Impact of childhood maltreatment on psychosomatic outcomes among men and women with disabilities

PURPOSE

This project examined the impact of childhood maltreatment types on psychosomatic outcomes among adults with a range of self-reported disabilities.

MATERIALS AND METHODS

Participants (n = 643) were recruited using Amazon Mechanical Turk and Cloud Research. Single-item questions assessed sociodemographic information. The Childhood Trauma Questionnaire measured childhood maltreatment types (emotional, physical, and sexual abuse, and emotional and physical neglect) and the RAND-36 Item Health Survey evaluated physical functioning, pain, and energy/fatigue. Logistic regressions determined associations between childhood trauma and psychosomatic outcomes; stratified models compared men and women.

RESULTS

Multivariate-adjusted models indicated physical abuse was positively associated with poor physical functioning (OR: 2.03; 95%CI: 1.35-3.06) with this relationship being stronger for men (OR: 3.25; 95%CI: 1.42-7.43) than women (OR: 1.91; 95%CI: 1.17-3.13). Adjusted models showed that physical neglect was protective against fatigue (OR: 0.58; 95% CI: 0.36-0.94), while emotional neglect increased the risk of fatigue (OR: 1.74; 95%CI: 1.02-2.95). Lastly, physical abuse was positively associated with pain (OR: 1.53; 95%CI: 1.01-2.33). This relationship was stronger in men (OR: 4.99; 95%CI: 1.91-12.99).

CONCLUSIONS

Results improve our understanding of risk factors for poor physical health outcomes and can guide the development of trauma-sensitive rehabilitation services.Implications for RehabilitationIndividuals with disabilities who report childhood maltreatment may experience poor psychosomatic outcomes in adulthood.Consequences of experiencing childhood maltreatment may manifest differently between men and women over the course of the lifespan.It is essential to integrate trauma-informed principles into treatment plans for individuals with poor psychosomatic health.Rehabilitation professionals should screen for abuse and refer individuals to the appropriate mental and physical health services.

Differential Effects of Functioning on the Career Development of Individuals with Disabilities

Individuals with disabilities experience disproportionate rates of unemployment and underemployment when compared with individuals without disabilities. Furthermore, health functioning impacts career development and employment across multiple life contexts. To build on what is known regarding the relationships between functioning and career development, this study focuses on delineating how varying aspects of functioning differentially impact specific areas of career development. Based on data collected from 674 individuals with disabilities, this study investigated the relationship between individual health functioning and the following three core components of career development: vocational identity, work personality, and work adjustment. Findings illuminate important differences across dimensions of functioning that impact career development. Results suggest that a multidimensional approach to career development would be most efficacious in supporting the functioning of individuals with disabilities.

Doctoral Dissertation Research in Rehabilitation Counseling: 2013

Our team recently examined the 2012 doctoral dissertation research in our field. This article continues a series of annual reviews of rehabilitation doctoral dissertation research. In 2013, there were a total of 22 doctoral dissertations completed from identified doctoral programs in rehabilitation counseling. Dissertations were organized by research topic, methodology used, model, and statistical analysis, and an annotated bibliography was provided. The analysis also included institutional productivity and trends in employment outcomes for doctoral graduates. Findings of the current analysis demonstrated that majority of the studies consisted of quantitative descriptive research designs. Compared to analyses from previous years, in 2013, advanced statistics were used at the highest rate since 2005. The proportion of dissertations focusing on professional issues topics was greater than any of the prior reporting periods. Implications for the practice of rehabilitation counseling, education, and future research are discussed.

Relations among gratitude, adaptation to disability, and flourishing among adults with disabilities: A longitudinal mediation model

PURPOSE/OBJECTIVE

Flourishing, a primary outcome of rehabilitation psychology, is understudied among adults with disabilities. Gratitude has emerged as an individual strength that is both malleable and robust in predicting flourishing and adaptation to disability. The purpose of this study was to assess the influence of gratitude on flourishing over time and to analyze the potential mediating role of adaptation to disability on this relationship for a group of adults with disabilities.

RESEARCH METHOD/DESIGN

Data were collected at 3 time points over 21 months (N = 429). A single mediator model with external demographic variables was tested to determine the relationship of gratitude (Time 1) with adaptation to disability (Time 2) and flourishing (Time 3). Approximately 40% of the initial sample was retained across all time points.

RESULTS

Gratitude predicted later flourishing and adaptation to disability accounted for a significant portion of this relationship, accounting for 27% of the total effect.

CONCLUSIONS/IMPLICATIONS

Results of this single mediator model indicate that adaptation to disability serves as a partial mediator of the relationship between gratitude and flourishing, with both gratitude and adaptation to disability having a significantly positive influence on flourishing. Understanding gratitude's influence on later adaptation and flourishing provides data to inform rehabilitation psychology interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effectiveness of internet-based behavioral activation on quality of life among young adult survivors of childhood brain tumor: a randomized controlled trial

PURPOSE

Diagnosis and treatment of childhood brain tumor have detrimental effects on physical, neurocognitive, psychological, and social functioning that lasts into adulthood and effects quality of life (QOL). To address diminished QOL, an Internet-based behavioral activation (BA) intervention was developed. Behavioral activation aims to increase activities and behaviors likely to improve thoughts, mood, and QOL.

METHODS

Participants included 127 young adult survivors of childhood brain tumor (SCBT) randomized into the experimental group (n= 64) or the waitlist control group (n= 63). The dependent variables included: life satisfaction, stress, and activation and were assessed with a two-way mixed analysis of variance (ANOVA).

RESULTS

Results revealed a significant interaction between the intervention and time on life satisfaction, F(1, 125)=4.793, p = 0.03. There were no significant main effects over time for perceived stress and activation.

CONCLUSIONS

Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult SCBT. Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.Implications for rehabilitationBehavioral activation (BA) is aimed at increasing positively reinforcing overt behaviors that are likely to promote improved thoughts, mood, and quality of life (QOL).Results indicated study participants in the experimental group demonstrated a significant gain in life satisfaction compared to the control group after receiving the Internet-based BA intervention; and provides support that the intervention was associated with positive changes across time.Findings offer initial evidence that BA can be delivered over the internet and that Internet-delivered BA can have a positive effect on the QOL of young adult survivors of childhood brain tumor (SCBT).Internet-based BA interventions can serve as a resource for young adult SCBT who desire to boost their mood and QOL.

Company Characteristics, Disability Inclusion Practices, and Employment of People with Disabilities in the Post COVID-19 Job Economy: A Cross Sectional Survey Study

Purpose In the post coronavirus disease 2019 (COVID-19) recession economy, rehabilitation counselors, transition specialists, and other disability service providers must redouble their efforts to connect with employers to create employment opportunities for people with physical and mental impairments. The purpose of the present study was to investigate company characteristics and effective disability inclusion practices that are related to employment of people with disabilities. Methods Four hundred sixty-six employers completed a demographic questionnaire and the Disability Inclusion Profiler. Results Results indicated company characteristics and disability practices were positively related to employment of people with disabilities. Conclusions Findings of the present study can be used by transition specialists, rehabilitation counselors, and other disability service providers to engage and connect with employers to increase employment opportunity for people with disabilities in the post COVID-19 economy. Future research and practice implications are provided.

Development and validation of the social motivation scale in people with disabilities

OBJECTIVE

Social effectiveness is key to success in the labor market. For decades, social motivation has been empirically studied as both a presumed cause and consequence of social effectiveness. Yet, few direct measures of social motivation exist, and even fewer have been validated with a disability population. This study provides the measurement structure and psychometric properties of a newly created measure of social motivation tested with a general disability population.

RESEARCH DESIGN

Participants included 1,013 US adults with disabilities. Exploratory factor analysis (EFA) and Confirmatory Factor Analysis (CFA) were implemented to validate the measure.

RESULTS

Results of the EFA suggest that a reduced 26-item inventory exhibits a 5-factor structure in a general population of people with disabilities. These results were confirmed with the CFA. Concurrent validity analysis revealed that most factors were significantly associated with relevant psychosocial variables in the expected directions.

CONCLUSIONS

The Social Motivation Inventory provides a useful tool for enhancing understanding of social motivation in rehabilitation psychology and rehabilitation counseling research and practice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The tripartite efficacy beliefs model in vocational rehabilitation: Implications for working alliance and client engagement

BACKGROUND: Given the importance of working alliance to client engagement and outcomes in vocational rehabilitation, there is a need to better understand predictors of the client counselor relationship. Research has shown the tripartite efficacy model as a way of understanding working alliance in various contexts but has never been examined in vocational rehabilitation. OBJECTIVE: This study evaluates the relationship among tripartite efficacy beliefs constructs (self-efficacy, other-efficacy, and relation-inferred self-efficacy [RISE]), working alliance, and engagement for 350 clients receiving state vocational rehabilitation services. METHODS: Researchers used a path analysis to assess the hypothesis that the tripartite efficacy model would predict client engagement through its impact on working alliance. RESULTS: The hypothesized model had a close fit. Other-efficacy and RISE beliefs had significant positive direct effects on working alliance and indirect effects on client engagement. Self-efficacy had a significant negative direct effect on working alliance and client engagement. CONCLUSIONS: The study supports the tripartite efficacy beliefs model as a way of better understanding client perceptions of working alliance in vocational rehabilitation.

Development and Validation of the Satisfaction With Labor Market Participation Survey

Employment is often assumed to be the universally desirable outcome in vocational counseling and research; however, many personal and environmental factors affect individual decisions about the costs and benefits of work and the amount of work that is desired. The objective of this study was to validate an instrument capturing satisfaction with labor market participation regardless of one’s employment status. The Satisfaction with Labor Market Participation Survey (SLMP) was administered at two points in time to adults with disabilities. Analyses included a combination of exploratory and confirmatory factor analysis. A nine-item, two-factor scale emerged from the exploratory factor analysis and was supported by confirmatory factor analysis. All correlations were in the expected direction, and regression analysis with both the SLMP and employment status showed the SLMP significantly predicting satisfaction with life while employment status did not after controlling for the SLMP. Preliminary data support the SLMP as a reliable and valid tool for assessing satisfaction with labor market participation for use with people with disabilities in vocational counseling and employment research.

A tool to measure work adjustment in the post-pandemic economy: The Illinois work adjustment scale

OBJECTIVE: This article introduces the Illinois Work Adjustment Scale (IWAS) and sets out to confirm the internal validity of the IWAS as well as determine if there are meaningful dimensions among the items of the IWAS that can be further defined as instrument subscales. METHODS: In order to meet these objectives, a survey of 738 individuals, all of whom self-reported as having disabilities, was conducted online. RESULTS: As a result of this survey and exploratory and confirmatory factor analyses, the IWAS was reduced from a 26-question scale to an 18-question scale consisting of two meaningful subscales, Work Context and Work Capacity. Significant and meaningful correlations between the two subscales indicate that Work Context and Work Capacity are related to the broader concept of work adjustment and assess unique aspects of work. CONCLUSION: The IWAS has the potential to be applied to facilitate positive career development and vocational rehabilitation outcomes for people with disabilities and chronic health conditions. This is of greater importance now as the COVID-19 crisis has significantly impacted the economy and workforce, leaving those with the greatest barriers to employment such as individuals with disabilities and chronic health conditions further marginalized and disconnected from work.

The Relationship Among Demographic Factors, Transition Services, and Individual Development Account (IDA) Saving Participation Among Transition-Age Youth With Disabilities

Saving participation in adolescence is crucial for young adults to achieve financial well-being over their lifetime. Yet, very little is known about the factors that encourage saving participation among youth with disability, including youth who receive supplemental security income (SSI). This study examines relationships between personal and family factors, transition services, and participation in Wisconsin Promoting Readiness of Minors in Supplemental Security Income (PROMISE) individual development account (IDA), within a sample of youth with disabilities who receive SSI. Results of the hierarchical binary logistic and hierarchical multiple regression analyses suggests that the PROMISE interventions variable sets emerged as the most frequent predictors of IDA saving participation among youth receiving SSI. Specifically, work incentive benefits consultation services, financial capability-focused financial coaching services, and self-advocacy training were significant predictors of a youth’s IDA saving participation. This study’s findings offer important implications for transition planning and building financial capability.

Doctoral Dissertation Research in Rehabilitation Counseling: 2012

This article continues a series of reviews of rehabilitation doctoral dissertation research. In 2012, there were 30 doctoral dissertations completed from identified doctoral programs in rehabilitation counseling. Dissertations were indexed by research topic, methodology used, model, and statistical analysis. An annotated bibliography is provided. A consideration of institutional productivity and doctoral graduate employment outcomes were also included in the analysis. Results of the current analysis show that a majority of studies comprised quantitative descriptive research designs. Unlike analyses from previous years, advanced and basic statistics were utilized equitably. The proportion of dissertations focusing on attitudes toward persons with a disability was greater than any of the prior reporting periods. Predictive outcome studies and clinical population research also remain prevalent. Implications for the practice of rehabilitation counseling, education, and future research are discussed.

The Impact of Risk and Resistance Factors on Quality of Life in Caregivers of Individuals with Dementia

OBJECTIVES

The present study investigates the effect of caregiver and care recipient risk and resistance factors on caregiver quality of life (QOL). Risk factors are those characteristics that contribute to psychosocial maladjustment of the caregiver and reduce QOL, while resistance factors promote caregiver adjustment and improve QOL.

METHODS

One-hundred and three caregiver/care recipient dyads were recruited from a memory assessment clinic in Midwestern United States. Caregivers completed questionnaires estimating perceived social support, spirituality, social problem-solving, and care recipient functional dependence. Care recipients' results from the Mini-Mental State Examination and Animal Naming task were also collected.

RESULTS

In the final model, caregiver age, relationship type, social problem-solving, perceived social support, and care recipient functional dependence each accounted for a significant portion of variance in caregiver QOL. The final model accounted for 46.1% of the variance in caregiver QOL.

CONCLUSION

Caregiver age, relationship type, social problem-solving, perceived social support, and care recipient functional dependence are important contributors to caregiver QOL. Further research is needed to specify which caregiver and care recipient characteristics are most important to caregiver QOL.

CLINICAL IMPLICATIONS

Health professionals should assess caregiver problem-solving skills, social support, and care recipient functional dependence, as these may provide important information about caregiver QOL. Study results also suggest that caregiving has more of a negative impact on caregiver QOL for midlife adult caregivers compared to older adult caregivers, and appears to have a greater negative effect on spouses than on children.

Are You Getting Enough to Eat? Addressing Food Insecurity in Rehabilitation Clients

Food insecurity is a well-known risk factor for poor health and quality-of-life outcomes. Recent explorations of census data have concluded that it is experienced disproportionately by individuals with disabilities, making it an important area of focus for rehabilitation counseling and research. The purpose of this study is to explore the relationship between food insecurity and work barriers and intrapersonal characteristics that are often the focus of rehabilitation counseling. Findings from a national sample of adults with disabilities ( N = 435) reveal that individuals with less than a bachelor’s degree or in a household earning less than $40,000 per year were more likely to report high food insecurity. In addition, food insecurity correlated with unfavorable outcomes in measures of self-reported health, depression, social support, acceptance of chronic illness and disability (CID), and vocational self-efficacy. Implications are presented for increasing attention to the issue of food insecurity within the context of rehabilitation counseling practice and research, including strategies for augmenting services to include food assistance in a way that is sensitive to the experience of individuals with significant resource gaps.

Predictors of perceived social effectiveness of individuals with serious mental illness

OBJECTIVE

Social effectiveness continues to play a critical role in recovery of people with serious mental illness (SMI), with greater social effectiveness predicting many positive life outcomes. Despite the abundance of literature supporting the relationship between perceptions and behavior, little is known about predictors of perceived social effectiveness of individuals with SMI.

METHODS

The purpose of this study is to examine the predictors of perceived social effectiveness of individuals with SMI. Cross-sectional data of 192 participants with SMI recruited from four psychiatric rehabilitation clubhouses in 2 states in the South and Midwest regions of the United States were used for this study. Self-report data on category of psychiatric disabilities, psychiatric symptoms, cognition, insight, educational attainment, empathy, interpersonal interactions and relationships, self-stigma, disability acceptance, and perceived social effectiveness were collected and analyzed using multiple regression analysis (MRA).

RESULTS

MRA yielded a regression model that accounted for 56% of the variance in perceived social effectiveness, which is considered a large effect size. Controlling for all other factors, mood disorder, educational attainment, empathy, interpersonal interactions and relationships, and disability acceptance were found to be significant predictors of perceived social effectiveness of persons with SMI.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Practitioners should consider determining points of intervention and targeting specific elements that enhance perceived social effectiveness. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Validating a Model of Psychological Capital in Vocational Rehabilitation Consumers

Background:

Psychological Capital (PsyCap) is a prominent, well-established model of psychosocial strengths in the organizational positive psychology literature. PsyCap is a higher order construct consisting of hope, optimism, resilience, and self-efficacy that has been identified as a powerful predictor of work-related outcomes, with strong potential for application in vocational rehabilitation (VR). However, PysCap has not yet been validated for individuals with disabilities in rehabilitation settings.

Objective:

The purpose of this study was to explore the relevance of PsyCap for individuals with disabilities in VR.

Methods:

Confirmatory Factor Analysis was used to validate the structural model of PsyCap in a sample of adults with disabilities who have received public VR services (N= 229).

Findings:

VR client data supported the hypothesized factor structure of PsyCap. In an initial exploration of the relationship between PsyCap and employment status, individuals who reported employment had a higher mean PsyCap score than those reporting unemployment.

Conclusions:

These results highlight the potential utility of PsyCap for VR consumers. Additional research is needed to explore this construct as it pertains to VR services.

The Influence of Social Capital and Social Role on Starting Wage for People With and Without Disabilities

People with disabilities are arguably the most economically marginalized population in America. Employment does not address the problem unless wages reach adequate levels, suggesting the need for better understanding of factors influencing compensation in employment. The purpose of this study is to replicate previous findings on social capital and starting wage while also considering the influence of social role for people with and without disabilities. The responses of university health students to hypothetical hiring scenarios were analyzed using a three-way mixed ANOVA. Results support and extend prior research suggesting that social capital and social role have a positive influence on starting wage for both people with and without disabilities. Scenarios depicting social capital and positive social role resulted in an increase in hourly wage of more than US$1,500.00 per year than those with low levels of social capital and a negative social role. A similar but weaker relationship between pay and social capital existed when there was one degree of separation (i.e., the friend of a friend) between employer and new employee. Social role, along with social capital, is an important factor in starting wage decisions. Implications for the job search are provided.

A Needs Driven Model of Workplace Social Effectiveness in Adults With Disabilities

Social effectiveness is central to workplace success. Yet, surprisingly little is known about the factors that influence effectiveness in managing the social requirements of the workplace. This study provides a preliminary analysis of a model of workplace social effectiveness for adults with disabilities. A total of 330 adults with disabilities participated in an online, cross-sectional research study. Researchers used several measures to assess the extent to which latent variables representing communal and positive approaches to social situations influenced workplace social effectiveness and whether that relationship was mediated by the ability to connect with others. Results from a structural equation model analysis suggest that both a communal and positive social approach predict workplace social effectiveness. The ability to connect with others partially mediated relationships between both communal and positive approaches and workplace social effectiveness. Although the cross-sectional and self-report nature of this study limits the conclusions that can be drawn, the findings lay a groundwork for further model testing and clinical interventions in rehabilitation counseling services. The results offer an alternative socioemotional approach for identifying and intervening on workplace social effectiveness that can be applied to adults with disabilities.

Disability Diversity Training in the Workplace: Systematic Review and Future Directions

Purpose Misinformation and negative attitudes toward disability contribute to lower employment rates among people with disabilities. Diversity training is an intervention intended to improve intergroup relations and reduce prejudice. We conducted a systematic review to determine the use and effectiveness of disability diversity training aimed at improving employment outcomes for employees with disabilities. Methods Five databases were searched for peer-reviewed studies of disability diversity training interventions provided within the workplace. Studies identified for inclusion were assessed for quality of methodology. Results Of the total of 1322 articles identified by the search, three studies met the criteria for inclusion. Two of the three articles focused specifically on training to improve outcomes related to workplace injuries among existing employees. The other study provided an initial test of a more general disability diversity training program. Conclusions There is currently a lack of empirically validated diversity training programs that focus specifically on disability. A number of disability diversity trainings and resources exist, but none have been well researched. Related literature on diversity training and disability awareness suggests the possibility for enhancing diversity training practices through training design, content, participant, and outcomes considerations. By integrating best practices in workplace diversity training with existing disability training resources, practitioners and researchers may be able to design effective disability diversity training programs.

Social Effectiveness

The ability to effectively manage social interactions is key to achieving many life goals. A substantial amount of research has been conducted in rehabilitation counseling and rehabilitation psychology that includes a consideration of some aspect of social effectiveness. The purpose of this study was to collect and synthesize the past 30 years of rehabilitation counseling and rehabilitation psychology research addressing aspects of social effectiveness. A total of 13 terms (e.g., interpersonal skills, social competence, social functioning, and soft skills) were used to search six of the most prominent rehabilitation counseling and rehabilitation psychology journals from the period January 1982 to May 2013. A total of 608 articles were identified as including at least one of the search terms, with 175 using a search term prominently and the other 433 only passively. Social skills, social functioning, and social competence were among the most frequently used search terms, accounting for almost 90% of all used terms. It was found that social effectiveness constructs were rarely defined and often used interchangeably. Twenty-nine interventions studies had been published in the 30-year period. Results reflect a substantial and useful body of literature in this area of research while also conveying an opportunity for the development of a more systematic, unified, and theory-driven approach to understanding and addressing aspects of social effectiveness.

Assessing readiness for self-directed learning within a non-traditional nursing cohort

Increasing deregulation of the Australian tertiary system has led to changes in entry behaviours anticipated in non-traditional student cohorts. Many nursing students are returning to formal studies later in their lives seeking a career change. Accessibility and flexible study paths make external study increasingly attractive. However external studies require a level of commitment and willingness to develop self-direction and a capacity for resilience. This study sought to elicit the level of self-directed learning readiness (SDLR) among undergraduate nursing students currently enrolled at a bachelor level, and to elicit what differences existed in the levels of SDLR in relation to age, gender, academic year, and previous qualifications. An online survey questionnaire was utilised based on the Self-directed Learning Readiness Scale for Nursing Education. In contrast to earlier work, the participant profile in this study was predominantly non-traditional and captured participants from all three years of the nursing programme. Results found no significant age or gender differences. First year students demonstrated lower levels of self-directed learning readiness. However, unexpected results were demonstrated in the survey subscales in relation to previous qualifications. Participants who already held post-graduate qualifications showed lower scores for Self-Management than those who held diploma qualifications, while students who already held a bachelor's degree had the highest scores in Desire for Learning. The study findings suggest that universities should not assume that SDL capability is dependent on mature age or length of exposure to tertiary study.

Core self-evaluations and Snyder's hope theory in persons with spinal cord injuries

OBJECTIVE

The objective of the study was to evaluate a motivational model of core self-evaluations (CSE), hope (agency and pathways thinking), participation, and life satisfaction in persons with spinal cord injuries.

DESIGN

A cross-sectional, correlational design with path analysis was used to evaluate the model.

PARTICIPANTS

187 adults with spinal cord injuries participated in this study.

RESULTS

The results indicated an excellent fit between the data and the proposed model. Specifically, CSE was found to directly predict agency and pathways thinking, participation, and life satisfaction. CSE was also found to indirectly predict participation and life satisfaction through agency thinking.

CONCLUSIONS

Although CSE contributes directly to participation and life satisfaction, it also has a unique role in increasing individuals' motivation to pursue goals, which also predicts participation and life satisfaction. Counseling interventions should be multifaceted and address the components of CSE to increase hope, participation, and life satisfaction.

The Influence of Social Capital on Starting Wage for People With and Without Disabilities

Disability is associated with low employment rates and earnings. The gap in earnings between people with and without disabilities continues among those who exit vocational rehabilitation (VR) services with an employment outcome. Hypothetical hiring scenarios were presented to undergraduate business students, and the potential influence of social capital on starting wage was examined for both persons with and without disabilities. Results suggest that both direct and indirect social capital have a positive influence on starting wage. Scenarios depicting high levels of social capital resulted in an increase in hourly wage of over US$1,500.00 more per year for a direct relationship and over US$800.00 more per year for an indirect relationship. Social capital, along with human capital, is an important factor in starting wage decisions. A comparison between human and social capital suggests important differences in (a) where the capital is located, (b) potential for indirect use, and (c) resources for investment. Implications for provision of VR services include increased use of a customized, strength-based approach for development and use of social capital for both consumers and counselors.

A Qualitative Study of Job Placement Provider Decisions in Vocational Rehabilitation

A modified consensual qualitative research approach was taken to determine factors that influence job placement services in selected state Vocational Rehabilitation agencies. Thirty-five counselors, supervisors, and administrators participated in semistructured interviews on job placement and how they determine whether the counselor or another professional (e.g., in-house placement specialist, community rehabilitation provider) provides the direct service. Results indicated that several factors were noted by at least half of the participants, including anticipated intensity of services needed by the client, counselor caseload size/available time, existing employer relationships, availability of a placement service provider, and placement skills. Results highlight the impact of consistently high client volume on placement services, particularly for individuals with the most significant disabilities. Implications related to the current state of policy and practice for placement services, as well as potential future directions, are discussed.

Doctoral Dissertation Research in Rehabilitation Counseling

This article begins a series of planned annual reviews of rehabilitation doctoral dissertation research. Twenty doctoral dissertations completed in 2011 from recognized doctoral programs in rehabilitation were identified and analyzed. Dissertations were indexed according to their research topic, methodology employed, model, and statistical analysis, and an annotated bibliography was developed. Institutional productivity and employment trends of doctoral graduates were added as baseline data points for future analysis. Results of the current analysis reflect that a majority of the studies consisted of quantitative descriptive research designs. Unlike prior analyses, advanced and basic statistics were utilized equitably. Dissertations focusing on attitudes toward persons with a disability were higher than any of the prior reporting periods. Predictive outcome studies and clinical population research also remain prevalent. Implications for the practice of rehabilitation counseling, education, and future research are discussed.

Prediction of Membership in Rehabilitation Counseling Professional Associations

Declining membership is a concerning yet poorly understood issue affecting professional associations across disciplines (Bauman, 2008). Rehabilitation counseling association membership is in decline even while number of certified rehabilitation counselors continues to increase (Leahy, 2009). Factors influencing rehabilitation counseling professional association membership were explored and motives for membership examined using tenets of social exchange and social identity theories. A sample of 1,257 professionals was obtained from the databases of Commission on Rehabilitation Counselor Certification, American Rehabilitation Counseling Association, National Rehabilitation Counseling Association, and Rehabilitation Counselors and Educators Association. Results support tenets of exchange and identity theories for membership motives, with perceived value of membership and professional identity salience predicting current membership. Graduate programs and the workplace were also shown to play an important role in predicting membership status. Results provide multiple individual and organizational means for addressing professional association membership decline.

Doctoral Dissertation Research in Rehabilitation Counseling

This article continues the tradition of reviews documenting doctoral rehabilitation research. Doctoral dissertations completed during calendar years 2008–2010 from recognized doctoral rehabilitation programs were identified and reviewed using the same approach used by Tansey, Zanskas, and Phillips. Analysis of 88 dissertations resulted in a topical index of research topic, methodology, model, and type of statistical analysis that were considered independently and in relation to previous reviews. Among findings, the increase in predictive outcome studies observed in Tansey et al. was also observed in this review. An increase in research on specific clinical populations was also observed. Implications for the practice of rehabilitation counseling, rehabilitation education, and future research are discussed.

Doctoral Dissertation Research in Rehabilitation Counseling

Graduates of doctoral level programs are the stewards of their profession. Historically, doctoral dissertation research has been summarized as a service to improve research accessibility, analyze research trends, and suggest potential areas for future inquiry. The current review analyzes 99 doctoral dissertations from recognized rehabilitation counseling programs for the years 2005 through 2007. Departing from previous inquiries, the present study analyzed the methodology employed, the research model, and the type of statistical analyses implemented to answer the research questions posed by the dissertator. These additional points were included to reflect the growing emphasis in the field of rehabilitation counseling on evidence-based practice. A description of the methodology utilized to develop the reference citations, content summaries, observations, trends, and the annotated bibliography is provided. Potential implications for the practice of rehabilitation counseling, teaching, and future research are discussed.

The Tidal Model as experienced by patients and nurses in a regional forensic unit

The Tidal Model has been implemented in Rangipapa, a regional secure mental health forensic unit in New Zealand. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four Registered Nurses and four Special Patients. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism. Levelling was experienced as an effect emerging from individual and group processes whereby a shift in power enhanced a sense of self and connectedness in their relationships. These interpersonal transactions were noted by the special patients as being positive for their recovery. This enabled effective nurse-patient collaboration expressed simply as working together. The participants reported a feeling of humanity, so that there was a human face to a potentially objectifying forensic setting. Implications arising from this study are that the use of the model enables a synergistic interpersonal process wherein nurses are professionally satisfied and patients are validated in their experience supporting their recovery.

A survey of mental health nurses' opinion of barriers and supports for research

The need to demonstrate efficacy, efficiency and quality of practice through research is acknowledged in mental health nursing standards of practice. Yet the findings of a preliminary survey of two local District Health Boards (DHBs) shows that high workloads and lack of relief staffing appear as the greatest hurdles to mental health nurses participating in practice-based nursing research. A further constraint on their participation is lack of research expertise and experience. Consultative discussions with senior mental health nurses support these conclusions. In this paper mentoring and flexible research designs are promoted as possible ways of overcoming these barriers.