Counselling approaches U-4, 4.4

Question	Answer
What is the primary goal of rehabilitation counselling?	The primary goal of rehabilitation counselling is to assist the individuals with disabilities to gain or regain their dependence and freedom through employment or some form of meaningful activity. So, this goal is based on the assumption that meaningful activities may help the individuals with disabilities to become productive members of the society, establish networks and interpersonal relations, and ultimately experience a good quality of life.
When and how was rehabilitation counselling established?	Rehabilitation counselling emerged as a profession in 1920 with the passage of Smith Fess Act, which established the federal-state vocational rehabilitation program. The Vocational Rehabilitation Act Amendments of 1954 further spurred the profession by allocating funding for the development of rehabilitation counselling.
How was the effectiveness of graduate rehabilitation counsellor training programs supported by a series of studies?	The support of the effectiveness of the rehabilitation counsellor training programs was supported by a series of studies conducted by Szymanski and colleagues and many others who investigated the relationship of rehabilitation counsellor education and experience to client outcomes in Arkansas, Maryland, New York, and Wisconsin. Results of these studies showed that counsellors who had Master’s degree had better outcomes from their clients than those counsellors who didn’t had such education qualification.
What type of amendment was carried out in 1997?	As a result, in 1997 the Rehabilitation Act was amended to include the Comprehensive System of Personnel Development (CSPD), which was designed to ensure that federal-state VR programs employ rehabilitation counsellors who hold the highest local or national certification licensing credential for the field. This amendment required all new hires as well as currently employed rehabilitation counsellors to have or obtain a master's degree in rehabilitation counselling and/or being able to obtain the national Certified Rehabilitation Counsellor (CRC) certificate.
What are the various settings in which rehabilitation counsellors work? What are their needs they need to meet?	Today, rehabilitation counsellors work in various settings including proprietary rehabilitation companies, private practice, private non-profit rehabilitation facilities/organizations, insurance companies, medical centres or general hospitals, and businesses/corporations, and are required to meet the diverse needs of a wider and more complex spectrum of disability groups with various degrees of severity. While the central role of rehabilitation counsellors has not changed substantially, the specific functions of counsellors do vary according to their practice settings (public, private for profit, community-based rehabilitation organizations, etc.) and the disability group being served. The diversity of rehabilitation counselling functions has become increasingly apparent in recent studies investigating the roles, functions, knowledge and skills of today’s rehabilitation counsellors.
Define: Rehabilitation counselling?	Rehabilitation counselling has been described as a process where the counsellor works collaboratively with the client to understand existing problems, barriers and potentials in order to facilitate the client's effective use of personal and environmental resources for career, personal, social and community adjustment following disability. In carrying out this multifaceted process, rehabilitation counsellors must be prepared to assist individuals in adapting to the environment, assist environments in accommodating the needs of the individual, and work toward the full participation of individuals in all aspects of society, with a particular focus on independent living and work.
Explain the 1973 Amendment?	With the passage of the 1973 Rehabilitation Act Amendments emphasizing services to people with severe disabilities, the philosophy of rehabilitation has evolved from an economic-return philosophy to a disability rights philosophy. Issues related to consumerism have received considerable attention, particularly in recent years, in the field of vocational rehabilitation. The demand for consumerism was first reflected in the legislative arena with the passage of the 1973 Rehabilitation Act Amendments, when consumer involvement was mandated in the rehabilitation planning process. Not surprisingly, the mandate that the Individualized Written Rehabilitation Program (IWRP) be required by statute was the result of efforts by advocacy groups such as the American Coalition of Consumers with Disabilities and was the first time that consumers were recognized by legal statute as equal partners in the rehabilitation process.
Explain the 1992 and 1998 amendments?	The 1992 and 1998 Amendments extended the active role of consumers throughout the vocational rehabilitation program. The importance of empowerment continued in the 1998 Amendments of the Rehabilitation Act, as new provisions enhanced a collaborative relationship between consumers and rehabilitation counsellors in the vocational rehabilitation program.
What are the goals of rehabilitation counselling?	Within the disability rights context, the goals of rehabilitation have been identified as: (a) inclusion, (b) opportunity, (c) independence, (d) empowerment, (e) rehabilitation, and (f) quality life. Both rehabilitation professionals and consumers generally accept the notion that the goals of the rehabilitation process can be better achieved when there is maximum consumer involvement in the development, implementation, and use of vocational rehabilitation services.
Explain: Consumer informed choice?	The concept of consumer informed choice is intended to maximize the involvement of consumers in their vocational rehabilitation programs. Rehabilitation counsellors assist consumers in exercising informed choice throughout the vocational rehabilitation process by (a) providing consumers with information pertaining to various options (e.g., job development service providers, vocational evaluation service providers, IPE development), (b) providing recommendations and professional opinions, and (c) providing consumers with information concerning the policies and procedures on service provision (e.g., comparable benefits, licensure and accreditation of service providers).
What was the study done by Muthard and Salamone on the roles and functions of the counsellors in rehab counselling?	Muthard and Salamone conducted the first study investigating the roles and functions of rehabilitation counsellors working in state VR programs – the dominant practice setting at that time. Their results suggested that counsellors divide their time equally among three areas including: (a) counselling and guidance; (b) clerical work, planning, recording, and placement; and (c) professional growth, public relations, reporting, resource development, travel, and supervisory administrative duties. Since this investigation, roles and functions studies have been conducted on a regular basis, with several receiving supports from the Commission on Rehabilitation Counsellor Certification (CRCC) and the Council on Rehabilitation Education (CORE).
Explain: The study done by Leahy et al.?	Leahy et al. conducted the most recent roles and functions study, which involved a survey of a large random sample of certified rehabilitation counsellors. This study examined the perceived importance of major job functions and knowledge domains that underlie contemporary rehabilitation counselling practice and credentialing. Results revealed seven major job functions as central to the professional practice of rehabilitation counselling in today’s practice environment including: (a) vocational counselling and consultation, (b) counselling interventions, (c) community-based rehabilitation service activities, (d) case management, (e) applied research, (f) assessment, and (g) professional advocacy.
What did Rubin and Roessler proposed regarding the effectiveness of the individuals with disabilities?	They proposed that rehabilitation counsellors must operate as “sophisticated professionals” who possess multiple skills and knowledge domains and have the ability to integrate a multifaceted service delivery system.
What are the six knowledge and skill domains given by Leahy.et al.?	Leahy et al. identified six knowledge and skill domains perceived by certified rehabilitation counsellors as important for contemporary rehabilitation counselling practice including: (a) career counselling, assessment and consultation; (b) counselling theories, techniques, and applications; (c) rehabilitation services and resources; (d) case and caseload management; (e) healthcare and disability systems; and (f) medical, functional, and environmental implications of disability.
Explain: The Certified Rehabilitation Counsellor(CRC) credentialing process?	The Certified Rehabilitation Counsellor (CRC) credentialing process was the first, and considered to be the most, established certification mechanism in the counselling and rehabilitation professions within the United States. The Commission on Rehabilitation Counsellor Certification (CRCC) was officially incorporated in January 1974 to conduct certification activities on a nationwide basis. Since this time, over 23,000 qualified professionals have participated in the certification process. Today, over 15,000 CRCs are practicing in the United States and in several other countries.
What is the purpose of certification of the rehab counsellor?	The primary purpose of certification is to provide assurance to rehabilitation counselling clients that services will be provided in a manner that meets the national standards of quality. Such standards are also considered by the profession to be in the best interest of the client. To guide these standards, the CRCC established a Code of Professional Ethics for Rehabilitation Counsellors.
Why is it a necessity for a rehab counsellor to have knowledge and skills?	As said in the in-service training, the knowledge and skills in areas like health care and disability systems had not been covered when many CRC’s received their graduate training. So, in order to meet the demands of the today’s diverse practice environments and complex cases effectively, practicing rehabilitation counsellors must become knowledgeable about both traditional and emerging knowledgeable areas.
What was the “two hats theory” and who gave it?	Patterson proposed the “two hats theory” suggesting that the practice of rehabilitation counselling is based or involves two fundamental roles. He posited that the rehabilitation counsellors should function as either psychological counsellors or rehabilitation coordinators where the former one plays the role of working with clients who need personal adjustment counselling & the latter one provides case management and vocational adjustment counselling.
What suggestions were given by Whitehouse in his “big hat theory”?	Patterson advocated the “big hats theory” suggesting that rehabilitation counselling involves a number of roles and functions of the rehab counsellor. He also says that the rehab counsellors must be trained to work with the whole person and should have a knowledge base. It was believed that the rehab counsellors should have skills that encompass many roles including those of a therapist, guidance counsellor, case manager, case coordinator, psychometrician, vocational evaluator, educator, community and consumer advocate, and a placement counsellor.
Explain the relationship between the “big hat theory” and rehabilitation counselling?	The “big hat” definition of rehabilitation counselling was used as the primary model in the development of rehabilitation education and training curricula and certification in 1970s. While this approach facilitated the development of a separate professional status for rehab counselling, at the same time, it weakened the relationship of rehab counselling to the broader field of counselling. Today, debates regarding this relationship have reached the forefront, becoming a standard practice in many settings which rehab counsellors are employed.
Why are the older adults in a need for a psycho-therapeutic treatment?	It’s generally not the case that an older adult will pursue psychotherapy as a treatment in the same manner as do the younger adults. So, older adults may present to their physicians with a myriad of symptoms with physical illness. Some of the common of these symptoms are depression, anxiety, sleep disturbances, memory loss, forgetfulness, physical fatigue, physical illness and aches etc. Complaints such as these maybe taken at the face value and explored or treated as physical problems. However, many of these symptoms may reflect an underlying mental health issue in need of an evaluation and treatment. We shouldn’t overlook the fact that many elders who are physically ill may also be clinically depressed and hence in need for a treatment.
Why is it very difficult to diagnose depression in older adults?	Older adults themselves tend not to label or describe their negative feelings as depressed but often report such as complaints of worthlessness, hopefulness, demoralization or despair. 2. It’s not clear how to interpret behavioural and somatic symptoms of which older persons may complain. 3. We and others have noted that, emotionally, older adults may present with a depressed tone that may be quite obvious to an interviewer, but maybe denied by the patient. 4. No such specifiers were considered as a present standard for diagnosing late-life depression. 5. But, now to diagnosis the depression in older adults we use the Diagnostic and Statistical Manual for Mental Disorders (DSM).
Briefly describe how late-life depression is assessed?	1. It’s crucial to begin with an assessment of cognitive functioning in order to screen for dementing disorders, and to evaluate whether or not the client has the cognitive capacity to participate in the psychotherapy. Then, a general Mini-Mental State Examination(MMSE) is done which is a 20-item screening tool that offers general information about a patient’s cognitive function and is both quick to administer points based on their performance. 2. A more psychometrically sound alternative for MMSE is the Dementia Rating Scale. 3. Many mental health professionals use the Hamilton Rating Scale for assessing one’s level of depression. 4. In addition to this, a Beck’s Depression Inventory is used and along with these scales, 5. Medications like SSRI and anti-depressants are prescribed to the individual.
What are the general barriers while preparing an older adult for the treatment?	1) The problems like financial restrictions, travel difficulties, low income, low energy level. In order to overcome these problems a practitioner may choose the in-home delivery of therapeutic care to elders with depression. 2) for many older adults, there is a stigma while seeking mental health treatment where there are feelings of shame and embarrassment because they can’t solve their own problems and must rely on others for help. Hence, this aging itself can add to the difficulty of seeking psychotherapy that is based on learning new coping skills and self-management techniques. 3) Lack of programs for older adults and 4) the psychotherapists aren’t trained in working with this population.
Who are frail elderly clients?	A special category of patients who experience multiple barriers to seeking and completing psychotherapy are called as the frail elderly clients. They have been defined as elderly persons (usually over the age of 75 years) who present with multiple physical and/or mental disabilities that interfere with their ability to function independently. Its assumed that these older adults are unable to benefit from any therapy, but recent studies proved that Cognitive- Behavioural therapy (CBT) is effective for these clients.
What is reminiscence therapy?	It’s used to treat elderly patients having chronic illness. In this therapy the positive aspects of the individual’s life are brought up for discussion and promote positive affect and to help these older adults realize his/her contributions throughout the lifespan.
What are the benefits of in-home services?	1) It may help ameliorate stigma of mental health care because patients may be able to receive mental health services in the same location that they receive primary medical care. 2) mental health and non-medical professionals may quickly and conveniently access needed medical information by placing a call to the physician or staff that may help in diagnosis and management of psychological problems. 3) the mental health professionals may be updated to the changes in medical treatment which will impact their own treatment plans for the elderly adults and may help to achieve the treatment goals.
What are the several factors that seem critical for maximizing the likelihood that CBT will be effective with the elderly?	1) The elderly needs to be socialized into the therapy, meaning that the roles & expectations of client and therapist need to be articulated, as well as incorrect expectancies elicited, so that working contract maybe established. 2) the therapist needs to recognize the sensory problems and cognitive problems that can make it difficult for elderly adults to communicate in the therapy sessions and tend to affect homework assignments as well. 3) the therapy pace with elderly tends to be slower.

Next up

Counselling approaches U-4, 4.4

Description

Resource summary

Similar

	Created by Siddhi Deshpande about 6 years ago