The Workplace Discrimination Experiences of Individuals with Cancer in the Americans with Disabilities Act Amendments Act Era.

Background The purpose of this study was to investigate the patterns in allegations of workplace discrimination filed by individuals with cancer. Objective The goal of the research was to describe discrimination, both actual and perceived, that has occurred against individuals with cancer in comparison to a group of individuals with other general disabilities (GENDIS) through analyses of the United States Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database. Methods An ex post facto, causal comparative quantitative design was used to examine Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints received by the EEOC from people with cancer from 2009 through 2016 (n = 10,848) in comparison to the GENDIS group over the same time period (n = 13,338). Results Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared to the GENDIS group, the cancer group was significantly older and had proportionally more individuals who identified as Asian than the GENDIS group. People with cancer were more likely to allege discrimination in the areas of unlawful discharge, demotion, wages, layoff, benefits, and referrals. They were less likely to allege discrimination in areas of reasonable accommodation, hiring, and suspension. Also, the cancer group was more likely than the GENDIS group to file allegations against smaller employers and employers in the Southeast region of the United States, while employers in the Mid-Atlantic and Rocky Mountain regions were less likely to be named in allegations by people with cancer. The cancer group was also significantly more likely than the GENDIS group to find that EEOC investigations of their allegations resulted in merit-based case resolution, that is, discrimination had indeed occurred. Owing to the large sample size, some of these between-group differences were small in magnitude. Conclusion The workplace discrimination experiences of people with cancer are substantially different from those of people with other disabilities.

Disability disclosure as an impression management technique used in the workplace: A grounded theory investigation.

BACKGROUND: In order to overcome obstacles to entry and inclusion in the workplace, individuals with disabilities engage in various impression management strategies to present themselves as the socially acceptable 'ideal employee.' OBJECTIVE: This study expands on previous disclosure research by asking individuals with disabilities to share their experiences of identity management and workplace challenges. METHODS: We leveraged qualitative research techniques to explore the reciprocal impact of workplace treatment and disclosure. RESULTS: Impression management emerged as an especially salient aspect of participants' disclosure decisions, and participants used an array of impression management tactics. Some employees with disabilities described positive experiences; however, we also learned that impression management can present unique challenges that may outweigh potential benefits. CONCLUSION: Our findings affirm that managing the image we project can be remarkably complicated and effortful when having a disability. This paper concludes with implementation recommendations for vocational rehabilitation counselors and human resource practitioners.

A "win-win" perspective on workplace accommodations: RETAIN Kentucky's self-advocacy guide to promote successful return to work and stay at work outcomes for workers with disabilities.

BACKGROUND: Research has long documented the low cost and effectiveness of most workplace accommodations to enable qualified people with disabilities to seek, secure, and maintain employment. OBJECTIVE AND METHOD: RETAIN Kentucky's return to work and stay at work intervention involves focused training for participants on requesting needed accommodations from their employers. RESULTS: In this article, we describe the win-win approach to reasonable accommodations, which serves as the basis for helping Kentuckians with disabilities identify and request on-the-job supports to aid in their efforts to remain in the workforce. CONCLUSIONS: Workers with disabilities are more likely to stay in the workforce and continue making valuable contributions to the national and global economies if they have effective accommodations and other employment supports available to them.

Post-traumatic growth and trauma-informed care in vocational rehabilitation through the lens of the conservation of resources theory.

BACKGROUND: Trauma has high prevalence rates in populations of people with disabilities, and the effects of traumatic experiences can negatively impact employment. OBJECTIVE: The purpose of this article is to review the existing literature regarding post-traumatic growth (PTG), trauma informed care (TIC), and the conservation of resources (COR) theory. METHOD: We begin with an overview of PTG, TIC, and trauma in relation to disability and employment. Then, we review the personal, condition, object, and energy resources within the COR theory. RESULTS: The remainder of the article focuses on applying PTG and TIC in state-Federal VR programs with a theoretical framework defined by COR. We conceptualize the application in four major VR phases: (a) eligibility determination, (b) rehabilitation plan development, (c) service provision, and (d) job placement. CONCLUSION: By implementing TIC and considering the consumer's resources, VR counselors can help emphasize PTG throughout the process and prioritize PTG as the ultimate goal. The authors provide brief and preliminary implementation recommendations for VR counselors.

Providing quality employment services to people living with asthma in the vocational rehabilitation program: A model for meeting the needs of an emerging clientele.

BACKGROUND: With incidence and prevalence rates of asthma diagnoses steadily increasing in the United States and worldwide over the past 30 years, people with asthma are an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: This article describes the job acquisition and return to work considerations facing employees with asthma. METHODS: Following an overview of the etiology, incidence, prevalence, and career development implications of this chronic respiratory disease, the authors present career preparatory and return to work recommendations to meet the needs of Americans with asthma across the phases of the VR process. RESULTS: The importance of access to quality healthcare, lifestyle, and environmental modifications to promote respiratory health, employer consultation, workplace accommodations and universal design, and interface with medical and mental health professionals is emphasized throughout the article. CONCLUSION: Asthma is an emerging disability that disproportionally affects people of color and people who live in poverty. Rehabilitation professionals must be prepared to meet the needs of this growing and diverse clientele as people with asthma seek assistance from the VR program in acquiring, maintaining, and advancing in meaningful, satisfying employment.

Emerging vocational rehabilitation strategies for people with diabetes mellitus.

BACKGROUND: People with diabetes mellitus constitute an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: The objective of this article is to (a) describe the characteristics and needs of Americans with diabetes mellitus, (b) examine the often devastating effects that this highly prevalent disease of the endocrine system has on employment and career development, and (c) suggest strategies that rehabilitation professionals can use to improve VR services and outcomes. METHOD: Following an overview of the etiology, incidence, prevalence, and impact of this high incidence endocrinological disease, the authors present strategies to meet the service and support needs of Americans with diabetes mellitus across the phases of the VR process. RESULTS: The importance of individualized case planning, employer consultation, workplace accommodations, interface with medical and mental health professionals, and adherence to self-care and symptom management regimens is emphasized throughout the article. CONCLUSION: Diabetes mellitus is an emerging disability that can affect people of any age, one that disproportionally affects people of color and people who live in poverty. Rehabilitation professionals must be prepared to meet the service needs of this growing clientele.

Anxiety and employment discrimination: Implications for counseling and return to work practice.

BACKGROUND: The most prevalent mental health diagnosis is anxiety disorder, which remains largely undertreated. OBJECTIVE: This investigation considered differences in workplace discrimination against adults with anxiety disorders during two eras of legal history: the original Americans with Disabilities Act (ADA, 1990-2008) and the ADA Amendments Act (ADAAA, 2009-present). METHOD: Research questions addressed differential (a) numbers and types of allegations, (b) case resolutions, and (c) demographic characteristics of the charging parties. RESULTS: Results indicated substantially more allegations and merit-based resolutions filed by charging parties with anxiety disorders post-ADAAA. Furthermore, the post-ADAAA era revealed increases in allegations from women and people from non-white racial groups. CONCLUSION: These findings can inform advocacy and counseling and rehabilitation services for clients who experience anxiety.

Quality of life and experience with the national multiple sclerosis society strategic plan priorities for people with multiple sclerosis: Findings from a path analysis.

BACKGROUND: The National Multiple Sclerosis Society (NMSS) strives to ensure that people affected by multiple sclerosis (MS) can live their best lives. This mission is reflected in the Society's strategic plan, which establishes the roadmap for the Society's continued commitment to a world free of MS. OBJECTIVE: The purpose of this article is to add to the understanding of both the scope and complexity of the impact of MS and MS-related supports on quality of life (QOL). METHODS: A national sample of people with MS (n = 748) participated in the study by completing validated surveys assessing their QOL, physical and mental health, MS self-efficacy, resilience, participation in NMSS, perceived stress, emotional support, and social roles and activities. A path model was used to examine how the frequently identified MS QOL predictors, including demographic, MS, psychosocial, and physical functional status variables relate to each other and to QOL. RESULTS: The model exhibited reasonable model fit with hypothesized paths being statistically significant and in the hypothesized direction. CONCLUSION: Findings revealed that the relationships among mental health, demographic factors, overall MS experiences, QOL, NMSS participation, and resonance with the mission of the NMSS are complex, highly nuanced, and yet strongly correlated. More importantly, the study highlights the strong influence of variables that are more readily amenable to change through programmatic and clinical intervention, and active self-management and participation.

A conceptual framework to promote career development for vocational rehabilitation consumers with traumatic brain injuries.

The purpose of this article is to describe the Illinois Work and Well-being Model (ILW2M), a multi-domain framework for conceptualizing the employment development of people with traumatic brain injuries (TBIs). The model emphasizes the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A brief discussion of potential implications regarding vocational rehabilitation research and service is offered with the overall goal of reinforcing employment development as the foundation of vocational rehabilitation services for adults with TBIs.

Assessing consumer satisfaction in rehabilitation and allied health care settings.

This article describes the challenges that in here to consumer satisfaction research in the fields of rehabilitation and health care, discusses strategies for improving the psychometric soundness and scientific rigor of research in this increasingly important knowledge domain, and cites several examples from the contemporary literature of measurement and design approaches that have been identified as particularly useful in gauging consumer satisfaction with services. Mixed-method and qualitative research strategies such as in-depth interviews and focus groups are emphasized as ways of broadening and deepening the field's understanding of the multi-dimensional construct of consumer satisfaction.

Economic analyses of rehabilitation services as research methodologies.

This article describes the objectives and methods involved in economic analyses of rehabilitation services. Demonstrated approaches to cost-effectiveness and cost-benefit studies are presented, illustrated with examples from the contemporary literature. The strengths and limitations of economic analyses are considered within the context of current trends in rehabilitation policy and practice.

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.

The use of focus groups in rehabilitation research.

In this article, the authors explore the applications of focus groups to rehabilitation and disability research. Key issues in designing focus group research (e.g., methodological considerations, strategies for conducting focus groups, data analysis procedures) are highlighted. The authors then discuss specific considerations for conducting focus groups with people with disabilities. The article concludes with a review of three research studies in rehabilitation that used a focus group methodology.

Disadvantagement-related correlates of career optimism among college and university students with disabilities.

This paper describes research regarding factors predicting career optimism for a group of postsecondary students with disabilities (N = 208) who were enrolled in seven colleges and universities in four states. Career optimism was defined as a student's self-confidence regarding his or her ability to choose, maintain, and advance in an appropriate career. The proposed model incorporated variables related to employment discrimination and disincentives such as perceived impact of disability on one's education and quality of life, racial/ethnic status, gender, and presence of disability benefits. Results indicated that two aspects of "disadvantagement," specifically severity of perceived impact of disability and racial/ethnic status, were significant predictors of career optimism. Implications of the findings were discussed in terms of informational interventions, curricula, development of self-advocacy and self-determination, and research topics.

Multiple chemical sensitivity and workplace discrimination: the national EEOC ADA research project.

Information from the Integrated Mission System of the United States Equal Employment Opportunity Commission (EEOC) was used to investigate the employment discrimination experiences of Americans with multiple chemical sensitivity (MCS) in comparison to Americans in a general disability group with allergies, asthma, HIV, gastrointestinal impairment, cumulative trauma disorder and tuberculosis. Specifically, the researchers examined demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom allegations were filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcomes or resolutions of these allegations. Findings indicate that persons with MCS were, on average, older than the comparison group and comparatively overrepresented by Caucasians and women. People with MCS were proportionally more likely than the comparison group to allege discrimination related to reasonable accommodations. People with MCS were proportionally more likely than the comparison group to file allegations against employers in the manufacturing and public administration industries, employers with 201-500 workers, and employers in the Western Census region. People with MCS were proportionally more likely than the comparison group to receive non-merit resolutions as a result of the EEOC's Americans with Disabilities Act Title I investigatory process. Implications for policy and advocacy are addressed.

Patterns in perceived employment discrimination for adults with multiple sclerosis.

Using multiple correspondence analysis, data from the US Equal Employment Opportunity Commission (1992-2003) were examined for types and patterns of allegations of discrimination filed by adults with multiple sclerosis (MS) under Title I of the Americans with Disabilities Act (ADA). Women comprised the majority of the Charging Parties (n=687, 67%), and most of the Charging Parties were White (n=769, 76%). The total number of allegations studied (N=3,668) was divided into two datasets, specifically 1,142 occurring separately and 2,526 occurring as part of a multiple allegation set. The four most frequent allegations were related to discharge, reasonable accommodation, terms and conditions of employment, and harassment. Multiple correspondence analysis indicated that a 5 axis model was required to explain approximately 50% of the variance in allegation patterns, and no charging party or employer characteristics were related to the axes. Axis themes derived from perceived discrimination on the part of employers included threats to retention (2 axes), employer hostility, informal or formal employer actions, and barriers to career mobility. Results supported the need for rehabilitation counseling interventions to help adults with MS identify and address precipitants to discharge (involuntary termination) or constructive discharge (voluntary termination in response to an untenable work situation).

Gender as a differential indicator of the employment discrimination experiences of Americans with multiple sclerosis.

Information from the Integrated Mission System of the United States Equal Employment Opportunity Commission (EEOC) was used to investigate the employment discrimination experiences of women and men with multiple sclerosis (MS). Spanning the years 1992 to 2003, the EEOC database included 3,663 allegations of discrimination filed by 2,167 adults with MS. With respect to women and men with MS, the researchers examined the comparability of a) demographic characteristics; b) industry designations, locations, and size of employers; c) the nature of discrimination alleged; and d) the legal outcome or resolution of those allegations. On average, women and men with MS were in their early forties, with the majority of both groups being Caucasian. Both women and men were most likely to allege discrimination related to discharge and reasonable accommodations, although women were more likely to file harassment charges than men. Men with MS were more likely to allege discrimination regarding hiring and reinstatement. Women with MS were more likely to file allegations against employers in the service industries, and men were more likely to file allegations against employers in the construction, manufacturing, and wholesale industries. No gender differences were found in the geographic distribution of allegations. Both groups had comparable rates of merit closures (23% vs. 27%) as a result of the EEOC's investigatory process. Implications for rehabilitation counseling and employer-oriented interventions are discussed.

Qualitative case studies of professional-level workers with traumatic brain injuries: A contextual approach to job accommodation and retention.

BACKGROUND: Traumatic brain injury (TBI) is a multi-systemic disability that causes a wide range of difficulties with personal and social functioning. METHODS: Four individuals with TBI participated in an evaluation of barriers to their continued employment following graduation from college. A trained interviewer completed the Work Experience Survey (WES) in teleconsultation sessions with each participant. RESULTS: Researchers applied a qualitative case study research design. Participants reported a wide range of difficulties in performing essential functions of their jobs (3 to 24) that have the potential to significantly affect their productivity. Career mastery problems reflected outcomes associated with TBI such as 'believing that others think I do a good job' and 'having the resources (e.g., knowledge, tools, supplies, and equipment) needed to do the job.' Indicative of their wish to continue their current employment, participants reported high levels of job satisfaction. CONCLUSIONS: The WES is a cost-effective needs assessment tool to aid health and rehabilitation professionals in providing on-the-job supports to workers with TBI.

Single subject research methods in rehabilitation.

The article describes single-subject research designs as an efficient and cost-effective way to assess the impact of targeted interventions on individual behavior. The authors overview the basic tenets of single-subject research, provide examples of several types of single-subject designs, and describe the utility of single-subject designs in rehabilitation research.

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.