Multicultural counseling literature has critiqued traditional counseling practices, and education for cultural bias toward individualism, middle-classness, and certainly ability. This chapter describes advocacy in rehabilitation counseling by attending to the contribution of multicultural counseling perspectives. It discusses the relevance of incorporating multicultural competency and advocacy in rehabilitation counseling. The chapter addresses the role of advocacy in professional practice and describes various models and definitions of advocacy. It focuses on education and practice implications, with particular attention to the professional responsibilities of rehabilitation counselors (RCs) and the challenges they face as they attempt to advocate for their clientele. Currently, a major challenge in rehabilitation counseling may be that training on the issue of being an advocate for clients may not be well integrated into curriculum or internship. Effective training could be enhanced with exercises such as developing skills in identifying problem situations and determining which type of advocacy might be appropriate.
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This chapter discusses the difference between medical models of disability and psychosocial models of disability. It addresses the environmental and psychosocial influences on relationships of individuals with disabilities and explains how people with disabilities can achieve and maintain optical health and functioning. The chapter describes the current health care systems in the United States and reviews alternative ways to improve weaknesses of the health care system. There are two ways to access to health care in the United States. The first is by having private health insurance purchased from a for profit health insurance company by your employer, yourself, or a family member. The second is by being eligible for Medicare or government-funded programs, most commonly Medicaid, the Veterans Health Administration, or the Indian Health Service. An organization of activist people with disabilities called ADAPT is dedicated to creating a priority on home-based services over institutionalization for people with disabilities.
Rehabilitation counselors (RCs) work with “persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals in the most integrated setting possible”. In rehabilitation counseling practice, there are three models that construct disability from three different points of view: the medical or disease model, the functional limitations or economic model, and the sociopolitical or minority model, also known as the social model as posited by the Disability Rights community. This chapter discusses some of the complexities of the Disability Rights community, including the emergence of the independent living movement, disability studies, and disability culture, in order to prepare practitioners to locate rehabilitation within the broader experience of disability. It also talks about the services provided by centers for independent living (CILs). Individual advocacy supports the self- determination of individuals to obtain necessary support services from other community agencies, such as state-federal vocational rehabilitation.
Rehabilitation counseling, based on trait-factor philosophy and grounded in the psychomedical paradigm, was a conglomeration of methods that were used to assess and to treat clients. Family relationships and family dynamics plays a major role in the rehabilitation process and rehabilitation outcomes. This chapter describes the influence of relational factors in the rehabilitation process, and focuses primarily on the effect of disability from the perspective of the family. Debilitating progressive diseases or serious permanent loss of function are some of the most difficult situations for families to face. A family practice model involves the counselor anticipating, planning, and participating in full family involvement in the rehabilitation process. Rehabilitation counselors (RCs) should be educated about social systems theory and family therapy. Although cross-training in family therapy would be ideal, RCs must at least be willing to obtain continuing education and appropriate training to identify relationship factors impinging the rehabilitation process.
This chapter discusses the nature and significance of person-centric assessments to rehabilitation support interventions for people with disabilities. It defines person-centric assessments and positions them within the framework of the WHO’s International Classification of Functioning, Disability and Health (ICF). The ICF provides a universally accepted biosocial conceptual framework for understanding health and disability. The chapter discusses the ways in which the ICF can be used in conjunction with the Diagnostic and Statistical Manual of Mental Disorders (DSM) and other WHO classifications systems to provide person-centric data for rehabilitation support interventions with people with disabilities. Finally, the chapter proposes a conceptual model for applying ICF framework concepts to the design, selection, and use of person- centric rehabilitation assessments for life design with disability. Person-centric assessments for rehabilitation supports provide data on the appropriateness, intensity demands, and opportunity affordances for a satisfying life with disability.
This chapter reviews the current scope of practice in rehabilitation counseling and the impact that counselor licensure legislation has on the field concerning eligibility for counselor licensure and becoming an independent rehabilitation practitioner. It defines the foundational skills and scope of practice required for effective, competent, and ethical rehabilitation counseling practice. The chapter explains a psychosocial model for rehabilitation counselors (RCs) who want to structure therapeutic interactions with clients who have chronic illnesses and disabilities. The counselor uses the counseling relationship to help clients draw from their personal history, knowledge, coping abilities, resiliency skills, and overall life experiences to derive meaning. Counselors across a variety of work settings and theoretical orientations must be proficient, competent, and ethical in working with a range of people with disabilities who may be culturally different. There are both universal and specific counseling approaches, programs, and services used during therapeutic interactions for people with disabilities.
The development of a strong professional identity rests on clear professional standards of practice. Clients need solution-focused, respectful, nonexploitative and empowering, and, therefore, ethical relationships with their counselors. This chapter deals with the ethical standards of rehabilitation counseling and three types of professional standards which includes the internal standards of the profession, clinical standards for the individual practitioners within a profession, and external regulatory standards. Colleges and universities provide professional education and research services, doing so under the review of credentialing bodies such as the Council for Accreditation of Counseling and Related Educational Programs (CACREP). The intent of a code of ethics is to provide rehabilitation counselors with guidance for specific situations they experience in their practices. The Tarvydas integrative decision-making model of ethical behavior builds on several well-known decision-making models widely used by professionals in the mental health and counseling communities.
The relationship of rehabilitation counseling to the larger profession of counseling has evolved in response to ongoing changes in the legislative, social, and business arenas. This chapter reviews the parallel histories of the counseling profession and the counseling specialty of rehabilitation counseling, and explores the changes that have affected this evolution over time. It focuses on rehabilitation counseling, bringing the reader up to the current merger of Council for Accreditation of Counseling and Related Educational Programs (CACREP) and Council on Rehabilitation Education (CORE) and its implications for rehabilitation counseling and the larger profession moving forward, starting with the earliest history. The values and beliefs underscoring the practice of rehabilitation counseling had its roots in the turn-of-the-century movements that emphasized a humanistic approach to assisting individuals in need, such as poor, destitute, and mentally ill people, as well as those with physical disabilities.
This chapter discusses the array of laws that govern and impact the provision of vocational rehabilitation (VR) services. It explains the specific provisions of laws related to improved employment outcomes for people with disabilities. The Americans with Disabilities Act (ADA) is the seminal piece of federal legislation addressing disability in the workplace. The greater impact of Health Insurance Portability and Accountability Act (HIPAA) on the practice of rehabilitation counseling, however, involves the situation in which an occupational health provider qualifies as a health care provider or business affiliate under HIPAA. The 2010 Patient Protection and Affordable Care Act (PPACA) refers to two pieces of legislation: the PPACA and the Health Care and Education Reconciliation Act. Genetic Information Nondiscrimination Act (GINA) prohibits employers from discharging, refusing to hire, or making other decisions related to the terms and privileges of employment based on an employee’s genetic information.
This chapter defines disability in an international context and compares global disability issues in high-resource and low-resource countries. It discusses the relevant disability demographics, constructs, and resources that relate to global perspectives of disability issues and the expanding role of rehabilitation counselors (RCs). According to the UN, comparative examinations of disability-related legislation indicated that “only 45 countries have anti-discrimination and other disability-specific laws” thereby highlighting the urgent need to advocate for disability-friendly policies worldwide. These important issues relate directly to theoretical perspectives on disability, definitions of disability, and the role of RCs. The chapter addresses the awareness of current global contextual factors and other issues affecting disability such as culture, poverty, trauma, crisis, large-scale disaster, HIV and AIDS, and psychosocial issues across the life span. The WHO has published guidelines for community-based rehabilitation (CBR), including a matrix that covers the five components of health, education, livelihood, social dimension, and empowerment.