Academic journal article The Journal of Rehabilitation

A Test of the Theory of Informed Consumer Choice in Vocational Rehabilitation

Academic journal article The Journal of Rehabilitation

A Test of the Theory of Informed Consumer Choice in Vocational Rehabilitation

Article excerpt

If people with disabilities are to experience personal satisfaction and quality of life (QOL), they must play a vital role in directing the disability policy and rehabilitation service delivery that are central to their empowerment. To empower a person is to provide him or her opportunity to make choices and decisions regarding his or her life. Choice and control are highly valued prerogatives that reflect the autonomy, identity, and independence of an individual (Condeluci, 1987; Kosciulek, 1999a). The right to make choices, express preferences, and exercise control over life issues are critical ingredients for empowering and enhancing the QOL of persons with disabilities (Kiernan & Hagner, 1995).

Unfortunately, people with disabilities too often are denied the opportunity to exercise control over the most basic aspects of daily life. The opportunity to make choices concerning living arrangements, work, and recreation has been limited or is nonexistent for many individuals who have disabilities. For example, some individuals may never have been provided with more than one choice, adequate information about alternatives may never have been made available, decisions may have been made by professionals who feel they know best, or capabilities and self-assertions may have been ignored or underestimated (Bannerman, Sheldon, Sherman, & Harchik, 1990; Parent, 1993).

Choices made by persons with disabilities are often based on the avoidance of undesirable alternatives, or upon the acceptance of the available, rather than on true preferences. External forces such as agency regulations, lack of accessibility, inadequate supports, or stereotypical attitudes (Hagner & Marrone, 1995) have frequently restricted decisions. In addition, while sometimes individuals with disabilities are involved in disability policy development and rehabilitation service delivery in a minor or token fashion (e.g., membership on an advisory council), these processes continue to occur, to a large extent, without the participation and involvement of people with disabilities (National Council on Disability [NCD], 1996). Parent (1993) concluded unequivocally that "it has become increasingly evident that the powerlessness and lack of self-direction often felt by people with disabilities are more frequently related to the attitudes and practices of caregivers, service providers, funding agencies, social institutions, and society in general, rather than to any limitations or impairments resulting from the disability itself" (p. 21).

Informed Consumer Choice in Vocational Rehabilitation

Given that employment is a key to independence and improved QOL for people with disabilities (Federal Register, 2002), choice in the selection of employment goals and rehabilitation services necessary to meet those goals is a critical element for empowering persons with disabilities (Kosciulek, 1999b). Informed choice is a process during which a person sets goals, gathers information, considers a range of options, and then takes responsibility for selecting the option that best meets his or her criteria. Informed choice refers to a person's ability to understand and use programs successfully, because the programs and services are designed to enable consumers to navigate them competently and without fear of reprisal. More specifically, and in direct relation to vocational rehabilitation (VR), informed choice is the process by which individuals participating in VR programs make meaningful decisions about their vocational goals, the services and service providers needed to reach those goals, and how those services will be procured (Rehabilitation Services Administration [RSA], 2001). It is presumed that an individual's skills and abilities to exercise informed choice can be developed through use of self-assessment techniques, training and experience in goal setting and decision-making, and consumer education. In this manner, skills in exercising informed choice could grow in a parallel fashion along with growth of specific vocational and employment skills, enabling the individual to continue making important life decisions following the completion of VR services. …

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