Academic journal article The Journal of Rehabilitation

Psychiatric Rehabilitation: A Survey of Rehabilitation Counseling Education Programs

Academic journal article The Journal of Rehabilitation

Psychiatric Rehabilitation: A Survey of Rehabilitation Counseling Education Programs

Article excerpt

An estimated 4 to 5 million adults in the United States are considered to have a serious mental illness. Although some gains have been made in service provision for individuals with severe mental illness (SMI), the increasing number of individuals with severe and life-long psychiatric disabilities continues to challenge rehabilitation professionals. Along with other human service workers, rehabilitation counselors are being challenged by the large number of people with severe and life-long mental disorders (Garske, 1999). According to McDonald Wilson, Revell, Jr., Nguyen, and Peterson (1991), vocational rehabilitation programs have demonstrated limited success for people with psychiatric disability, a population that represents the next-to-largest category of disability served by the state-federal vocational rehabilitation (VR) system.

Individuals with severe mental illness may experience deficits in social skills, personal management, symptom management, cognition, and coping with stress (Bond, 1995; Corrigan, Rao, & Lam, 1999). While such individuals may possess the necessary functional competencies, educational qualifications, and have a strong desire to work, many have not been successful in the labor market (Garske, 1999). While there appears to be a consensus among rehabilitation professionals that employment is an important part of life for persons with mental illness (VandenBoom & Lustig, 1997), estimates of unemployment for the working-age members of this population are at a rate of around 85% (National Institute of Disability and Rehabilitation Services, 1993). Even when persons with serious psychiatric disability seek vocational services, they have success rates only about half of those with physical disabilities (Marshak, Bostick, & Turton, 1990).

To help people with severe mental illnesses become and remain contributing members of society, rehabilitation, vocational training, and assistance in work settings are essential. Comprehensive psychiatric rehabilitation programs combined with effective medication management help such individuals meet the challenges of severe mental illness (Liberman, Corrigan, & Schade, 1989). The mission of psychiatric rehabilitation, as defined by Anthony, Cohen, and Farkas (1990), is to assist persons with long-term psychiatric disabilities increase their functioning so they are successful and satisfied in the environments of their choice with the least amount of ongoing professional assistance. Psychiatric rehabilitation typically involves helping individuals gain or improve skill levels, as well as identify and obtain resources and support required to attain their goals (Garske, 1999).

Although it appears that rehabilitation professionals understand the relationship between life adjustment and physical disabilities, rehabilitationists may not understand the principles and practices of psychiatric rehabilitation (Anthony, 1991). Many clients require comprehensive services dealing with a variety of psychosocial and emotional issues before they can focus effectively on vocational issues (Garske, 1999). From a rehabilitation counselor's point of view, it is understandable that the major focus of rehabilitation may be on improving vocational outcomes for people with severe psychiatric disabilities. However, clients who have poor social skills, limited peer relationships and who have difficulty adjusting to community living need more than vocational counseling services.

Today many rehabilitation counselors are working in community mental health centers, psychiatric hospitals, community residential programs, supported employment programs, and community support programs. Based on current trends, qualified rehabilitation counselors will continue to be in demand to work with persons with severe psychiatric disabilities. Psychiatric rehabilitation and case management services are very demanding and complex. Therefore, psychiatric rehabilitation professionals must have advanced training in an array of knowledge areas, including psychopathology, psychopharmacology, medical and psychosocial aspects of disabilities, vocational aspects of disabilities, assessment, intervention techniques, and community resource utilization (Chan, et al. …

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