Disability Management and Rehabilitation Counseling: Present and Future Opportunities

Article excerpt

The emerging importance of disability management within vocational rehabilitation and rehabilitation counseling has been recognized for over a decade (Bruyere & Shrey, 1991; Crystal, 1987; Gilbride, Stensrude, & Johnson, 1994; Habeck, Kress, Scully, & Kirchner, 1994; Kilbury, Benshoff, & Riggar, 1990; Matkin, 1987; McMahon & Matkin, 1983; Olsheski, 1996; Riggar, Crimando, Bordieri & Phillips, 1988; Rosenthal, 1997; Shrey & Mitchell, 1986). However, the degree of progress made in convincing employers that they are the most appropriate professionals to help manage disability at the work place remains debatable and difficult to quantify. The following discussion highlights some of the concerns that affect the potential employment of rehabilitation counseling professionals in employer-based disability management programs.

Concern one: The nature and quality of disability management programs among employers are highly variable. Consequently, employers may not have consistent conceptualizations of the responsibilities and job requirements of a disability management specialist.

A primary concern within rehabilitation counseling has been an increasing emphasis on meeting employer needs in preventing and managing employees' disabilities. However, the connection between the rehabilitation counselor's skills and the disability management needs of the employer has not been made as directly or expeditiously as anticipated.

For a variety of reasons, employers have been slow to recognize the value rehabilitation counselors can add to the disability management process. One factor may be that disability management practices among employers vary in terms of quality, philosophical orientation, scope, support services, return to work methods, etc. (Habeck, Leahy, Hunt, Chan, & Welch, 1991). Due to the diversity of disability management programs in the employer community, it is difficult to find consensus regarding the essential job functions of the disability management professional.

It may also be that the medical model of disability continues to influence employers' attitudes and responses to disability-related issues. Operating from a medical orientation, employers often view disability primarily as a medical problem that should be treated by medical professionals, e.g., nurses, physical therapists, physicians (Habeck, et al., 1991). Employers may also operate on the assumption that rehabilitation counselors lack expertise in medical issues and medical case management. Thus, it is more common to find occupational health nurses employed at the work setting than rehabilitation counselors (Olsheski & Breslin, 1996).

As a preliminary method of examining these issues, a survey was conducted using a convenience sample of 60 large Midwestern businesses (more than 100 employers). Employers participating in the survey represented the following: manufacturing (n=20); heavy manufacturing (n=15); food production (n=7); transportation services (n=5); banking and financial (n=3); and others (n=2). Eight of the 60 employers refused to provide any information.

Employers were requested to provide their companies' job descriptions of individuals who provide in-house disability management services. Fifty-two percent (n=27) of the employers stated that they had no such job title and that the responsibilities for managing disability were absorbed by employees in human resources/personnel and/or benefits/workers' compensation departments. Forty-six percent (n=24) of the job descriptions emphasized medical management; 15% (n=8) of the responses emphasized understanding the complexity of the interactions of disability and work. Only one respondent (2%) mentioned organizational consultation, program development, systems analysis, or mediation.

The results of this limited survey seem to support the observation that disability management functions exist in various departments within businesses. …

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