This paper examines employment issues concerning deafened adults, especially those with cochlear implants. The analysis shows that deafened people have fewer educational qualifications and are less likely to be in paid employment when compared with people without a hearing disability. In consequence, they report lower income levels. Conversely, respondents with cochlear implants reported higher levels of employment and income. In addition to disability, social factors such as age and sex may contribute to a person's socio-economic status. As such, rehabilitation interventions need to consider the person's social as well as auditory needs.

The present paper concerns the prevention and management of disability due to chronic pain. The problem of disabling chronic pain is presented and the impact on the community is highlighted. The scientific rationale for current approaches to management is discussed and the available empirical evidence reviewed. In particular, the present paper advocates application of the biopsychosocial model for the prevention and management of chronic pain-related disability. As such, the components of the biopsychosocial model are reviewed and recommendations for rehabilitation counselling practice are presented.

In a period of legislative reform, New South Wales' workers compensation stakeholders can learn at least broad lessons by making comparisons with the experience of other countries in post reform review. This article considers the overall impact of the 1993 reforms on the Californian workers' compensation system, with focus on reforms and outcomes in the Vocational Rehabilitation sector. It was found post reform that the number of claims and paid benefits have decreased substantially, and total premiums paid and Vocational Rehabilitation expenditures are down dramatically. However, the changes are blamed for an increase in legal complexity, as return-to work outcomes and post-injury earnings for injured workers appear to have worsened. Additionally benefit levels remain a continuing concern.

In this investigation of rehabilitation professionals in Australasia, where the profession of rehabilitation counselling might be described as emerging, the appropriateness of the Rehabilitation Skills Inventory for use in Australasian settings was evaluated. This resulted in an amendment to the original instrument and the development of the RSI (Amended) instrument. The instrument validation is discussed and the four component solution described.

The advent of managed care as a system driving purchasing in the health sector has brought with it an emphasis on purchasing outcomes rather than inputs. Although any change in purchasing schemes will have an effect on service providers, it should not prove to be too disruptive for those of us in rehabilitation since rehabilitation as a service system has always been outcome driven. In fact, our entire system is driven by needs based assessment and directed toward the meeting individually identified goals for service. These goals reflect the desired outcome of the service we provide for each individual served. The challenge we face, then, is translating our emphasis on goal directed, outcome driven services to meet the language, understanding and expectations of our funding agents as they begin to adopt a regime of outcome based contracts. The purpose of this paper is to argue the validity of individually determined outcomes as opposed to institutionally determined measures and to propose one method of measuring those outcomes in a manner that is applicable to the needs of the purchaser.

This paper explores the thorny question, what is this thing called rehabilitation? The concept is examined with a view to refining some of the values lying behind the rehabilitation process. A practitioner's viewpoint is taken and melded with a consumer bias to present two relatively simple working definitions of rehabilitation, and some dilemmas that challenge practitioners in an evidence-based climate. By asking when should rehabilitation services be used and what are rehabilitationists really about, we discover an intensely human process that calls for personal qualities and scholarship that are exemplary in the eyes of society. The paper concludes with an assessment of rehabilitation services in New Zealand.