Rehabilitation Counseling Bulletin

Unemployment is common for persons with disabilities but little is known about the different reasons why people with disabilities may not be seeking employment. This study identified the reasons that people living with disabilities in the United States report for not seeking employment, from the 2015 Kessler Foundation National Employment and Disability Survey (KFNEDS), and categorization of reasons by demographic, socioeconomic, and disability characteristics. We conducted a content analysis of responses to an open-ended question on the KFNEDS. The analytic sample (n = 1,254) consisted of adults (ages 18–64) living with disabilities who self-identified as either unemployed or not seeking employment. Team coding used a hybrid inductive/deductive approach to identify nine meaningful reasons why people with disabilities may not seek employment. Overall, medical conditions, functional limitations, or their disability were more likely to be reported as reasons for not seeking work, rather than situational reasons associated with workplace engagement, such as “lack of job opportunities.” Bivariate comparisons of codes across demographic, socioeconomic, and disability characteristics noted variability in reasons reported by respondents by sex, race/ethnicity, age, household income, and disability. These findings provide an understanding of diverse reasons for not seeking employment, which can inform programs and policies that promote labor force participation of people with disabilities.

The literature on racial differences in vocational rehabilitation (VR) services has not been updated for over a decade. Using the 2017 individual-level U.S. national RSA-911 data, supplemented with the 2017 American Community Survey and publicly available information from the Kaiser Family Foundation, we investigated racial differences at each step of the VR process—application, eligibility, service provision, and employment outcomes at closure. At the first step, application, White individuals with disabilities were less likely to apply than their African American, American Indian/Alaska Native, and Hispanic counterparts, and more likely to apply than their Asian counterparts. For the remaining three steps, the results were inverted: the White subgroup had higher eligibility rates, service rates, and employment rates than the African American, American Indian/Alaska Native, and Hispanic subgroups, and lower rates than the Asian subgroup. These findings suggest that racial and ethnic differences continue to exist in the VR process despite several legislative acts and policy efforts. Within each racial and ethnic minority group, we also found large variation in application rates and employment rates across states, which indicates a need for developing performance measures and standardized guidelines for state VR agencies to better serve individuals with disabilities from racial and ethnic minorities.

Coronavirus disease (COVID-19) may cause long-lasting adverse consequences after acute recovery, including functional limitations and reduced work capacity. Individuals with long-lasting complications of COVID-19 are known as long-haulers. There is a knowledge gap on how COVID-19 complications affect return-to-work (RTW) efforts. We aimed to describe the challenges that long-haulers encounter when returning to work from the perspectives of rehabilitation professionals. In this study, four certified rehabilitation counselors and four rehabilitation physicians in U.S. outpatient rehabilitation centers participated in focus groups. Participants discussed challenges in working with long-haulers, including personal attributes, post–COVID-19 symptoms and complications, uncertain recovery and unpredictable outcomes, limited health care accessibility and support, and unsupportive work environments. Participants provide individualized services to meet long-haulers’ diverse needs as they do for all persons with disabilities, although they expressed uncertainty due to the variable disease course and risk of infection. Modifying workplace policies, especially gradual RTW, were frequently mentioned accommodations. The findings highlight the RTW issues of long-haulers. We provide recommendations on increasing awareness of the challenges and job accommodations of long-haulers.

Microaggressions are daily insults to minority individuals such as people with disabilities (PWD) that communicate messages of exclusion, inferiority, and abnormality. In this study, we developed a new scale, the Ableist Microaggressions Impact Questionnaire (AMIQ), which assesses ableist microaggression experiences of PWD. Data from 245 PWD were collected using Amazon’s Mechanical Turk (MTurk) platform. An exploratory factor analysis of the 25-item AMIQ revealed a three-factor structure with internal consistency reliability ranging between .87 and .92. As a more economical and psychometrically sound instrument assessing microaggression impact as it pertains to disability, the AMIQ offers promise for rehabilitation counselor research and practice.

People with disabilities are sexual beings, yet there is little research on sexuality in this population. The present study explored the impact of sex education for people with congenital neurological disabilities, largely, spina bifida and cerebral palsy, on sexual self-concept and life satisfaction. This study included 104 adults with spina bifida, cerebral palsy, and other congenital neurological disabilities. Hierarchical regression analysis was used to examine the relationships among demographic variables, sexual health education variables, and outcome variables (sexual self-concept and life satisfaction). Serial mediation analysis was conducted to examine the mediating relationship of sexual self-concept variables (sexual anxiety and sexual self-esteem) between social support and life satisfaction. Results indicated that sexual self-concept was significantly predicted by relationship status, disability impact, and satisfaction with sex education. Life satisfaction was significantly predicted by relationship status, social support, disability impact, and sexual self-concept. Sexual anxiety and sexual self-esteem formed a partial serial mediating relationship between social support and life satisfaction. The findings expand upon existing literature on sex education for people with disabilities, reinforcing the notion that satisfactory sex education and strong social support positively impact the life satisfaction of individuals with spina bifida and cerebral palsy. Implications for rehabilitation research and practice are discussed.

Increasing community participation can reduce the risk for functional disabilities; participation is influenced by person and environment contextual factors. Development and validation of a brief community participation assessment can advance and support evidence-based assessment in clinical rehabilitation counseling practice. It will be an invaluable rehabilitation and public health surveillance tool that can be used to gauge the health conditions and participation of people with disabilities. The current study evaluated and validated the Wisconsin Community Participation Scale (WCPS) in 982 individuals with chronic health conditions and disabilities. Participants indicated five most meaningful life roles: (a) being able to get around with or without help, (b) live independently with or without help, (c) live a healthy lifestyle, (d) work, and (e) engage in leisure and recreation activities. The WCPS scores were positively associated with physical health, mental health, and life satisfaction and negatively related to functional disability in the theoretically expected directions. The WCPS can help rehabilitation counselors assess their clients’ current level of participation in meaningful life roles that are important to them. Rehabilitation counselors can use the WCPS assessment data to guide treatment planning and empower clients to build confidence and self-efficacy to participate in personally meaningful activities in the community.