Multiple sclerosis (MS) is a central nervous system disorder that impacts more than 400,000 people in the U.S. The disease results in multiple functional impairments that are diverse and varied across individuals. Additonally, MS has a profound impact on community participation which, like other rehabilitation outcomes, cannot be explained on the basis of functional limitations alone. The purpose of this study was to develop and evaluate a model of community participation for people living with MS using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. The model focused on the roles that personal factors have as predictors of community participation, while also serving as mediators and moderators for the relationship between activity limitation and participation. Results from the hierarchical regression analysis indicated that demographic characteristics (i.e. MS type), personal factors (i.e. core self-evaluations (CSE), MS self-management, resilience, and social skills), and activity limitations accounted for 64% of the variance in participation. Further, mediation analysis indicated that CSE mediated the relationship between activity limitation and community participation. Finally, moderation analysis indicated an interaction effect between educational attainment and MS self-management. Implications for future research in rehabilitation and clinical application are discussed.

In 2010, we proposed a personal factor classification which was published in this journal. Since then, the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO) and the biopsychosocial model were increasingly incorporated into the German Social Law Code for participation and rehabilitation, implying that personal factors are indispensable for individual assessments. For the present study, we aimed to come up with an updated version of the personal factors classification based on current research. To achieve this goal, we employed a qualitative approach to re-examine the basic structure, consistency, and selection of categories in the classification from our 2010 study, to amend and supplement the categories to reflect best practice personal factor classifications. Our findings indicate that the basic structure remained largely unchanged, with relatively minor changes, including the deletion of 5 categories from our 2010 classification, 10 categories revised in format or content, and 13 new categories. We believe our revised classification to be useful for supporting users in systematically, comprehensively, and transparently reporting influences on specific aspects of individuals’ life and living background on their functioning and participation, thus facilitating an equitable allocation of disability benefits.

A visual narrative intervention – Serious Storytelling with Images – was proposed to manage interview anxiety and performance. Its ability to evocate significant incidents and enhance narratives construction was evaluated ideographically in two case studies. The findings suggest varying levels of sophistication in interviewee actions, challenges encountered, and perceived roles of images. Counselors can refer to the hierarchical concepts when tailoring interview training and coaching. Further investigation is highly recommended to confirm and measure intervention effects.

Multiple sclerosis (MS) is a chronic, typically progressive immune-mediated disease characterized by inflammation and demyelination in the central nervous system (CNS), and is associated with a wide range of neurological, physical, and psychosocial effects. For people living with MS, access to relevant, timely, and accessible health information and resources may contribute to effective illness management, psychosocial health, and quality of life (QOL). In this study, we sought to increase understanding of the specific types of information most wanted by people with MS, as well as the sources and effects of this information. Specifically, we surveyed 748 adults with MS about (a) the sources from which they obtain information about MS, (b) the type of information that is most important in terms of improving their QOL, and (c) specific topics about which they would like to have more information, services, or resources. Content analysis of the qualitative results demonstrated the diversity of information sources accessed by people with MS and the importance of providing information through different formats and media. The participants prioritized information related to new MS medications and treatments, physical and mental health and wellness, and local opportunities for support. Implications for practicing rehabilitation counselors are discussed.

Anecdotally, there are frequent reports that peer-facilitated initiatives can be successfully used in employment services. However, in Australia, there is little information about how to effectively deliver peer support. In this paper, we discuss how peer-based interventions might be used to supplement formal return-to-work services and contribute to positive job-seeking outcomes. We illustrate the potential of vocational peer support using a real situation involving a young adult who successfully returned to work soon after sustaining a traumatic injury. Future research should explore the inclusion of various peer support structures and formats as a component of other employment services, to help people with long-term conditions and disabilities achieve a range of vocational outcomes and to guide practice in this area.

Vocational rehabilitation provides guidance and support to individuals with disabilities entering the workforce. Employment plans include considerations of goals, the job market, and pre-existing or trainable skills on the part of job seekers. This process also includes an understanding of the social forces that affect employment goals. Current models of disability include the medical, social, and embodiment models. Each is cognitively based and assumes an element of responsibility or blame, that is, respectively, focused on the individual with a disability, the community, or a combination of these two factors. The difference model of disability offers an alternative understanding of disability by providing an affect-based framework that eliminates the premise of blame. This conceptualization of disability provides a new approach to vocational rehabilitation.

The success of a lobectomy procedure for adult-onset epileptic seizure (AOES) would depend on the quality of the patient’s relationship with the health care provider. This ethnographic multiple case study explored patient and health professional relationship contexts following surgery for seizure activity reduction treatment. We interviewed five Australian men (aged 34–59) with a history of AOES and neurosurgery regarding the quality of their relationship with health care providers. Interpretive phenomenological analysis (IPA) of the data yielded three interrelated relationship themes of Timeliness (promptness of necessary care), Support (availability, understanding, and empathy), and Responsibility (adaptive communication, self-care, and decision-making ownership). Self-directed relationship resourcing enhanced subjective well-being in the patients.

This article reports on women’s experiences of career change following a breast cancer diagnosis and explores whether their illness represents the driving force to pursue previously unfulfilled career ambitions. The participants were four women who had been diagnosed with breast cancer and had changed career direction after their treatment. Data were conducted through in-depth interviews and were analyzed using Interpretative Phenomenological Analysis (IPA). Four themes prominent throughout each women’s narrative were identified: (i) a pre-diagnosis, unhappiness at work, (ii) a sense of stepping off the treadmill, (iii) a sharp focus upon their “self,” and subsequently (iv) a flourishing “work-life.” Further research is needed to investigate how common these findings are among women with breast cancer.

A total of 274 Australian workers aged 45 years and above completed a Work, Retirement, and Health Survey. Results indicated that older workers with work injury have significantly lower expected retirement age compared to those without work injury. The results also indicated that this pattern is still apparent among intrinsically work motivated older workers with high score on self-reported work centrality. Older workers with work injury appear more vulnerable to premature retirement, which has significant negative social and economic consequences for workers, employers, and rehabilitation professionals. It also appears there is a complex relationship between ageing and work injury and the need for rehabilitation professionals to consider work injury prevention strategies for older workers.

This study aimed to understand state-level variation in participation in the State/Federal Vocational Rehabilitation (State VR) System in the United States among transition-aged youth (persons under the age of 22 years at application for State VR services) with traumatic brain injury (TBI) in Federal Fiscal Year 2016. A weighted least squares regression analysis was conducted to determine the relationship of state-level population size, unemployment rate, and per-capita income to the number of State VR closures in each state for transition-aged youth with TBI. Population size and per-capita income significantly predicted closures, while there was no relationship between closures and unemployment rate. Research is needed that further explores and explains state-level disparities in participation among transition-aged youth with TBI.

People with mental illness and traumatic brain injury experience difficulties in gaining and maintaining employment and have a higher unemployment rate because of their symptoms and poor social skills including cognitive impairments. Cognitive remediation is an intervention developed to improve cognitive functioning such as attention, memory, and problem-solving, by providing them with specific designed cognitive exercises. After practicing those cognitive tasks repetitively and massively, people with cognitive deficits will improve cognitive processes which lead to better cognitive performance. There is evidence supporting the benefits of cognitive remediation in improving employment-related outcome. Thus, it might have a role for job seekers with neuropsychiatric disorders and cognitive dysfunctions.

Psychogenic gait disorders in children and adolescents represent a unique neuropediatric and rehabilitative challenge. The inability to walk frequently strikes abruptly. Triggers are not easily identifiable. Patients are commonly admitted to the hospital in an emergency. In view of the dramatic clinical picture, parents are perturbed. They expect rapid diagnostic clarification and therapy. If physical, laboratory, and X-ray examinations do not disclose any significant pathological findings, parents generally insist on consulting diverse specialists and clinics. The pivotal point of the course of treatment is the parent–doctor–patient relationship. This is notably true when child psychologists or psychiatrists have to be consulted. Typical risks and decision conflicts of the rehabilitation dynamics are described – these are augmented by several case vignettes.

This case study assessed the role of job burnout as it relates to employee organisational commitment. An interview was carried out with a disability support worker and the variables she perceived as contributing to her job burnout, affecting organisational commitment or turnover intentions. The Job Demands-Resources model was used for understanding job burnout; three areas of focus were identified: role ambiguity, role overload, and perceived supervisor support.

Recently, the Progressive Goal Attainment Program has grown in popularity as an intervention for injured workers experiencing psychosocial barriers when returning to work. This article provides an outline of the program and explores its implementation by a workplace rehabilitation provider. Data from 20 participants have been pooled to highlight typical presentations. Key features of the program and outcomes are discussed.

Vocational assessment is the foundation of future vocational choices available to a person with a disability. In a compensable environment with potential for litigation, the assessment process becomes more complex and challenging for claimant, practitioner, and other stakeholders. The purpose of forensic (medicolegal) vocational assessment in Australia is reviewed. Comparison of ethics, qualifications, and experience of Australian forensic assessors (practitioners) and their North American counterparts points to an urgent need for an accreditation framework. This paper discusses microaccreditation as an independent model of training and credentialing of Australian forensic vocational practitioners. Credentialing the forensic vocational practitioner serves to underpin the quality and rigor of vocational assessments undertaken in a highly scrutinized legal market.

A novel inpatient vocational counseling service (named “In-Voc”) was developed and evaluated in three Australian spinal cord injury (SCI) rehabilitation hospitals, aiming to improve vocational outcomes after SCI. The program provided a trained Vocational Counseling Coordinator who worked alongside the allied health team, medical, and nursing staff at each hospital. The Coordinators were interviewed to examine the role expectations and role behaviors associated with the introduction of their novel, vocationally focused, occupational role. The Coordinators’ descriptions of their role behavior were very similar to those defined by rehabilitation counselors in North America. They reported the novel role to be a productive and satisfying one. Encouragingly, the In-Voc program was associated with significantly higher post-injury employment outcomes.