Values and Valuing in Rehabilitation
Curtis, Rebecca S., The Journal of Rehabilitation
Rehabilitation service providers must identify what is valued in terms of consumer goals and outcomes. On a practical level, service providers must assess if values guide the provision of services or if, in actuality, standard practices shape the values that professionals hold toward consumers and services provided. In the latter instance, one may wonder if values evidenced by service providers reflect consumers' needs or service providers' needs. It is therefore significant to propose values that influence rehabilitation and understand their potential for impacting practices.
Values are indicators of what is held in esteem (Gordon, 1975; Rokeach, 1973). Values act as standards or beliefs that guide actions and judgments across situations and time. Typically values are organized by priority into what is known as a value system, thereby resulting in a continuum along which judgments are made regarding behaviors and actions (Kluckhohn, 1951; Rokeach, 1973, Schwartz, 1990). Values and resulting value systems operate at the individual or personal level, the institutional or professional level, and a societal or national level (Rescher, 1969; Schwartz, 1990). Personal values, for example, are values that do not necessarily involve interaction with others. Personal values are expressed by an individual's behavior that generally brings about the value satisfaction (for example, someone who works diligently on a job because he or she values a strong work ethic; Gordon, 1975). Institutional or professional values, alternatively, may be described as a specified prioritization or constellation of values that serve to express and encourage the identification and advancement of the group's values (Schwartz, 1990). In this sense, professional values serve as a group's standards and have the propensity to set the direction toward which an organization works (NICHCY News Digest, 1993). This happens whether values are clarified by the group and stated up front or whether they are ambiguous because they have not been formally identified. When values are not articulated, assumptions are made about what is considered to be of value. Unspoken values and assumptions made about what is of value to the group, however, will continue to influence and shape the behaviors and actions of the group. The purpose of this paper is to propose values that influence the field of rehabilitation and to explore how values influence both service providers and consumers of rehabilitation services.
Values Identified in Rehabilitation
In the field of rehabilitation, values serve as motivating forces (Jenkins, 1987). Hotz (1992), discussing philosophical considerations that serve as cornerstones in rehabilitation, outlined the following "Moral Argument" for rehabilitation: "In our society we greatly respect and value the human rights and dignity of all people, and feel a moral obligation to provide assistance to people with special needs" (p. 9). Emener, Patrick, and Hollingsworth (1984) stated that rehabilitation is "a process of helping handicapped [sic] individuals move from positions of dependency in their community toward positions of independency in a community of their choice" (p. 6). In this definition of rehabilitation, the values of helping (or altruism), independence, community, and choice are highlighted. Empowerment, a concept that has been identified as a central concern in rehabilitation psychology (Bolton and Brookings, 1996), incorporates the values or concepts of self-control, choice, independence, and self-determination (Szymanski, 1994). When operationally defined, these concepts potentially serve as motivating forces for policies and procedures within which rehabilitation counselors perform their jobs.
In rehabilitation, as in other professions and institutions, values help to establish the manner in which the organization or profession functions on a daily basis (Wilson, 1988). Service providers in the field of rehabilitation are guided by values that are inherent in mission or goal statements expressing the philosophy and purpose of the organization (McLaughlin & Warren, 1992). …