People with acquired physical disabilities in Greece in recession: How do they cope with issues of vocational (re-)integration?

Abstract

BACKGROUND:

This paper draws upon a broader empirical qualitative research about the educational and vocational (re-)integration of people with acquired physical disabilities in Greece.

OBJECTIVE:

Perceived motives and barriers, under the shadow of recession, coping mechanisms as well as the contribution of state, rehabilitation specialists and significant others on the return to the labor market of people with acquired physical disabilities in Greece of crisis are investigated.

METHODS:

The research was carried out using a focus group with 6 persons and focused semi-structured interviews with 20 persons, members of the Greek Association of Paraplegics and the Greek Company of Multiple Sclerosis.

RESULTS:

According to the main findings work makes people with acquired physical disabilities (PwAPD) feel useful and creative contributing to their physical and psychological rehabilitation. Despite the significant barriers they encounter, additionally burdened by the recession, e.g. no job offer, limited accessibility, discrimination, educational deficiencies, PwAPD succeeded in developing strategies to overcome their vocational (re-)integration barriers mainly via education, resistance to discriminatory attitudes and the support of the significant others.

CONCLUSION:

Despite of the existing barriers, affected by the financial crisis, PwAPD, still fight for their re-inclusion to social life, being equipped with a positive attitude. Still, the Greek State along with rehabilitation and relevant services should become more active and flexible to effectively support and empower this right fight.

Keywords

Disability barriers motives educational/vocational (re-)integration rehabilitation specialists

1 Introduction

Despite the efforts of the European Commission to promote employment of persons with disabilities, the unemployment rates of this population group are moving in an upward, especially when it comes to severe disabilities as well as to PwAPD (Ottomanely & Lind, 2009). Though there exist numerous studies on the underlying causes, the effects and the possible solutions of this problem, an effort to shed light on positive aspects of the subject as well as on the strategies developed by the persons themselves to deal with it has rarely been attempted. The present article is an attempt to fill this gap in the literature by investigating the motives of people with acquired physical disabilities to pursue their work’s (re-) integration and defining the ways they use to overcome the barriers they encounter, especially in a time of deep recession in the country.

The following questions led the study: What are the motives of PwAPD by deciding to pursue their vocational and educational1 (re-)integration? What are the barriers they encounter, under the Greek financial crisis, and how do they cope with them? What is the contribution of the state, rehabilitation specialists, and significant others in their educational and vocational (re-)integration?

1.1 Motives and barriers to employment

During the last decade serious evidence concerning the beneficial effects of work for people with disabilities (PwD) has been accumulated. Workers with disabilities feel that their work contributes to the improvement of their quality of life, and offers them the opportunity to socialize (Wik & Tossebro, 2014), to promote their sense of self-esteem and accelerate their adjustment process in disability (Dunn, Wewiorski, & Rogers, 2008), to gain a real meaning and a purpose in their lives, to obtain the necessary financial support and a decent living standard (Anderson et al., 2013). Regarding the benefits of an accessible working environment Solovieva et al. (2011) refer to productivity growth, highly qualified employees’ staying in work, new employees’ training cost reduction and improvement of relations with colleagues, while a variety of good practices to successfully include PwD at work are described by ILO (2014).

Nevertheless, people with disabilities and especially PwAPD face a significant number of factors hindering their working life. Discrimination in the workplace regarding the offered opportunities, the chances of improving qualifications, taking key positions, as well as payment, rights and work security is among the most frequently reported cases (Anderson et al., 2013; Erickson, Von Schrader, Bruyère, & VanLooy, 2014; Schur, Krause, Blasi, & Blanck, 2009). A most appropriate social policy to combat discriminatory behavior has been proved the designing and implementing of in-house programs as these build confidence and improve professional knowledge, skills and abilities of workers with disabilities (Wahat, 2011).

Reflecting the employers’ views for workers with disabilities, research refers to under-productivity, low quality labor results, poor work ethics, inadequate qualifications, skills, and professional experience, inexistent expectations of career advancement, high absenteeism and accident rates, lack of commitment to work and limited social skills that would allow them to socialize with their colleagues (Domzal, Houtenville, & Sharma, 2008; Van Mechelen, Verhoef, Van Asbeck, & Post, 2008). Misperceptions of the employers about the costs entailed in hiring persons with disabilities, transport difficulties, combined with an inappropriate working environment and the fear of a possible loss of social security and health care benefits build further significant factors inhibiting work (re-)integration (Al-Khodairy & Masry, 2006; Lengnick-Hall, 2007; Lidal, Huynh, & Biering-Sorensen, 2007; Shier, Graham, & Jones, 2009; Solovieva, Dowler, & Walls, 2011; Van Mechelen et al., 2008). However the negative impact of their disability onto their productivity may be reduced due to employers’ forethought to shape a working environment which is friendly to their employees with disabilities (Anderson et al., 2013; Erickson et al., 2014).

Regarding internal barriers reduced functional capability, need for frequent hospitalization and low self-perception are mentioned as mainly prohibitive for work integration. Exposed to negative employers’ behavior combined with the lack of promotion and professional development lead often people with disabilities to appear hesitant in setting and pursuing high professional goals (Wilson-Kovacs et al., 2008).

1.2 People with disabilities within the (Greek) socioeconomic2 crisis

Vulnerable population groups are mostly and deeper affected in times of recession. Deterioration in healthcare affects specific social groups and among them PwD (Dubois & Molinuevo, 2014; Milio, 2014; Rodrigues, Zólyomi, Kalavrezou, & Matsaganis, 2013). OECD and EC reported on a very modest increase of expenditures in health and disability areas already for the year 2009-2010 whereas declines followed from 2011 ongoing (Bontout & Lokajickova, 2013; OECD, 2012). The great recession affected heavily the employment of PwD, globally (Coduti, Leahy, & Roy, 2014).

Greece is the country most heavily affected by the crisis compared even to South-Eastern and Southern European countries (Bartlett & Prica, 2012; Busch, Hermann, Hinrichs, & Schulten, 2013; Marzaa, Marcuta, & Marcuta, 2015; Petmesidou & Guillen, 2015). Since the debt crisis broke out in 2009, three fiscal consolidation plans have been developed and imposed, affecting primarily social services, wages, and public ownership in the country (Busch, Hermann, Hinrichs, & Schulten, 2013).

Regarding PwD remarkable are the findings of a European study on the impact of austerity plans on the rights of the disabled in six European countries, Greece included as “indirect reduction of benefits and stricter entitlement conditions are the order of the day in most EU Member States” (Hauben, Coucheir, Spooren, McAnaney, & Delfosse, 2012, 86). In the country report Greece crucial issues were identified (Marinakou, 2012): the Greek welfare system is characterized by significant disfunctions; the lack of valid statistical data as well as of a national disability strategy, fragmented social services, limited rehabilitation services, absence of interdisciplinary cooperation impede the social inclusion of PwD. Moreover it was accepted that the recently established code of disability classification (2011) cannot function properly due to lack of specialized diagnostic centers in the Greek region.

Quality of life for PwD in Greece, has furthermore met a new low record during the recession: they face poverty as gradually more cuts in pensions and benefits are imposed; they cannot find employment due to the very high unemployment rates; public services, such as public transport, health and education either under-function or even do not exist (Karagianni, 2017; Marinakou, 2012). Relevant are the results of other research studies which criticize the Greek state for the identified problems, while PwD themselves face rising levels of stress, anxiety and isolation (Rodrigues, Zólyomi, Kalavrezou, & Matsaganis, 2013; Vandoros, Hessel, Leone, & Avendano, 2013; Zavras et al., 2012).

1.3 Social and vocational rehabilitation services

The effective (re-)integration of PWD requires the coordinated cooperation of parties, both outside and inside the workplace, starting from social services/social support, vocational rehabilitation professionals, and workers’ union organizations (Cotner, Keleher, O’Connor, Trainor, & Ottomanelli, 2014). Awareness and attitudes of employers, support of significant others as well as attitudes and engagement of the disabled themselves, play also a significant role (ILO, 2010; 2014). Especially for PwAPD early intervention vocational rehabilitation programs have been proved very effective (Middleton et al., 2015; Ottomaneli et al., 2017).

Having broad information about labor market requirements and being at the same time aware of people with disabilities’ needs and capabilities social workers involved in disability support have the duty to contribute to the efforts of people with disabilities to develop their career self-determination and strengthen their ability to adapt to occupational changes (Brand & Wilkinson, 2016). Moreover, vocational rehabilitation professionals should contribute to the improvement of the image of employees with disabilities (Anderson et al., 2013; Schönherr, Groothoff, Mulder, & Eisma, 2005). Rehabilitation programs should not only offer independence reinforcement but care about PwDs education and vocational training (Al-Khodairy & Masry, 2006; Schönherr et al., 2005). Workers’ unions and disability organizations should support workers wD so that they ensure their employment maintenance and their professional development (Roulstone et al., 2003).

2 Method

Interested in recording personal experiences, concerns, and perceptions on the vocational re-integration of PwAPD the researchers decided to use a qualitative approach. Of utmost importance is here not the generalizability of results – as in quantitative studies– but an in-depth description and dissemination of the perceived experiences (Lincoln & Cuba, 2011). As claimed by Auerbach and Silverstein (2003), the validity and reliability of qualitative studies are reinforced by “transparency in analysis, communicability of theoretical constructs, and internal coherence” (p. 78).

2.1 Participants

Twenty people with various acquired disabilities (quadriplegia, paraplegia, etc.) participated in the research (13 men and 7 women). This feasibility sample was approached through their membership at the Greek Association of Paraplegics (16 individuals) and the Greek Multiple Sclerosis Society (4 people). Participants were included only by meeting the following criteria: a) at least three years post-injury and b) the return to work or the continuation of their studies after the occurrence of the disability. Their age ranged from 24 to 64 years. The majority had working experience before disability while a few of them worked after their injury; their education ranged from compulsory education graduates up to doctorate holders. The sample of 20 PwAPD was sufficient according to the relevant literature (s. Robinson, 2014; Malterud, Siersma, & Guassora, 2016; Baker & Edwards, 2012). Demographics of the participants can be seen in Table 1.

Table 1
Demographic characteristics of participants

Age Group Gender Type of disability Work experience Educational level

20–39 11 Male 13 Quadriplegia 4 Before disability 11 High school 13

40–59 6 Female 7 Paraplegia 8 After disability 9 Bachelor 6

60+ 3 Mutilation 4 Ph.D 1

Spastic quadraparesis 3

Hemiplegia 1

Age Group	Gender	Type of disability	Work experience	Educational level
20–39	11	Male	13	Quadriplegia	4	Before disability	11	High school	13
40–59	6	Female	7	Paraplegia	8	After disability	9	Bachelor	6
60+	3			Mutilation	4			Ph.D	1
				Spastic quadraparesis	3
				Hemiplegia	1

2.2 Research tools and procedures

The qualitative material was gathered through one focus group followed by semi-structured interviews based on the already mentioned research questions. These tools were considered appropriate as they give more space to the participants so that as many as possible views, experiences, attitudes and opinions are collected.

The focus group discussion took place at the beginning of the research process in order to highlight issues to support the designing of the interview guide. The group consisted of four people with APD who had some working experience after obtaining their disability, while the three of them had previous employment experience. Two family members of the participants took also part in the discussion. The group discussed under the guidance of one of the researchers while the second researcher kept notes on the procedure and the conversation. The discussion was recorded and transcribed. The following issues emerged and were included in the interview guide: a) the career difficulties PwAD are facing, b) how they tackle these difficulties, c) the factors which act as a disincentive to their professional (re)integration, d) the advantages of their participation in the labour market.

The focused semistructured interview allows the researcher to give more space to the interviewees as they can comment on various issues without having to respond to a specific order of questions. An interview guide was conducted including seven main questions, based on the research purpose and questions. While data analysis is more complicated than in a highly structured form, this type of interview was chosen because it better suited the scope and purpose of the current research. All interviews were conducted by one of the researchers face-to-face; they were audio-recorded and then transcribed by the interviewer. Thereafter, the second researcher verified the accuracy by listening to and checking the transcript. All inconsistencies found were of minor importance and thus, ignored.

2.3 Data analysis

Data coding followed Auerbach and Silverstein’s method (2003), the basic idea of which is ‘moving from raw text to research concerns in small steps, each step building on the previous one’ (p. 35). Their method is based on Grounded Theory where the qualitative researcher both systematically and carefully follows coding processes, repeatedly comparing the expressed ideas of the participants to the initial research concerns (Charmaz, 2006; Strauss & Corbin, 1998). Grounded Theory was selected by the researchers as it is a structured and highly reliant method suiting our research which was not guided by a specific theory. The steps followed by this procedure are: Raw Text, Relevant Text, Repeating Ideas, Themes, Theoretical Constructs, Theoretical Narrative and Research Concerns. Authors initially coded the emerging Themes independently and then compared their coding, reaching a high agreement level of 87%. For the purposes of the research all unrelated codes were discarded and for each Theme two or three quotes were selected and translated into English by consensus of both researchers. Following systematically this procedure 223 Simple Ideas were identified and organized into 48 Repeating Ideas, which were categorized under19 Themes. Finally, Themes were grouped into 6 Axes (Theoretical Constructs): 1) motives to education and employment of PwAD, 2) barriers to education and employment of PwAD, 3) coping with barriers to education and employment of PwAD, 4) social policy in the context of motor disability, 5) the role of rehabilitation specialists in labor (re-)integration of PwAD and 6) the role of the significant others in labor (re-)integration of PwAD. The above Axes corresponded directly to the three Research Concerns (Questions). Figures 1 –3 depict the final form of the trees structure, in which the procedure of grouping the 19 Themes, into the 6 Axes and then those corresponding to the 3 Research Concerns is explicitly shown (s. Results).

Fig.1

Motives to employment.

Fig.2

Barriers to employment and coping strategies.

Fig.3

Contribution of the state, rehabilitation specialists and significant others to vocational (re-)integration.

3 Results

3.1 Motives and barriers to education and employment

Axis 1: Motives. Several of the participants referred to the benefits of the disabled people working. Their need to use their time creatively is evident: ‘One tries to find a creative work’ (S1), ‘I am bored doing nothing’ (C1), ‘when we work we feel useful’ (A1). Working has healing attributes too, as A2 stated ‘occupational therapy kept me upright’, at the same wavelength P2 noted, ‘when someone works, feels healthier’; according to others economic reasons are a powerful motivation: ‘I had to have my own income. As I realized that my parents could not support me financially it was obvious I had to find a job’(J2). Furthermore, they considered autonomy as a prerequisite for their vocational (re-)integration: “For the time being I am struggling to become autonomous; then I will work’ (D2).

Axis 2.1: Barriers. Every single one of the participants commented on the lack of infrastructure, either in educational or professional frameworks: ‘I could not attend the seminars because the venues were not accessible; they were not willing to provide it having so few workers with disabilities’ (P1), ‘We lost a whole semester because there was no ramp or lift’ (D1), ‘It was a problem to move in the building’(J1), ‘in some auditoriums there was no way for me downstairs’ (K2).

Discrimination from their prospective and current employers was another important issue: ‘ ... They did not show any adaptability or flexibility towards me’ (A2), ‘When I told them about it (disability) I perceived a strange behavior. Are they ignorant? Are they afraid to come face to face with disability? ... there exists discrimination’ (S2), ‘in every evaluation committee I was told: you are unable to work (P2), ‘the university strongly discriminates us because PwD ruin its image; they just don’t want us there’ (B).

Some participants tried to improve their qualifications through education but they soon gave it up: ‘I found no sense in doing anything else’ (A2), ‘I wasn’t in a mood to sit down and study again’ (C1). Others realized that they had made a wrong choice: ‘I attended vocational training in computing, as better matching to my situation (disability) but it was far away from what I had expected’(D1). Even when PwAD decide to continue their studies, they are confronted with teachers’ inability to collaborate: ‘they had no previous experience of disability before. They didn’t even know how to get along with such a person’.

The absence of promotion, the complacency of finding any work, the impact of increased work pressure on their health, the transportation difficulties and the lack of funding to create their own business, are further barriers mentioned: ‘One gets depressed seeing their subordinates surpassing them’ (P1) ‘ ... After the accident I decided that there was no reason to take the high school diploma. I didn’t try to find another job. I was ok with it’ (A1), ‘I gave up due to stress and long working hours’ (A2), ‘I would like to do something on my own but money is needed, so it is impossible’ (J1), ‘I tried a few times to get on urban minibuses, impossible!’ (J1).

Last but not least, the majority expressed their belief that spending their lives within a discriminatory environment PwAPD internalize this situation accepting their socially imposed failure to work or study while denying in parallel to accept their disability: ‘Opening my own store is a big risk for me and I think I will fail’ (C1), ‘I’m afraid no one can help, I’m done now. I feel like a burden’ (A3), ‘It is like brainwashing for the disabled, they out there really believe that we cannot work anymore’ (S1).

Axis 2.2: The financial crisis. The Greek financial crisis was proved to be a heavy barrier for the vocational reintegration of the participants. Even when they oversaw other impediments and showed positive in finding a job, this became rather impossible due to the recession: Indicatively: ‘I had applied for these 8-months jobs at the archaeological museums. They had announced vacancies for 50 persons, there were 500 applications. I was among the first 50, but finally only 35 were employed, you know the crisis ... ’(X1). In the private sector there are obvious needs but employers do not want to pay: ‘When I work (journalist) it is without payment, everybody looks for volunteers, there exist no paid jobs, you know because of the current situation (crisis)’ (S2). On the same wavelength: “It is the problem there are no jobs now. How ... , where to find one? University graduates simply don’t have jobs, today. I know it is better for us when we work, but no jobs ... ”(X2). Similar was the situation within local authorities or via acquaintances: “I also looked for a job within our municipality, major told me: just wait, things will get better (financially), when we have new job vacancies, we can do something for you too (X1). Remarkable is the proactive decision of one participant to retire, being afraid of the coming crisis: “I decided to retire in 2010, the injury happened in 2000. This was a quick decision when we heard we would get into the memoranda, we all know what IMF means ... ” (P1).

Axis 3: Copying with the barriers. Despite the adversity they encountered research participants developed defense mechanisms, their “antidotes” to resignation moments. Education was considered to be the key for their return to the labor market and their financial independence. Many of them showed eager to receive a ‘brief training’ (S1) or to ‘get a degree’ (G2) because, ‘if I did not have this educational background I could not earn my living here in Thessaloniki’ (B). The value of education was frequently expressed through the insecurity caused by its absence: ‘If I were educated enough I could try to do another job’ (C2), ‘ ... the notice is clear and I’m afraid I’ll have a problem as I do not have a certificate in English’ (C1).

Opposing to the perceived discriminatory behavior participants recognized an empathetic one too, coming from individuals in the participants’ environments; this behavior armed them with the necessary power to further pursue their (re-)integration: ‘Customers of the café knew me well’ (A1), ‘As I always worked through acquaintances I didn’t face discrimination’ (J2), ‘ ... my teachers weren’t just simple supporters, words are not enough to thank them’ (B). Having experienced a totally different attitude towards disability while living abroad, some of them attributed their discriminatory treatment to the different Greek culture: ‘Being disabled is not considered as sick abroad. It is simply a matter of different culture here’ (P1).

Obvious became also the participants’ willingness to engage in the same activities as their able-bodied colleagues in order to be equally treated: ‘I did not invoke my problem. I always wanted to be equal with everyone’ (A3), ‘I had the freedom from my super-ordinates to work for an hour and leave, but this was not my way’ (P2). The acceptance of their disability, the imposition of personality and mental strength as well as the projection of their occupational skills were regarded as effective strategies to overcome impediments: ‘The point is to impose ourselves in such a way that they won’t see us as disabled any more’ (P1), ‘The more we accept our disability, the easier we continue with our life’ (D4), ‘I didn’t experience a discriminatory behavior maybe because of my character ... ’ (B), ‘When one has an occupation, people see them differently’ (N) (s. Fig. 2)

3.2 The contribution of the state, rehabilitation specialists and significant others to vocational (re-)integration

Axis 4: Social policy. Regarding the current social policy towards physical disability in Greece, opinions differ. While participants have recognized the existence of basic laws encouraging the recruitment of PwAD and providing more favorable arrangements for their retirement, serious objections have been raised about the laws’ accuracy, efficiency and implementation: ‘If one has worked for 15 years in a row and has been attributed with a high disability percentage, the law favors receiving full pension ... ’ (P2). On the other hand: ‘there is no real social concern for us’ (B). In some cases the existence of benefits functioned as an alibi, allowing them to remain inactive, due to the provided financial support which offered them a tolerable living standard: ‘I don’t feel like deciding to take a step forward; I feel safe since I get the allowance’ (C1), ‘after a while it only seems convenient; one thinks, since I get the benefits, why shouldn’t I take advantage of it?’ (S1).

Axis 5: The role of rehabilitation specialists. The positive contribution of rehabilitation specialists to the (re-)integration of the participants was also acknowledged: ‘she [psychologist] helped me psychologically too, she taught me to control my nerves and the others [rehabilitation specialists], they just said a few words and one takes courage’ (N). Furthermore to realize that ‘one can do things’ (P1), to receive information ‘on technical issues’ (I1) and to ‘give oneself motives to deal with something other than one’s micro-world’ (A2) were also mentioned as gains through the contact with a specialist. On the other hand some participants underlined indifference and lack of focused support: ‘the only thing these [rehabilitation] centers do is raising money, nothing else’ (K1), ‘the employees of social services who were supposed to support us didn’t have the necessary training in order to guide us’ (S1).

More satisfied from the services were on the contrary participants, hospitalized in rehabilitation centers abroad. Though the training provided didn’t focus explicitly on vocational (re-) integration, participants were there supported to gain confidence towards their ability to normally continue their lives and to reach a satisfactory level of independence: ‘ ... there, when you have an accident, social workers give advice of what to do after that, they prepare one for life’ (P1), ‘Initially, I had a negative stance/attitude, after some time I realized they could help me ... ’ (K2).

Axis 6: The role of significant others. Several participants preferred to receive support from their close friends or family members: ‘I wanted to discuss with A or B, they were [my] psychologists. But I didn’t want to reveal everything to my psychologist. I wanted to confide in my brother or my cousin’ (D3), ‘I have my sister who psychologically helps me very much’ (P2), ‘I trust those who know me better’ (A3). Nevertheless, help received from their own/close people was mainly limited to the activities of their daily life and the psychological support they needed. One of the participants mentioned additionally that she was encouraged by people within her wider social environment to pursue her (re-)integration to labor market: ‘Able-bodied acquaintances, being familiar with the problem, not specialists, were those who advised me to return to work’ (A1).

4 Discussion

Main purpose of the research was to explore motives and barriers that PwAD experience in the course of their educational and professional lives and to detect the contribution of the state, rehabilitation specialists and significant others in their vocational (re-)integration.

The existence of employment coincides with the contribution to society, an opinion adopted by the majority of the participants (Johnson et al., 2004). Creatively using their time for the benefit of the community, PwAD feel that they are still useful and they actively participate in life. Paid work functions therapeutically, promoting their physical rehabilitation and their psychological balance (Ferdiana et al., 2014). However, since many of them – due to the physical limitations– are prevented from adequately performing their duties they prioritize their functional recovery, leaving their vocational (re-)integration second (Ottomanelli et al., 2017; Ottomanelli & Lind, 2009).

The results of this study confirm the international research about work motives. For our participants financial independence is one of the most important work motives, while their placement in adequately paid jobs enhances their decision to work (Johnson et al., 2004; Wik & Tossebro, 2014).

Recession due to the Greek socioeconomic crisis is regarded by all participants as a steadily present impediment to vocational reintegration even when other obstacles are successfully overcome. Relevant to other research shrinking of opportunities for paid work and quality of life of PwAPD were thus confirmed (Marinakou, 2012; Vandoros, Hessel, Leone, & Avendano, 2013).

Limited accessibility to educational and professional premises together with employers’ reluctance to respond to the needs of their employees with disabilities confirm the allegations of the majority of the participants for discrimination behaviors towards them in the workplace. Employers usually adopt a stereotypical behavior toward them (Draper, Reid, & McMahon, 2011) which may partially stem from the PwD’s failure to meet the aesthetic standards of the western society (Bailey, Gammage, Ingen, & Ditor, 2016).

In agreement with the results of previous research all participants connected their educational deficiencies to the limited occupational (re-) integration opportunities (Ottomaneli et al., 2017; Ottomanelli & Lind, 2009; Yasuda, Wehman, Targett, Cifu, & West, 2002). Furthermore, the failure of the educational community to cooperate with people with physical disabilities hinders their educational development, stripping them from any kind of ambition (Husain & Ahmad, 2010).

Regarding the barriers faced by participants in their job-finding efforts, the transportation difficulties, the health issues due to disability, the fatigue due to the long working hours and the fear of not being able to carry out their tasks were the most often mentioned. The limitation of their functional abilities and their inability to cope with demanding tasks reduce the job opportunities or hinder the preservation of their existing employment driving them often to resignation (Meade, Forchheimer, Krause, & Charlifue, 2011). Yet, some of them refusing to remain inactive because of employability barriers either establish their own business or provide volunteer work in order to adapt the nature, the place and the schedule of their work to their specific needs (Balcazar, Kuchak, Dimpfl, Sariepella, & Alvarado, 2014).

The participants’ self-image has been negatively affected by their chronic exposure to the stereotypical perceptions of society about PwD’s incompetence to perform complicated tasks. By accepting their failure to perform challenging tasks, they eventually become inactive members of society (Mejias, Gill, & Shpigelman, 2014), internalizing and simultaneously confirming these stereotypes. Due to this internalization some participants admitted that they developed self-limiting behaviors or refused to accept their disability.

Worthwhile to mention is a revealed dimension clearly underrepresented in the existing literature. This concerns the equal treatment experiences of participants from their educational, working and social environment. Participants, who attended rehabilitation programs and experienced a different social treatment of PwD abroad, emphasized the influence of culture on the attitudes of society towards disability. Furthermore, many participants expressed their gratitude for their able-bodied colleagues, students and teachers, who often proved to be a valuable source of support.

In order to resist towards any kind of negative behavior, the participants mentioned a variety of practices they use, varied from establishing a good relationship with their fellow human beings to their life attitudes. Moreover, the acceptance of disability by the majority of participants together with the development of a positive self-image enabled them to convert the disability stigma into a positive personality trait, filling them with pride, forcing at the same time the state and society to reconsider their attitude towards PwD (Mejias et al., 2014).

Partially conflicting were the views of the participants regarding the applied social policy in Greece. Some of them recognized the efforts of the state while others raised serious objections to the political correctness and effectiveness of these efforts. Many of them argued that the current pension and benefit policies play often a preventing role from them to actively try to re-integrate (Barr et al., 2010).

Although rehabilitation services were considered to be an integral part of PwAD’s effort to regain control of their lives, their assessments regarding these services varied. Some of them described how experts succeeded in bending their initial resistance, offered the necessary psychological empowerment and the appropriate autonomy techniques in order to enable them to live independently (Weitzner et al., 2011). Nevertheless, the majority of the participants argued that: a) the goal of returning to work, has been sidelined, b) health professionals focus their attention on getting financial rewards and c) in positions of counseling and vocational guidance are placed people who are not adequately trained, thus they are unable to meet the needs of their clients with disabilities (Weitzner et al., 2011).

Expected for the Greek reality were the findings of the present research regarding the role of significant others in the vocational (re-)integration of PwAD. People in whom the participants confide – mostly family members and friends– constitute a strong network capable to support them psychologically, help them with their everyday problems, promote their health and even contribute to their successful return to the labor market (Manns & May, 2006; Skea, MacLennan, Entwistle & N’Dow, 2011). This explains their usual tendency to seek support from people in their immediate environment rather than rehabilitation specialists.

4.1 Implications for vocational rehabilitation services

The results of the current study could be of importance for the vocational rehabilitation practitioners. Not only barriers and their causes but also motives and ways of barriers’ overcoming were good identified.

Vocational rehabilitation counselors could appropriately use the relevant findings with clients-PwAD, who are seeking their educational and vocational (re-)integration. On the one hand counselors may gain deeper empathy towards their clients’ reality leading to better understanding and confidence in their relationship. On the other hand rehabilitation practitioners can focus their intervention more on ways of coping with the re-integration barriers such as strengthening their educational qualifications, accepting disability and being assertive within work and society; thus clients’ self-awareness, self-efficacy and career resilience could be enhanced. As identified in the current research working within rehabilitation programs based on supported employment, practitioners may communicate to employers, ways for successful adjustment of their employees with APD in the workplace. Such ways may focus to managers and employees awareness, information on the benefits of employing PwAPD etc. Working under the crisis effects rehabilitation practitioners in Greece could encourage their clients towards self-employment alternatives especially within social economy. All the above can ameliorate the counseling intervention leading to a more effective approach towards educational and vocational (re-)integration of people with acquired physical disabilities.

5 Limitations of the study and further research

There are some limitations in the current study that should be noted. Due to the nature of our sample and their accessibility issues we limited our participants to PwAPD living in the area of Thessaloniki. The sample of 20 individuals, though satisfactory within general and especially disability population, cannot be representative as common in qualitative research. Although we tried to have an equal participation of people from both sexes, men’s overrepresentation, about 65%, was not avoided.

5.1 Conclusion

In his book ‘Talks to Teachers on Psychology: And to students of Life Ideals’, James (1899) mentions: ‘The blindness in human beings... is the blindness with which we all afflicted in regard to the feelings of people and creatures different from ourselves’ (p. 229). Consistent with the view of James, we attempted to penetrate into the feelings, the views and the experiences of PwAPD, the testimonies of whom were first hand life reports hoping that we managed to contribute to the understanding of the issues under investigation.

Conflict of interest

None to report.

Footnotes

Educational (re)-integration is also included in our research as this is an essential component or even a prerequisite for occupational integration.

There are many adjectives following the term ‘crisis’ in the Greek case: financial, socioeconomic, fiscal, debt, etc., depending respectively on the aspect of the crisis investigated. We use here the term ‘socio-economic’ as more responsive to the issue of disability.

Acknowledgments

The authors would like to express their gratitude to all participants for their willingness to contribute to the present research. They would also like to express their gratitude to the Greek Association of Paraplegics, branch of Macedonia-Thrace, and the Greek Company for Multiple Sclerosis for their valuable contribution to the realization of the research.

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