Comparison of the German and American Systems of Rehabilitation

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Comparison of the German and American Systems of Rehabilitation

The comparison of the German and American systems of rehabilitation must be made within the philosophic premises as well as the economic differences of two nations. One of the major premises of the American system is that people with disabilities have the right to choose their own destiny. The rehabilitation system provides people with disabilities opportunities to choose an occupation which is comensurate with their abilities, aptitudes, and interests, and which leads to competitive employment in the community or to supported employment, defined as "competitive work in an integrated work setting for individuals who, because of their handicaps, need ongoing support services to perform that work" (Federal Register, 1987). The American system was designed originally to provide counseling and guidance, vocational training, and job placement to meet the needs of persons with industrial accidents, physical disabilities, and primarily ambulatory impairments. Gradually, it was expanded to include persons with emotional illness, mental retardation, severe physical disability, traumatic brain injury, and developmental disability. As each new disability group was brought into the network of rehabilitation services, creative mechanisms had to be developed to meet each group's needs. Frequently services have not developed fast enought to meet the needs of new groups pressing at the door.

The successful integration of persons with severe disabilities, including developmental disabilities has been enhanced by a variety of innovative community based programs, such as supported work in unsubsidized competitive employment, transitional employment which helps persons with severe disability to try work in a competitive setting for six months while being subsidized and supported by a job coach, and long term supported employment with ongoing emotional and vocational support by a job trainer. Individuals who formerly would have spent their lives in institutions are working in the community.

The movement toward integration, however, has not been exacted without a price. The fragmentation of services for housing, jobs, recreation and special education has resulted in inadequate services for many disabled persons in the United States (Goldberg, 1984). The provision of employment services in an integrated work site does not resolve the problem of social isolation while off the job. Similarly, integration of handicapped with non-handicapped children in the regular classroom may result in social isolation of the child with a disability or less intensive educational preparation. Mainstreaming is insufficient when a local school system fails to provide necessary academic and technical aids for children with disabilities, or when the community fails to provide the required social and recreational outlets for students with disabilities. In order to understand the differences between the two systems, it is necessary to provide some details about the German system.

Federal Republic of Germany

The Federal Republic of Germany emerged as a separate independent political entity in 1949 as a consequence of the partition of Germany at the end of World War Two. Under stable political and economic conditions several pieces of social legislation were enacted. The Federal Social Assistance Act of 1961 defined the rights of every citizen in a social and democratic state for financial and social assistance, including assistance to blind persons, alcoholics, drug addicts, the homeless, sickness and maternity assistance, hospital treatment to mitigate the effects of chronic illness, aid for persons with tuberculosis, and assistance to aged persons to maintain them within their community (Flamm, 1974).

The basic law governing the rehabilitation system, enacted on April 29, 1974, and amended in 1976 and 1986, provides a comprehensive, multi-disciplinary system of interlocking institutions embracing medical, educational, social, and vocational training institutions (Jochheim, 1984). …