Individual status at the start of rehabilitation: Implications for vocational rehabilitation programs

This research investigated the situation of 143 unemployed sick leavers at the start of vocational rehabilitation in Sweden. It is argued in this paper that in order to gain a meaningful picture of the vocational rehabilitation process it is necessary to know and understand something of individual differences and status at the onset. In doing so, assessment was carried out of the possible influence of one contextual factor and five individual factors on health, duration of sick leave and unemployment. Findings suggest that individual differences exist in health status, length of sick leave and unemployment, at the upstart of vocational rehabilitating. Locus of control was found to exert important influence on the differences between the individuals in the study sample, with persons of external locus of control having a less favourable point of departure at the start of vocational rehabilitation compared to other groups. It is therefore assumed that these persons will be in greater need of support during the vocational rehabilitation process. The level of unemployment within a geographical area was also found to influence the length of sick leave. CONCLUSIONS: Our suggestion is for rehabilitation programs to be developed and selected to match the special needs and differences whether they are of individual or of social nature.     

How can cooperation between rehabilitation professionals in rehabilitation planning be improved? A qualitative study from the employer's perspective

Research shows that there are often problems with cooperation between rehabilitation professionals within vocational rehabilitation. The aim of this study was to describe employers' experiences of how cooperation between different rehabilitation professionals can be improved in a vocational rehabilitation planning process. Ten employers who had sent their employees to vocational rehabilitation at a rehabilitation centre in the north of Sweden during 2000 and 2001 participated in the study. Qualitative interviews were performed and analysed by thematic content analysis. The employers' cooperation with clients could be improved by a focus on clients' needs and participation in the rehabilitation process. The employers cooperation with Social Insurance companies could be improved by, 1) early prevention and intervention, 2) knowledge of each other's roles, responsibilities and opportunities and 3) priority making. The employers' cooperation with rehabilitation professionals could be improved by, 1) early identification of rehabilitation needs and goals and early rehabilitation and, 2) increased focus on own responsibilities from each part in the process.     

Strengths of Gay Male Youth: An Untold Story

This exploratory study found that gay male youths develop strengths that enable them to successfully cope with the challenges and stresses associated with their overall development. These internal and external resources were (1) protective in nature, (2) indicated the presence of resilience, and (3) assisted participants in managing their sexual orientation in adolescence. Bivariate analysis revealed participants had positive self-esteem and an internal locus of control comparable to, or better than, youths overall. Age, social support from gay, lesbian, and bisexual friends and from family, and a preadolescent sense of difference were significantly correlated with self-esteem and/or locus of control.     

The stability of personality traits in adolescence and young adulthood

Models of economic decision-making usually assume that personality is stable over time. We assess the validity of this assumption over an eight-year time frame in adolescence and young adulthood using nationally representative panel data from Australia. Our study shows that unconditional mean-level changes in personality traits are small—with the exception of conscientiousness which increases by 0.38 SD—because most individuals do not change their scores in a statistically reliable way during adolescence and young adulthood, or changes occur in equal proportions in opposite directions. Controlling for systematic panel attrition and multiple hypothesis testing, we demonstrate that personality traits do not systematically respond to the majority of common one-off family-, income-, and health-related shocks. However, a small number of life events—marriage, family members detained in jail, leaving the workforce and long-term health problems—are associated with subsequent changes in personality. In particular, youth who experience long-term health problems including bodily pain increase their external locus of control by 0.5–0.9 SD, an economically meaningful change when expressed in terms of hourly wage penalty.     

Posttraumatic stress disorder (PTSD) symptoms among firefighters: Roles of resilience and locus of control

Firefighting is a an extremely stressful occupation that risks exposure to traumatic events as part of the job. Despite this, the literature on stress and trauma pays little attention to this occupation and its generalization to other, high risk occupations. This study examined resilience and work locus of control as predictors of posttraumatic stress disorder (PTSD) symptoms among Nigerian firefighters. Participants were 116 paid, professional firefighters (98 males and 18 females) who completed the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Resilience Scale (RS-14), and Work Locus of Control Scale (WLCS) and provided vital demographic information. Multiple regression analysis was used to analyze the data. Results showed that resilience negatively predicted PTSD symptoms such that higher resilience was associated with fewer symptoms of PTSD. Work locus of control was a positive predictor of PTSD symptoms, indicating that externality of control beliefs in the workplace was associated with more PTSD symptoms. Relevant demographic factors especially higher years of service, being a senior firefighter, and higher educational status were associated with lower PTSD symptoms. Findings underscore the potential value of resilience training and implementing behavioral health programs to modify firefighters’ external locus of control beliefs. Interventions should consider resilience and locus of control focused interventions as protective factors for PTSD.     

Interdisciplinary team discussion on work environment issues related to low back disability: a multiple case study

From both a social and cost-benefit perspective, disability prevention and associated management strategies for assisting employees with back pain are only successful if they address critical return-to-work (RTW) determining factors present in the workplace, including ergonomic factors. Despite our current knowledge of the importance of an integrated team approach targeting these factors, questions remain regarding the conceptual framework adopted by contemporary rehabilitation teams as it relates to work-oriented interventions to accommodate employees back to work. The purpose of this study was to explore and describe the work environment issues discussed by an interdisciplinary team engaged in the work rehabilitation process of low back disability cases. A qualitative content analysis was conducted for 10 sample cases that underwent a rehabilitation program in Quebec (Canada). Drawing on the results of these analyses, a framework representing a synopsis of practitioners' involvement in the person-environment dynamic is presented and discussed. This study makes a unique contribution to the understanding of the 'real-life' content of an interdisciplinary activity in disability management, thus, helping rehabilitation practitioners to build knowledge on the practical application of a cross-disciplinary framework to address work environment issues during the RTW process of those patients sick-listed due to back pain.     

Intervention options: Participation in work activities for people with schizophrenia

Vocational rehabilitation is a method by which people with disabilities are able to learn skills and receive supports that are necessary to take part in work activities. Vocational rehabilitation interventions can be used in a wide variety of settings with many different populations of people with disabilities, including those with schizophrenia. However, there is little available research to help guide clinicians to identify which vocational rehabilitation intervention methods may be the most effective for their clients. OBJECTIVES: The purpose of this paper is to identify what is the best practice for obtaining and maintaining participation in work activities for people with schizophrenia. STUDY DESIGN: This paper reviewed sixteen previously conducted studies (seven specific solely to schizophrenia) to identify which vocational rehabilitation method is the best practice to aid those with schizophrenia to obtain and maintain participation in work activities. RESULTS: The reviewed literature suggests that there are a variety of vocational rehabilitation intervention methods that may be effective treatment interventions. The effective interventions were those programs that had a client-centered approach and enabled the client to play an active role in his/her vocational rehabilitation. CONCLUSION: With this study review, clinicians will be able to examine a variety of successful client-centered vocational rehabilitation methods that may aid in helping their clients with schizophrenia to obtain and maintain participation in work activities.     

An historical overview of Australia's largest and oldest provider of vocational rehabilitation--CRS Australia

CRS Australia, the largest and oldest vocational rehabilitation provider in Australia, is examined over its 60-year history. The Australian government located CRS initially in the Department of Social Security, and subsequently in the Department of Community Services however, its establishment required a complexity of policy and range of skills that were not found in one arm of government alone and required cooperation from many government departments. A disagreement between the government and the medical profession about the purpose and control of rehabilitation features in the early history of CRS Australia. Factors such as greater involvement of people with disabilities and government inquiries led to a move from a centre-based to a community-based approach to vocational rehabilitation in the 1970s. CRS Australia is a large employer of health and human service professionals and has played a significant part in the development of these professions in Australia. In recent years, CRS Australia has provided greater business accountability to government and the broader Australian community. CRS Australia's role as an expert vocational assessment agency and vocational rehabilitation provider is expected to continue as welfare reform progresses in Australia.     

Maternal Age,Psychological Maturity,Parenting Cognitions,and Mother–Infant Interaction

In the context of the trend toward delayed childbearing, the aim of this study was to examine relations among maternal age and the quality of maternal interactive behavior at 7 months assessed using sensitivity and mind‐mindedness, while also considering whether age effects were attributable to psychological maturity and parenting cognitions. Participants were 150 Australian mothers (mean age 33‐years) and their firstborn infants who were participating in a prospective study of parenthood. Path analysis showed maternal age had both direct and indirect associations with maternal interactive behavior. Older mothers made more mind‐related comments to their infants. They were also more sensitive; however, this effect was indirect and explained by greater psychological maturity (hardiness) and a more internal locus of control with regard to parenting. Results suggest that older maternal age may confer some benefits in terms of responsive parenting in infancy.     

Characteristics of Children Who Experience Positive or Negative Reactions to a Sexual Abuse Prevention Program

ABSTRACT

This study evaluated a sexual abuse prevention program to identify characteristics of children who benefited from the program or became afraid of unwanted touch. Utilizing a pre- and post-test design, 542 2nd-6th graders completed measures including abuse-related knowledge, locus of control, and anxiety. Knowledge increased; age, lower anxiety, and an internal locus of control were positively associated with higher scores after participating in the program. Prior exposure to the program resulted in higher knowledge scores. Further analyses identified those characteristics associated with children reporting that they benefited from the program or became more afraid after participating in the program. Such findings will enable parents and school personnel to take preventive measures to minimize negative impact and maximize learning.     

Assistive technology outcomes in work settings

Successfully documenting the outcomes of assistive technology (AT) interventions in the workplace benefits people with disabilities, service providers and agencies. However, no work related system currently exists that comprehensively collects the data needed to analyze such outcomes. Part of the reason for this absence of an outcome system is that, while the concept is simple, the process is complex and depends on the acquisition of data that represent many outcomes related variables. This article describes the exploratory work of the NIDRR (National Institute on Disability and Rehabilitation Research) funded ATOMS Project (Assistive Technology Outcomes Measurement System) and its efforts to identify existing data that might be used as the basis for an outcomes measurement system. Sample records from four assistive technology service programs were acquired and evaluated for the data they housed. This study discovered that AT service programs fail to collect consistent or sufficient data for outcomes analysis. However, discussions with AT programs that provided services to State vocational rehabilitation agencies revealed an interesting potential. Assistive technology service data in combination with data collected by State vocational rehabilitation departments might coalesce the needed data. The Federal Rehabilitation Services Administration (RSA) 911 Report aggregates many variables of outcomes related information including employment status and the success of the vocational rehabilitation investment. This combined database could answer a range of assistive technology outcomes related questions of interest to service providers, people with disabilities, and vocational rehabilitation State agencies. This paper describes the data needed in an outcomes system, reviews the data that appear to be available today related to AT outcomes, and projects how data from two diverse programs might be used together to create a significant outcomes database.     

Sexual abuse: a comparison between resilient victims and drug-addicted victims

The goal of this study was to determine which variables distinguish resilient victims from drug-addicted victims, who were sexually abused during their childhood--in addition, to measure the contribution of these variables to the level of distress experienced by the victims. There were two groups of 20 women interviewed. The resilient group showed no clinically significant symptoms of mental distress, and the addicted group were undergoing treatment for drug dependency. They all completed a semi-structured interview and a questionnaire regarding the type and severity of their sexual abuse, mental health status, self-esteem, locus of control, support and cognitive factors from Finkelhor's model. Both of these groups were equally and severely abused. Resilient and addicted women both received a moderate level of support. These women also reported the same sense of betrayal and powerlessness. Furthermore, both groups believe, to a large degree, that they now control what happens to them (internal locus of control). There were three distinguishing variables among the two groups, they were stigmatization, self-blame, and hazard for the locus of control. In comparison, resilient women had less self-blame for having been abused and they also felt less stigmatized than addicted women. In fact, stigmatization and self-blame account for 65% of the TSC-40 variance. These results suggest that cognitive strategies, particularly those that are linked to the interpretation of the event, may have some importance in the recovery.     

The empowerment of people with disabilities through qualitative research

The purpose of this article is to explore the use of qualitative research in vocational rehabilitation as a means of empowering people with disabilities to (a) take greater control of their lives and (b) directly inform public policy and vocational rehabilitation service delivery. After exploring various definitions of the construct empowerment, we provide a rationale for the use of qualitative research as an empowerment mechanism based on (a) philosophies espoused by leaders of the independent living movement, (b) disability legislation, and (c) a multi-constituency call for more consumer involvement in research. We then describe empirical properties of various qualitative methodologies that lend themselves to consumer empowerment. The article concludes with several examples of qualitative approaches to scientific inquiry from the rehabilitation literature that include many of the empowerment aspects described herein.     

Using and interpreting analogue designs

Researchers in rehabilitation counseling and disability studies sometimes use analogue research, which involves materials that approximate or describe reality (e.g., written vignettes, videotaped exemplars) rather than investigating phenomena in real-world settings. Analogue research often utilizes experimental designs, and it thereby frequently possesses a high degree of internal validity. Analogue research allows investigators to exercise tight control over the implementation of the independent or treatment variable and over potentially confounding variables, which enables them to isolate the effects of those treatment variables on selected outcome measures. However, the simulated nature of analogue research presents an important threat to external validity. As such, the generalizability of analogue research to real-life settings and situations may be problematic. These and other issues germane to analogue research in vocational rehabilitation are discussed in this article, illustrated with examples from the contemporary literature.     

Going beyond vocational rehabilitation as a training of skills: return-to-work as an identity issue

In western welfare states, labour participation is increasingly considered a vital aspect of taking part in society. Vocational rehabilitation programmes are intended to support people in the process of returning to work. These programmes pay much attention to the skills that clients need to develop in order to return to work. We argue, however, that vocational rehabilitation is more than the acquirement of skills, and that further attention should be paid to clients’ ‘identity work’ processes. Based on 45 life-stories, we present an analysis of the identity work expressed by people with a work disability in the Netherlands. We describe ‘separative’, ‘integrative’, and ‘pending’ processes of identity work. The presented typology can help vocational rehabilitation professionals become more sensitive to clients’ processes, and supports more inclusive vocational rehabilitation.     

Region‐Urbanicity Differences in Locus of Control: Social Disadvantage,Structure, or Cultural Exceptionalism?

People with internal rather than external locus of control experience better outcomes in multiple domains. Previous studies on spatial differences in control within America only focused on the South, relied on aggregate level data or historical evidence, or did not account for other confounding regional distinctions (such as variation in urbanicity). Using data from the National Education Longitudinal Study, we find differences in adolescents' loci of control depending on their region and urbanicity are largely attributable to differences in their social background, and only minimally to structural differences (i.e., differences in the qualities of adolescents' schools). Differences that persist net of differences across adolescents and their schools suggest the less internal control of rural Southern adolescents, and the more internal control of rural and urban Northeastern adolescents, may be due to cultural distinctions in those areas. Results indicate region is more closely associated than urbanicity with differences in locus of control, with Western and Northeastern cultures seemingly fostering more internal control than Midwestern and Southern cultures. These findings contribute to research on spatial variation in a variety of psychological traits.     

Multi-professional vocational rehabilitation group meetings with female clients: a qualitative study

Many women require vocational rehabilitation before they can return to work. The objective with the present study was to describe female clients' situation during the rehabilitation process, as it became apparent during the rehabilitation meetings with the various actors involved. The clients' diagnoses varied, but the majority was affected with musculoskeletal disorders. The meetings were audio-taped and transcribed verbatim, after which they were analysed by qualitative content analysis. The following themes emerged: Adaptation to the rehabilitation group; client's health status; the workplace's significance for rehabilitation; and the client's decision-point. Conflict between health and work was immensely important for rehabilitation. Differences in attitude were apparent during the rehabilitation meetings, as some clients were passive and exercised less influence on the planning, than the other more active clients did.     

The Financial Behavior of Emerging Adults: A Family Financial Socialization Approach

The current study examined the role of attachment insecurity, locus of control, and parental financial communication on the financial behavior of emerging adults from a family financial socialization theory perspective. Data were used from the Emerging Adult Financial Capability Study, the sample consisted of emerging adult college students (N = 321) from a large southeastern university in the United States. Structural equation modeling was used to examine the direct and indirect effects as well as the overall fit of the model that was constructed according to family financial socialization theory. Results suggested that increased attachment insecurity predicted decreased financial communication from parents and a decreased perception of an internal locus of control. Emerging adults who received greater financial instruction (both direct and indirect) and who felt they had a greater ability to influence outcomes in their life engaged in more sound financial behavior. Results also suggested that financial communication and locus of control mediated the relationship between attachment insecurity and financial behavior. The findings supported the inclusion of attachment as an important family relationship variable in the financial socialization process, as well as the structure of a conceptual model of family financial socialization theory.     

Experience in developing a Transitional Employment Program (TEP) for the psychiatric patients in an acute general hospital in Hong Kong

This paper describes the application of a transitional employment program (TEP) for psychiatric patients in Hong Kong. The TEP and its values in psychiatric rehabilitation are introduced. The differences between TEP and Supported Employment (SE) were also highlighted. A TEP for psychiatric patients in an acute general hospital is outlined. Interviews of employer and trainees showed that, apart from increasing income, qualitative changes in the trainees were observed such as increased self-confidence, improved assertive and social skills, and increased work tolerance. Ongoing objective measurement should be conducted to demonstrate its effectiveness. TEP could be considered as a feasible alternative of vocational rehabilitation for patients with mental illness.     

Locus of control and saving: The role of saving motives

Using data from a longitudinal survey representative of the Dutch population, we analyze the relationship between saving and locus of control, and we study the underlying mechanisms. Locus of control measures the extent to which individuals perceive their life outcomes to be determined by their own actions, as opposed to external factors. Those who believe to be in control of future outcomes turn out to save more, both at the extensive (decision to save) and intensive margins (amount saved). We investigate the mechanisms behind this relationship. We implement a mediation analysis to examine the role of saving motives, distinguishing between specific and non-specific purposes. The effect of external locus of control is direct, while the effect of internal locus of control is indirect, largely driven by (non-specific) saving motives.