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.

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.

Credentialing refers to the general process of establishing the minimum standards, qualifications, and/or requirements essential to professional counseling practice. The credentialing process serves two fundamental purposes, namely control of the profession and public recognition of the profession. This chapter talks about rehabilitation counselors (RCs) to understand professional credentialing and the factors influencing the practice of rehabilitation counseling. It discusses the elements of accreditation, certification, and licensure as well as the role of professional associations and legislative changes. The purpose of accreditation in rehabilitation counseling is to guarantee that practitioners have obtained fundamental counseling skill and knowledge requirements prior to applying for certification and licensure. The primary accredition body of rehabilitation counselor education (RCE) programs has been the Council on Rehabilitation Education (CORE). The merger of CORE and Council for Accreditation of Counseling and Related Educational Programs (CACREP) represents an example of professionalization of the counseling profession.

This chapter identifies the origins of forensic and indirect service provision at the very start of the rehabilitation counseling profession and traces its growth and trajectory to its continued spread and growth today. It discusses the settings, methods techniques, resources, and ethics of forensic rehabilitation counselor (FRC) practice. The history of forensic rehabilitation and indirect service provision in rehabilitation counseling has often been assumed to be a modern phenomenon emerging with the current generation of practitioners. Workers’ compensation cases are the first cases to be found in the literature where FRC involvement became evident. A subspecialty in forensic rehabilitation counseling is life care planning, which merits mention in any discussion of forensic rehabilitation practice. Clinical judgment in forensics is not a subjective distal inference, guess, or opinion. The Commission on Rehabilitation Counselor Certification (CRCC’s) treatment of forensic and indirect service ethics is the most comprehensive in any counseling specialty.

Rehabilitation counseling concepts and models have evolved progressively over the last century. This chapter describes fundamental philosophical values that characterize rehabilitation counselors (RCs) and how they approach their work. It discusses four traditional models or conceptual frameworks of disability namely, moral model, medical model, labor market economic model and ecological model. The chapter also explains four newer models such as social model, disability culture model, technology model and consumer economic model that propose alternative interpretations and responses to the stimuli that disabilities represent. An asset-oriented approach or strengths-based orientation of uncovering and exploiting the positive aspects in both the person and the situation is the widely endorsed current expectation for RCs. The interdisciplinary team has been a primary model for the delivery of comprehensive rehabilitation services, especially in large clinical settings. RCs who work in vocational programs have an essential partner in employers, sometimes called the “second client”.

This chapter addresses the most significant areas of knowledge for rehabilitation counselor (RC) competencies-general scope of use of technology, counselor and client competencies, assistive technology, distance education, and the future role of technology in the field. Although high and low technology advances hold the potential of a better quality of life (QOL) for people with disabilities, technological access to those individuals with physical, mental, and cognitive functional differences continues to lag behind that of the general population. The first legal mention of assistive technology devices or services is found in the Individuals with Disabilities Education Act (IDEA, 1990). The individuals involved in the provision of assistive technology are considered to be from a multidisciplinary profession. There are a number of technologies holding promise for the future that may have profound effects on the field of assistive technology. Self-driving vehicles may be the most dramatic of these developments.

Rehabilitation counseling has evolved from its inception in federal legislation in the early 1900s to its current recognition as a specialization of the counseling profession. An initial focus on case management served a constructive purpose during the early years, given the historic link of rehabilitation counseling to the state-federal vocational rehabilitation (VR) system. A psychiatric disability is when an individual with a serious mental illness is unable to perform major life activities in particular life contexts, such as community participation, and independent living. Credentialing has defined and regulated the professional practice of rehabilitation counseling in recent years. The professional identity of a rehabilitation counselor (RC) as a counselor has had wide formal endorsement by the major professional organizations and leaders in the field. Counselor licensure laws emerged because of regulations by Medicare and Medicaid as well as private health insurance that required licensure for the reimbursement of mental health services.

This chapter explores how the transformation of the health care system in the United States has impacted service delivery of health care disciplines including rehabilitation counseling in providing the most effective clinical services. It provides a review of key evidence-based practice, knowledge translation, and research utilization concepts. It discusses how evidence-based practice can be utilized to improve the professional practice of clinical rehabilitation counseling. The chapter explains how the mechanisms of theory development, empirical evidence, and clinical application inform practice in vocational rehabilitation (VR) service delivery, improving evidence-based practice to enhance outcomes and quality of life (QOL) of people with disabilities. The development of a systematic research agenda and conducting meaningful theory-driven research and intervention research will generate new knowledge and accumulate high-quality evidence, enhancing the ability of rehabilitation counselors (RCs) to truly engage in evidence-based practice to improve employment outcomes and QOL of people with disabilities.

This chapter provides an introduction to the constructs, theories, and strategies that are relevant for practicing rehabilitation counselors (RCs) to assist individuals with disabilities to attain work, maximize productivity, and successfully adjust to the contemporary social, organizational, and personal dynamics in the work environment. It covers the topics that highlights the vocational focus of rehabilitation counseling: centrality of work in people’s lives, how work relates to individuals’ basic needs and how these needs can be used to develop multidimensional outcomes to measure the effectiveness of rehabilitation counseling, the Illinois Work and Well-Being Model, relevant theories of career development and work adjustment, and basic career and employment development interventions. In addition to the core value that work is central to people’s lives, the chapter is based on several assumptions that the authors believe are not only relevant, but also fundamental to the field and practice of rehabilitation counseling.

This chapter offers practical utility to help expand rehabilitation counselors’ (RCs) and other mental health professionals’ thinking about the various considerations that underlie a culturally competent social justice approach to rehabilitation counseling practice. Rehabilitation counseling has demonstrated its commitment to the importance of cultural competency in improving the quality and availability of counseling and rehabilitation services to clients from traditionally under represented racial/ethnic groups. The chapter describes the multicultural and social justice counseling competencies (MSJCC), with particular attention directed to the social justice framework and how it may be used to assist in working toward equity in the context of changing demographics in American society. It then explains how individual and group racial, sexual identity, cultural, and identity development may impact the counseling process. The counseling literature recognizes LGBTQ individuals as inclusive under the umbrella of multicultural populations, as well as intersecting with other groups because of multiple identities.

This chapter provides a foundation for deeper understanding of the nature of rehabilitation counseling practice. Job analysis, role and function, professional competency, critical incident, and knowledge validation research are all terms that describe a process whereby the professional practice of rehabilitation counseling has been systematically studied. Rehabilitation counseling has been described as a process in which the counselor works collaboratively with the client to understand existing problems, barriers and potentials in order to facilitate the effective use of personal and environmental resources for career, personal, social, and community adjustment following disability. A majority of rehabilitation counselors (RCs) still practice in the public, private, and not-for-profit rehabilitation sectors. However, more recently RCs have begun to practice in independent living centers, employee assistance programs, hospitals, clinics, mental health organizations, public school transition programs, and employer-based disability prevention and management programs.

This chapter describes the value of case management for rehabilitation counselors (RCs) and discusses the purpose of medical, psychological, and vocational case management. RCs use case management skills in a variety of work settings, including public rehabilitation, private for-profit rehabilitation, behavioral health treatment programs, community-based rehabilitation, private not-for-profit rehabilitation programs, and managed care. Case documentation may include case notes documenting the RC’s interactions with the client and other service providers Psychological case management may require assisting the client in referral to a mental health professional. A psychological or neuropsychological evaluation may be completed if additional information regarding the client’s cognitive and emotional functioning is required. Vocational case management requires that RCs have knowledge of their clients’ educational background and prior work and volunteer experiences. The chapter also explains how Lewy body dementia (LBD) can affect a client’s rehabilitation.

This chapter provides an operational definition of clinical supervision and examines initial considerations when seeking or providing clinical supervision. It describes a framework that exemplifies good clinical supervision and, in particular, one consistent with multicultural practice. As part of the clinical supervision process, rehabilitation counselor (RC) supervisors demonstrate appropriate ethical practices to promote counselor awareness, knowledge, and skills directed toward achieving successful rehabilitation outcomes. One of the most important considerations that counselors and supervisors address pertains to the basic understanding that supervision is provided in an ethical manner consistent with accepted standards of practice. Clinical supervision involves an evaluation process, which, by its nature, means that an unequal partnership exists with the supervisor usually having greater power. As a result, it can introduce anxiety, defensiveness, and tension for the supervisee. Supervisors have several options to review client–counselor interactions.