. Outreach 2. Intake 3. Evaluation 4. Eligibility Determination 5. Rehab Planning/ Individualized Plan for Employment (IPE) 6. Service Delivery

The INCOME Framework

A comprehensive framework that consists of six statuses, not stages to address the heterogeneity of the individual with disabilities: Imaging, iNforming, Choosing, Obtaining, Maintaining, and Exiting - The interaction of three dynamic factors: (1) the individual, (2) his or her environment, and (3) the culture and subcultures within which the other two factors reside - Age of disability onset and the progressive nature of certain disabilities are factors that impact career development and vocational behavior

Racial/Cultural Identity Development Model (R/CID)

A general model that covers all forms of identity development and addresses how one relates to self/ others/ and the dominant group.

Research

Access to healthcare and medical outcome - Epidemiological and statistical analysis - Qualitative and ethnographic understandings of the lived experiences of PWDs

Cultural Competence

Being a culturally competent counselor means you can attend to how a client's culture, identity, ethnicity, race, gender, disability, and other aspects of diversity can impact the rehabilitation process, and our interpretations of client behavior. It also means you recognize your own biases and your own lack of awareness of issues that may be impacting other groups.

Certified Case Manager (CCM)

CCM is particularly desirable if you chose to do case management, particularly in the private sector.case management has now become recognized, beyond a shadow of a doubt, as the fastest growing new occupation in health care. It is no longer regarded as an aspect of professional practice for other professionals. It is now clearly regarded as its own independent profession.

Systems-Driven Paradigm

Complexity of human need requires the coordination/integration of multiple forms of human services/multiple organizational venues/benefit systems/multiple providers

Consumer-Driven Paradigm

Consumers possess strong perspectives on what they want for themselves

Neutrality

Could be unaware of how race and ethnicity affect social interactions with individuals of other backgrounds

Integrative awareness

Develop a capacity to appreciate themselves as well as others

Multidisciplinary Configuration

Discipline-specific organizations face a challenge of integrating service structures and may resort to various integrative strategies cutting across departments or units

Professional training

Fostering international perspectives - Multicultural counseling competencies - Training counselors in psychiatric rehabilitation - Communities of practice

Trans disciplinary Configuration

Functional contributions, personal suitability, and mastery of core knowledge and best practices that all team members hold in common are important

Variety

Gives us the opportunity to do something different every day when one day is not like the next

Introspection

Grow concerns over the basis of self-appreciation and question ethnocentrism

Social Cognitive Career Theory

Highlights the interplay of three variables: - Self-efficacy: Judgments of one's own capabilities to attain specific tasks - Outcome expectations: Beliefs about the anticipated results of performing particular behaviors - Personal goals: Intention to carry out a particular activity or to produce a particular outcome People are capable of directing their own vocational behavior and even negotiating personal and contextual variables to prevail in career development.

Certified Rehabilitation Counselor (CRC)

It is the standard for what constitutes a professionally trained, graduate trained, rehabilitation counselor in this country.

Awareness

Lead to feelings of isolation as a result of the lack of an identified reference group

Evaluation

Once a person is in intake we undertake the process of evaluation and we're doing an evaluation for two reasons, we're doing an evaluation so that eventually if the client is deemed eligible for services an individually written rehabilitation plan can be designed. The other reason we're doing evaluation is to see if the person does meet eligibility criteria

Compensation

People motivated by compensation desire to be well paid. It's very pure and simple and all the principles of operant conditioning apply.

Co-Workers

People who are heavily motivated by co-workers value very much who they work with and they want to and expect to be friends or at least be friendly to the people at work.

Interdisciplinary Configuration

Professionals of diverse backgrounds meld naturally into team structures, often time creating integrative tools and routines

Social Identity Complexity Model

Proposes the following logic: (a) it is not only how many social groups an individual identifies with that matters, but more importantly, (b) how those different identities are subjectively combined to determine the overall inclusiveness of the individual's in-group memberships

Dissonance

Question their cultural identity and sense of self-esteem as they come to realize the impact of culture in their own life

Transition

Realize that they cannot choose to identify as a member of any one group

Acceptance

Recognize and acknowledge that they belong to a racial or ethnic reference group

Rights-based approach

Respect for all aspects of human dignity and participation - Equal access to health care - Special needs of women and of children with disabilities - Issues of accessibility, mobility, and the responsibilities of the professionals providing care to PWDs

Security

Security still motivates many people particularly those who are older, who are close to their retirement years, or who are government employees and seek the civil service protections that are afforded by government work; however this is probably increasing to include younger workers as they are now witness to the effects of high unemployment and a poor economy.

Resistance and immersion

Sense self/cultural group appreciation and reject the dominant cultural group

Authority

Some people just love to tell other people what to do.

Supervision

Some people work because of the type of supervision that they can receive and in this type of supervision it is supervision-human relations and that basically means is my boss a nice person, are they easy to get along with, can I be friendly with them or even friends with them, are they cordial, do they treat me with attention and respect, are they fair, do I enjoy working for this person and have respect for this person as a person.

Community-based rehabilitation

Support access to regular services and opportunities - Assist people with disabilities to actively contribute to their own communities - Encourage communities to promote and respect their human rights

System Selling Job Placement

System-selling placements simply involves a form of bartering between the CRC and a company.

Advocacy

The action a counselor, or psychologist takes in assisting clients and client groups to achieve therapy goals through participating in clients' environments; Has tended to focus on facilitating access to services, yet the field has been somewhat slower to address advocacy with individuals who are marginalized within the rehabilitation system

Case Management Process

The case management process is cyclical rather than linear; and recurrent rather than unidirectional; includes six steps— 1. Client identification, selection, and engagement in professional case management 2. Assessment and opportunity identification 3. Development of the case management plan of care 4. Implementation and coordination of the case management plan of care 5. Monitoring and evaluation of the case management plan of care 6. Closure of the professional case management services

Transferable Skills Analysis

The intent is to use the person's previous educational and work history as the primary determinant of what the client's skills are, and subtract from that skill bank those skills or abilities that have been compromised, or limited because of the onset of the disability, and to return to that skill bank those skills and abilities that can be compensated for or addressed by matters of reasonable accommodation.

Client-Centered Paradigm

The unique qualities of each human being and the formulation of case management direction from the perspective of the client are emphasized

The Multiple Heritage Identity Development (MHID) Model

There are six non-linear phases to the identity development process. Each phase stands on its own and can be revisited at different points in the individual's life.

Independence

These are people who are low on authority and do not want to be supervised. They may be somewhat a-social or aversive to high levels of social integration. They simply like to work alone and they are not inclined to work in teams or seek situations in which they have to participate in a lot of teamwork.

Social Service

These are people who choose a particular line of work with a sincere desire to be helpful to others.

Moral Values

These are people who want to work in an environment where there are no qualms of conscience.

Creativity

They like to create and try out their own ideas. Also you will find people like this who develop their own software and engage in a broad variety of creative occupations.

Eligibility Determination

They must have a medical impairment, and that impairment must represent some impediment to vocational functioning and, and this of course is the tricky one, feasibility. It must be feasible or reasonable to expect that once the service is outlined and the rehabilitation plan is provided that it will result in a positive vocational rehabilitation outcome, which in the main means competitive employment, but it also may mean a particular independent living status

4 Things Managers Do

They plan, organize, direct, and control

Altruism

They simply need to work in a place where the company policies and practices are fair. They are very concerned about fairness and that people are treated equally and that justice is evenly applied and the policies and practices of the organization are evenly applied. If they feel they are being treated unfairly or that others are they will leave

Selective Placement

This is the type of job placement that is in the minds of our clients and of many lay people. That what we will do as we as professionals will quote 'find you a job.' This actually happened for a long time. Also refers to the term job development.

Licensed Professional Counselor (LPC)

This permits counselors, trained at the graduate level, to do independent practice and to bill third parties for their services. Licensure outlines the permitted use of the professional title, the scope of practice, and the uniqueness of the profession. Each state's licensure laws are different, but many have some of the same components: legal definitions relevant to the profession, rules and responsibilities of the licensure board established for the profession, and requirements for education, clinical experience and supervision, examination of applicants, continuing education, and licensure fees in that state.

Experimentation

Try to fit into only one part of their racial identity to experience a sense of connection with others

Conformity

Value the dominant cultural group and devalue self and other ethnic/racial minority people

Recognition (multi-cultural)

Verbally define themselves as biracial

Web resource accessibility

W3C Web Accessibility Initiative offers strategies, guidelines, and resources to make the web accessible to people with disabilities

Recognition

We like to be recognized or acknowledged for what we do.

Work Adjustment Behaviors vs Work Behaviors

When you think about work behaviors that's why we do vocational training. When you think about work adaptive behaviors that's why we do work adjustment training.

Work Adaptive Behaviors

Work adaptive behaviors mean things like attention span, concentration, attendance, punctuality, hygiene, grooming, initiative, interpersonal skill, response to authority, self direction, cooperation and creativity. These are not things that are related to doing the job itself, but you know and I know that they have everything to do with why one person gets hired over another and why one person gets fired over another. They are as important to obtaining and maintaining employment as are work behaviors.

Case management

a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and [the use of] available resources to promote patient safety, quality of care, and cost-effective outcomes

Disability Management

a workplace prevention and remediation strategy that seeks to prevent disability from occurring or, lacking that, to intervene early following the onset of disability, using coordinated, cost-conscious, quality rehabilitation service that reflects an organizational commitment to continued employment of those experiencing functional work limitations.

Supported Employment

any service, the provision of any support, and I do want to underscore the word ANY, that helps an individual with disability obtain and maintain employment at the highest possible standard for the persons current abilities.

Forensic VR

considered a subset of our private VR work setting. - "application of professional knowledge and the use of scientific, technical, or other specialized knowledge for the resolution of legal or administrative issues, proceedings, or decisions"

MAC - Masters in Addictions Counseling

considered the elite, the national standard, and the highest standard that can be achieved by a truly professionally trained counselor or rehabilitation counselor.

CARF accreditation

example of different types of programs that may be accredited by CARF: - work adjustment programs, remember work adjustment programs are those that seek to enhance the work adaptive behaviors of our clients in terms of their vocational repertoire - occupational skills training - job placement -work services, which typically mean sheltered work or work activity centers - support of employment programs - personal and social adjustment programs, typically involved in the mental health arena in terms of the development of psychosocial skills or psychosocial adjustment skills - residential services, which basically would mean the provision of housing, congregate living facilities, group homes, adult foster care, and the like

Outreach

how we find clients and how clients find us.

Public Sector VR

in public sector vocational rehabilitation we see - individuals in the main who have more severe types of disabilities, cases more medically complex, the physical capacities are more reduced, the functional limitations of the individual are greater. We also serve, of course, much larger caseloads in the state/federal and VA programs frequently exceeding 100 or 200 and in the VA - much more counseling and training going on with clients because there are monies and the statutory authority there to approve such services and provide for them, particularly training. In public VR we have much more of a training-oriented service delivery system.

Knowledge dimension

one's understanding of the worldviews of clients who are culturally different, without imposing negative judgments, pathologizing, blaming, or invalidating others' experiences

Acculturation

refers to "absorption of the 'host' society's cultural norms, beliefs, attitudes, and behavior patterns by immigrants, or by other groups historically excluded from the larger society"

Integrated Disability Management

refers to efforts to coordinate the design and implementation of occupational, non-occupational, and other disability programs in order to improve overall effectiveness. Objectives: - Prevent workplace injuries and illnesses. - Promote rapid return-to-work. - Maximize employee productivity. - Contain program costs. - Simplify program administration.

Skills dimension

refers to one's ability to develop and practice appropriate, culturally relevant, sensitive intervention strategies in working with clients from historically marginalized groups and backgrounds

Follow-Up Services

relate more to the subject about keeping a job, known as job maintenance.

Action dimension

requires rehabilitation counselors (RCs) and other mental health professionals to extend their roles beyond the traditional office setting, using advocacy interventions and strategies to remedy social injustices by partnering and collaborating with community allies

Activity

some people work just so they can be busy and if they can be busy all the time, that's better. This is also frequently a high worker need for work addicted individuals but not necessarily.

Minnesota Theory of Work Adjustment

suggests that when we know an individual's worker needs which are important to them that we can measure with the Minnesota Importance questionnaire, and we seek and find a job that reinforces those needs, that worker will experience job satisfaction.

Dr. Hawley's Professional Recommendation for Specializing

take your disability ribbon and cross it with your function expertise ribbon. And at that intersection you should be the foremost authority in your work group, in your state, in your region and conceivable even nationally, on the interaction of a particular type of disability, with a particular aspect of the rehabilitation process.

Self-awareness dimension

taking inventory of one's own assumptions about human behavior, values, preconceived notions, limitations and biases regarding race, ethnicity, and culture

Intake

the first person they deal with and the first person they meet face to face for purposes of an intake will give them their first impressions about vocational rehabilitation and about the rehab professions. And those impressions are enduring.

Advancement

these are people who are ambitious. People heavily motivated by advancement frequently fair better in the private sector for the rewards of promotion and advancement are not linked to seniority or collective bargaining agreements.

Achievement

this is a feeling of accomplishment. Many work-addicted individuals are heavily motivated by achievement. They like to count things and they like to point to things that are concrete, that are measurable, objective, and that can distinguish them from their peers.

Working Conditions

this may refer to good and safe working conditions and comfortable environments and the like. Autonomy

Social Status

to be somebody in the community

Ability Utilization

to make use of ones individual abilities.

How we differ from other professions

we are first and foremost counselors, then, we are also vocational counselors, and that we are case managers, and that we study the full range of disabling conditions, not just mental health or substance use disorders as most other counselors would study.

Technical Supervision

we respect our boss whether or not we like him or her and we know we can stay in that position because we can learn from that person and we value that.

Job Seeking Skills Training

what methods people really use that are associated with the successful procurement or getting of a job

Three approaches to address the complexities of diversity

‒Dominance (occurs when one identity overrides other potential identities, remaining salient in most circumstances while other identities disappear) ‒Compartmentalization (occurs when various identities exist in an encapsulated form, with nonoverlapping that alternates dominating social perception and self-definition) ‒Integration (involves utilization of more than one identity membership and in some simultaneous fashion)