Demographic covariates and vocational rehabilitation services as predictors of employment outcomes of people with physical disabilities: a hierarchical logistic regression analysis.

PURPOSE: Stable employment is essential for the health, psychosocial, and financial well-being of people with physical disabilities (PwPD). Unfortunately, the low employment rate for PwPD in the U.S. exposes them to adverse effects of unemployment, including depression, anxiety, low self-esteem, and physical pain. Helping PwPD find gainful employment will improve their general health and well-being. However, few empirical studies examine factors affecting the employment outcomes of PwPD. This study aims to examine the relationship between demographic covariates, vocational rehabilitation (VR) services, and employment outcomes of PwPD. MATERIALS AND METHODS: This secondary data analysis study includes 17,598 PwPD from the U.S. Department of Education's Rehabilitation Services Administration's Case Service Report (RSA-911) dataset. Our analysical approach was hierarchical logistic regression analysis. RESULTS: For VR services, workplace support, technology support, job placement assistance, and VR counseling significantly contribute to predicting employment outcomes for PwPD. Even after entering VR services, the demographic variables (age, race, education, referral sources, low-income, long-term unemployment, and disability significancy) were still significant predictors of employment. CONCLUSIONS: Findings from this study can be used by state VR counselors and other disability service providers to plan and select effective employment-related interventions to improve the employment outcomes of PwPD.

The alarmingly low employment rate among PwPD significantly impacts their psychological, financial, social, and overall health well-being in the U.S.Vocational rehabilitation services, including workplace support, technology assistance, VR counseling, and job placement support, are pivotal in facilitating employment for PwPD.PwPD who received workplace support exhibited nearly six times higher odds of attaining employment compared to those without such assistance.PwPD who received technology support experienced four times higher odds of achieving employment in contrast to those without technology assistance.

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.

Examining the Role of Resilience and Hope in Grit in Multiple Sclerosis.

The purpose of this study was to examine the effects of resilience and hope on grit when controlling for demographic covariates, depression, and anxiety in people with multiple sclerosis (MS). This was a cross-sectional study with a sample of 348 participants with MS. Descriptive statistics were performed to examine participants' demographic characteristics. A three-step hierarchical regression analysis was conducted to evaluate the extent to which resilience and hope explain the unique variance in grit while controlling for demographic covariates, depression, and anxiety. Findings suggested that resilience and hope explained a significant amount of variance in grit when controlling for demographic covariates, depression, and anxiety. Furthermore, higher resilience and hope scores were associated with higher grit scores. Given that resilience, hope, and grit are modifiable, rehabilitation and mental health professionals (e.g., psychologists, psychiatrists, rehabilitation counselors) can integrate strength-based interventions into their practices to bolster resilience, hope, and grit in people with MS. Our paper also has implications for interdisciplinary research and clinical practice.

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.

A factor analytic evaluation of the Self-Stigma Scale-Short (SSS-S) among psychosocial clubhouse members in the United States.

The main purpose of this study was to examine the factor structure, the internal consistency, and other aspects of validity of the English version of the Self-Stigma Scale-Short (SSS-S). In the present study, the SSS-S was assessed in a sample of 194 adults with psychiatric disabilities from four Psychosocial Clubhouses in the Southern and Midwestern United States. Exploratory factor analysis (EFA; n = 98) supported a one-factor structure of the SSS-S, which accounted for 59% of the variance. Confirmatory factor analysis (CFA; n = 96) demonstrated that the factor structure of the SSS-S was satisfactory. The scale was also reliable, with a Cronbach's alpha of 0.93 and 0.91 for the EFA and CFA samples, respectively. The SSS-S showed adequate convergent and criterion-related validity, as indicated by statistically significant positive correlations between internalized stigma with perceived societal stigma, symptom severity, and functional impairment, as well as negative correlations between internalized stigma with perceived social self-efficacy, social support, and resiliency. Overall, these findings support the English version of the SSS-S as a valid and reliable tool for determining the internalized stigma of adults with psychiatric disabilities in clinical settings and similar research.

The impact of motivational interviewing training on rehabilitation counselors: Assessing working alliance and client engagement. A randomized controlled trial.

OBJECTIVE: To determine the impact of a motivational interviewing (MI) training designed to improve rehabilitation counselors' counseling skills to promote clients' engagement in return-to-work behaviors and to establish strong working alliance. PARTICIPANTS: The target population for this study was counselors who work for the state vocational rehabilitation (VR) program and their clients. Data were collected from a total of 347 participants (67 counselors and 280 clients) in the experimental and comparison groups, during the pre-and-posttests. STUDY METHOD: A randomized controlled trial was used in this study. The counselors in the experimental group received a 4-hr standardized MI training and a 4-week follow-up coaching sessions. RESULTS: The counselors in the experimental group demonstrated significant gains in their MI competence scores compared to the comparison group. The clients of the experimental group's counselors improved their engagement in VR services and working alliance with their counselors. CONCLUSIONS: The findings of this research indicated a need for carefully developed counseling trainings and incorporation of the evidence-based practices in the VR programs to provide better quality of rehabilitation services. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychometric evaluation of Turkish version of the Perceived Stress Scale with Turkish college students.

BACKGROUND: The Turkish version of the Perceived Stress Scale (T-PSS-10) measures the extent to which situations in one's life are appraised as stressful. AIMS: The purpose of this study was to evaluate the measurement structure of T-PSS-10. METHOD: Two-hundred and thirty-five Turkish university students (93 men and 142 women) completed the T-PSS-10, the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder 7-Item Scale (GAD-7), and the Inventory of Common Problems (ICP). RESULTS: Confirmatory factor analysis results indicated that a one-factor model did not fit the data, whereas a two-factor correlated model (stress related self-efficacy beliefs, stress related feelings of helplessness) provided a better fit between the model and the data. Significant moderate correlations were found for the stress-related self-efficacy beliefs and stress-related feelings of helplessness factors with depression, anxiety, academic difficulty, relationship problems and health problems. The internal consistency reliability coefficients for the stress-related self-efficacy beliefs and stress-related feelings of helplessness factors were 0.68 and 0.85, respectively. CONCLUSIONS: This study provided support for the reliability and validity of T-PSS-10 suggesting that it can be used as a screening instrument by health professionals working with Turkish college students.

Working Alliance and Stages of Change for Employment: The Intermediary Role of Autonomous Motivation, Outcome Expectancy and Vocational Rehabilitation Engagement.

Purpose Working alliance is one of the most important common factors for successful counseling/psychotherapy outcomes. Based on the empirical literature about working alliance, it seems that self-determination and self-efficacy theory (SDT/SET) can potentially be used as a motivational model to explain the relationship between working alliance and vocational rehabilitation (VR) outcomes. The purpose of this study is to evaluate three primary SDT/SET constructs, autonomous motivation, expectancy and engagement, as mediators for the relationship between working alliance and stages of change (SOC) for employment. Methods A serial multiple mediation analysis (SMMA) was computed to evaluate autonomy, outcome expectancy, and VR engagement as mediators of the relationship between working alliance and SOC for employment in a sample of 277 people with chronic illness and disability (CID) receiving services from state VR agencies in the United States. Results The SMMA results indicated that working alliance was positively associated with SOC for employment (total effect), while the direct effect between working alliance and SOC for employment was not significant after controlling for the effects of the mediators, indicating significant mediation effects. The mediation effects were estimates of the indirect effects for working alliance on SOC for employment through (a) autonomous motivation, (b) outcome expectancy, (c) VR engagement, and (d) autonomous motivation, outcome expectancy and VR engagement together. Conclusions The results indicated that a strong working alliance has the benefit of helping consumers develop autonomous motivation to work and increasing their vocational outcome expectancy and engagement in VR services, leading to employment.

Testing an integrated self-determined work motivation model for people with disabilities: A path analysis.

OBJECTIVE: Individuals with disabilities are more likely to live in poverty, have more health issues, and be less likely to be employed than their same-aged peers. Although these issues may be attenuated by vocational rehabilitation services, amotivation and ambivalence to employment can limit the readiness of persons with disabilities to engage in these services. Drawing on self-efficacy, self-determination, and stages of change theories, the purpose of this study was to develop and test an integrated self-determined work motivation model for people with disabilities. METHOD: Participants included 277 people with disabilities recruited through vocational rehabilitation agencies across 8 states. Path analysis was used to evaluate the contribution of functional disability, self-determination, and social efficacy variables in a hypothesized integrated self-determined work motivation model. Model estimations used maximum likelihood estimation and model-data fit was examined using several goodness-of-fit indices. RESULTS: The initial path analysis indicated a less than optimal fit between the model and the observed data. Post hoc model modifications were conducted based on examination of the critical ratios and modification indices and theoretical consideration. The respecified integrated self-determined work motivation model fit the data very well, χ²ldf = 1.88, CFI = .99, and RMSEA = 0.056. The R2 for the endogenous variables in the model ranged from .19 to .54. CONCLUSIONS: Findings from this study support the integrated self-determined work motivation model in vocational rehabilitation as a useful framework for understanding the relationship among functioning levels, self-determination and self-efficacy factors, vocational rehabilitation engagement, and readiness for employment. (PsycINFO Database Record

Predicting quality of life in adults with severe mental illness: Extending the International Classification of Functioning, Disability, and Health.

PURPOSE/OBJECTIVE: The International Classification of Functioning, Disability and Health (ICF) framework was used to investigate person-environment contextual factors, mental functioning, activity limitations, and participation as predictors of quality of life (QoL) in adults with severe mental illness (SMI). RESEARCH METHOD/DESIGN: A quantitative descriptive design using multiple regression and correlational analyses was used. One hundred ninety-four individuals with SMI from 4 community-based mental health agencies in 2 states from Southern and Midwestern regions of the United States participated in the study. The criterion variable was QoL. Predictor variables comprised the ICF constructs: (a) demographics, (b) personal factors, (c) environmental factors, (d) mental functioning, (e) activity limitations, and (f) participation. RESULTS: A majority of participants were White (60.3%) and not employed (59.8%). Half of them received Social Security Disability Income and/or Supplemental Security Income (50.0%). Correlations between QoL and the predictor variables ranged from small to large (r = .01 to .63, respectively). The final regression model accounted for 58% of the variance in QoL. After controlling for other factors, social competency, social support, societal stigma, psychological distress, cognitive dysfunction, activity limitations, and participation were found to be significant predictors of QoL in adults with SMI. CONCLUSIONS/IMPLICATIONS: The study supports the use of the ICF to predict QoL for adults with SMI. Evidence-based treatments focused on increasing social competence, social support, and participation should be developed to promote rehabilitation outcomes and overall QoL.