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American Rehabilitation Counseling Association (ARCA) 50 th Educational Conference. Tampa, Florida U.S.A. November 2007. The Status of Rehabilitation Counseling Services Across the Globe Rapporteurs/Coordinators: David Hershenson, Ph.D.

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american rehabilitation counseling association arca 50 th educational conference

American Rehabilitation Counseling Association (ARCA) 50th Educational Conference

Tampa, Florida U.S.A.

November 2007

slide2

The Status of Rehabilitation Counseling Services Across the Globe

Rapporteurs/Coordinators:

David Hershenson, Ph.D.

Professor Emeritus, University of Maryland-College Park

Irmo Marini, Ph.D.

University of Texas, Pan America

Daniel Wong, Ph.D.

East Carolina University

international panel
International Panel

Nicholas Buys, Ph.D.

Griffith University, Australia

Hal Cain, Ph.D.

Queens University, Canada

Kane Hattori, Ph.D.

Kobe City College of Nursing, Japan

Gail Kovacs

Vocational Rehabilitation Association, United Kingdom

international panel4
International Panel

Li Jian Jun, MD

Qiu Zhouying, Ph.D.

Shi Hongmei

China Rehabilitation Research Center, China

Ming-Hung Wang, Ph.D.

Ming-Yi Wu, Ph.D.

Taiwan Rehabilitation Association, National Kaohsiung Normal University, Taiwan

international panel5
International Panel

Jun Yaeda, Rh.D.

University of Tsukuba, Japan

Dal Yob Lee, Ph.D.

Taegu University, Korea

voc rehab counselling services
Voc Rehab Counselling Services

Vocational rehabilitation counselling services are provided in several systems

  • Social security - Federal
  • Workers compensation - State
  • Motor accident – State
provision of vr services
Provision of VR services
  • Range of disciplines include:
    • Rehabilitation Counsellors
    • Occupational therapists
    • Psychologists
    • Physiotherapists
    • Social workers
  • Range of titles:
    • Injury manager
    • Rehabilitation coordinator
    • Rehabilitation case manager
    • Disability employment worker
  • Training is usually a tertiary degree in one of the behavioural sciences or allied health
status of rehabilitation counselling
Status of Rehabilitation Counselling
  • Rehabilitation Counselling profession exists in Australia
  • Small numbers
  • RC degree programs exist at Bachelors and/or and Masters level at 7 universities No registration or licensure
  • Two professional bodies – RCAA & ASORC
status of rehabilitation counselling10
Status of Rehabilitation Counselling

Rehabilitation Counselling Association of Australasia is of the view that voc rehab counselling services should be provided by professionals with specific tertiary training in rehabilitation counselling

national legislation and policies
National legislation and policies
  • Federal Government avoided issue of which professions should deliver VR services
    • Focussed more on outcomes rather than which profession does the work
  • State Governments more prescriptive in workers comp
    • Queensland has Table of Costs specifying which professions can deliver what services and at what cost
role of rehabilitation counsellors
Role of Rehabilitation Counsellors
  • Role depends on system and employer
  • VR services for social security recipients – case manage from intake through to job placement
  • Occupational rehab services in workers comp and motor accident:
    • Full program
    • Case coordination only
    • Specific services such as vocational evaluation or job placement
  • Disability employment services
    • Job placement and retention
use of icf in rehabilitation
Use of ICF in Rehabilitation

Limited to date – main areas of use:

  • Data collection
  • Research - measure of therapy outcomes
  • Classification system
  • Identification of support needs
  • Education
challenges for rc profession
Challenges for RC profession
  • Deprofessionalisation of VR services
  • Lack of recognition by governments
  • Governments want outcomes – not interested in who delivers services
  • Small numbers
  • Professional body lacks resources to lobby
challenges to providing services
Challenges to providing services
  • Fragmentation of service delivery system
  • Ongoing employer reluctance to hire
  • Aging population and increase in chronic conditions
  • Lack of services in rural and remote areas
  • Multiple service delivery systems
  • Lack evidence base to guide practice
best outcomes practices
Best outcomes & practices
  • Social security recipients:
    • Demand side approaches
  • Workers compensation recipients:
    • Employer-based disability management programs
    • Key stakeholders (doctors, employers, insurers, workers) fully engaged
    • Provision of suitable return to work duties
    • Focus on psychosocial issues not just medical issues
    • Build healthy organisations with positive workplace cultures
    • Reduce common law access
similarities differences with us
Similarities/Differences with US
  • Currently undertaking a study of RC competencies in Australia
  • Limited studies to date indicate role and function is similar
  • US has stronger focus on forensic rehab, possibly because more litigious
responses in context of canada rehabilitation counselling

Responses in context of Canada: Rehabilitation Counselling

Hal. M. Cain, Ph.D., CRC

Queen’s University

Kingston, ON

Rehabilitation Counselling Association of Canada

professional disciplines providing vocational rehabilitation counselling services
Professional disciplines providing vocational rehabilitation counselling services?
  • a variety professional disciplines including, but not limited to:
    • occupational therapy
    • social work
    • psychology
    • nursing
  • a few practitioners specifically trained in counselling but fewer trained in rehabilitation counselling
official professional title of this professional discipline
Official professional title of this “professional”/“discipline”?
  • there is no “official” professional title in Canada
    • many practitioners call themselves “Rehabilitation Consultants”
    • others adopt job titles, including “Rehabilitation Counsellor,” as set by various employers and employment settings
  • “Rehabilitation Counsellor” and “Vocational Rehabilitation Counsellor” included in the National Occupational Classification (NOC)
training or academic credential needed
training or academic credential needed?
  • no particular level or academic training specified
  • in the NOC, under the category of “Family, Marriage and Other Related Counsellors”
    • a “master’s degree in counselling, mental health, or related social service field is usually required”
    • however, the NOC also indicates that, “An undergraduate degree or college diploma in a social science is required for certain areas of counselling.”
national legislation policy and or regulation to support
national legislation, policy and/or regulation to support?
  • no stand-alone legislation or policy in at the national level in Canada
  • however, non-discrimination and rights laws are integrated into various legislation, such as the Canadian Charter of Rights and Freedoms
  • some federal funding and policy is given in support of disability related issues – largely administered at a provincial level
  • disability / rehab legislation and policy exists at the provincial and territorial level
rehabilitation services guided by the classifications of disabilities
rehabilitation services guided by the classifications of disabilities?
  • The International Classification of Functioning, Disability, and Health (ICF) is used for classification of disabilities in Canada.
role and function
role and function?
  • role and function of rehabilitation counsellors in Canada is very similar to that of rehabilitation counselors in the U.S.
  • rehabilitation counsellors do assessments/evaluations, manage cases, provide counselling, provide expert testimony, conduct research, etc.
type of services rehabilitation counselors provide
type of services rehabilitation counselors provide?
  • rehabilitation counsellors in Canada provide a variety of services depending on the setting
  • these services include, but are not limited to:
    • case management
    • vocational evaluation
    • career/vocational counselling
    • employment training.
challenges of this profession
challenges of this profession?
  • some of the challenges for rehabilitation counselling in Canada are the same as in the U.S.
    • few lay people and not many allied rehabilitation professionals know what rehabilitation counselling is about
    • issues of professional identity within the profession
challenges of this profession continued
challenges of this profession? (continued)
  • major specific challenges for rehabilitation counselling in Canada
    • lack of rehab counsellor education programs (only one at this time)
    • credentialing issues: loss Canadian Certified Rehabilitation Counsellor (CCRC) & no regulation of counselling in Canada except in Québec.
challenges of providing vocational psychosocial services to persons with disabilities
challenges of providing vocational & psychosocial services to persons with disabilities?
  • widely accepted, typically supported, and largely available
  • depending of province or territory, may be funding and procedural issues that pose a challenge for service providers
best outcomes e g employment outcome and best practices
best outcomes (e.g., employment outcome) and best practices?
  • Best outcomes in Canada are based on community integration, in general, and sustained employment.
  • “Best practice” includes a whole-person approach.
variables that play a major role in the voc rehabilitation process
variables that play a major role in the voc rehabilitation process?
  • no major socio-demographic variables play a role in the vocational rehabilitation process in Canada
  • in addition, everyone has equal access and protected from discrimination based on gender, age, and socio-economic, etc.
role and function united states v canada
role and function: United States v. Canada?
  • the role and function of rehabilitation counsellors in Canada are very similar to that of rehabilitation counselors in the U.S.
  • differences in settings impact particular role and functions depending on the focus or mission of these various settings
role and function united states v canada continued
role and function: United States v. Canada?(continued)
  • a major difference is the settings in which rehabilitation counselling is practiced
    • In the U.S., the majority of rehabilitation counsellors appear to work in state/federal systems (public sector)
    • In Canada rehabilitation counsellors work more in the private sector (for-profit and not-for-profit).
rehabilitation and disability in china

Rehabilitation and Disability in China

Li Jian Jun, MD

Qiu Zhuoying, Ph.D.

Shi HongMei, M.S.

China Rehabilitation Research Center

Beijing, China 100068

slide35

Rehabilitation for People with Disabilities in China: Approaches and Development

Background Information on China

  • History
    • China is the one of the world’s most ancient civilizations with a recorded history of nearly 4,000 years.
  • UNDP Human Development Index
    • According to the Human Development Report 2005 (UNDP), China's Human Development Index (HDI) value in 2003 was 0.755, ranking 85th worldwide.
slide36

Rehabilitation for People with Disabilities in China: Approaches and Development

  • Population & Natural population growth rate
    • Fifth national census on 1 Nov 2000 by NBS
    • Total Population: 1,295,330,000.
    • Population growth rate: less than 10 per thousand.
slide37

Rehabilitation for People with Disabilities in China: Approaches and Development

Statistics of Disability and Birth Defects

Disabilitystatistics in China

  • UN estimates: 10% population with disability
  • In 1996, China Disabled Persons Federation (CDPF) estimated 60 million disabled persons in China.
  • About 5% of the total population has some type of a diagnosed disability.
slide39

Rehabilitation for People with Disabilities in China: Approaches and Development

Laws, Policies and Coordination Mechanism of disability and rehabilitation in China

  • Laws and regulations on rehabilitation, education and protection for children
    • LAW OF THE PEOPLE'S REPUBLIC OF CHINA ON THE PROTECTION OF DISABLED PERSONS
    • People with disabilities have the right to rehabilitation, education and social life
  • National Rehabilitation Office
  • Regulations and policies of rehabilitation
    • Rehabilitation for All
rehabilitation and disability system

Rehabilitation for People with Disabilities in China: Approaches and Development

Rehabilitation and Disability System
  • Administrative System
    • State Council
    • Ministries
    • CDPF
  • Professional Institutions
    • Hospitals
    • Rehabilitation Centers at national, provincial and other local levels
    • Rehabilitation Stations (clinics) at grass-root level
    • Social Services Institutions
slide41

Rehabilitation for People with Disabilities in China: Approaches and Development

Rehabilitation for All

  • Policy:
    • The ministries of Health, Civil Affairs, Finance, Public Security, Education and China Disabled Persons’ Federation had issued Comments on the Rehabilitation for People with Disabilities on August 24, 2004
  • Total Target: Rehabilitation for All by the year of 2015
  • Assessment Indexes: Baseline survey
slide42

Rehabilitation for People with Disabilities in China: Approaches and Development

Rehabilitation Delivery System

  • Public Health System
    • Primary care:
      • Neonatal care: Early diagnosis and treatment, referral services
    • Secondary care: Rehabilitation treatment and surgery
    • Tertiary care: Rehabilitation Departments
  • National Rehabilitation Networks
    • National, Provincial, cities
    • PT, OT, ST and others
  • Rehabilitation services by non-governmental organizations (NGOs)
  • Community Based Rehabilitation (CBR)
slide43

Rehabilitation for People with Disabilities in China: Approaches and Development

Institution and hospital-based services for people with disabilities

  • Early screening and diagnosis
  • PT, OT, ST and other rehabilitation services
  • Psychosocial support
slide44

Rehabilitation for People with Disabilities in China: Approaches and Development

Community-based rehabilitation (CBR)

  • Concept
    • CBR has been defined as a strategy in communities for the rehabilitation, equalization of opportunities, and social integration of people with disabilities (ILO, UNESCO, and WHO, 1994; UNICEF, and the Ministry of Education and Science, Spain, 1994).
    • Home-based and model center-based approaches.
  • CBR for Disabled Children and their families
    • to encourage children with disabilities to attend public schools with the goal for them not be limited by different social expectations, negative attitudes and environmental constraints.
    • to mobilize local resources to enable people with disabilities and their communities to create their own solutions to eliminate barriers and create programs for rehabilitation.
slide45

Rehabilitation for People with Disabilities in China: Approaches and Development

Prevention to Disability

  • National Action Plan
    • In 2002, Ministry of Health and CDPF issued a National Action Plan for Improvement of Quality of Health for the Population and Reduction of Birth Defects and Disability (2002-2010).
    • Reduce 0.8-1 million congenital birth abnormalities per year.
    • 40% coverage of reproductive health services for all women.
  • Established a System of Rehabilitation Services
  • Publicity and advocacy of knowledge and methods for disability prevention.
slide46

Rehabilitation for People with Disabilities in China: Approaches and Development

National Work Programmes

National Work Programmes on Rehabilitation for all People with Disabilities

Key National Rehabilitation Projects (2001-2005)

Main and update advances in rehabilitation for children and youth with disabilities (1988-2002)

slide47

Rehabilitation for People with Disabilities in China: Approaches and Development

National Work Programmes on Rehabilitation for People with Disabilities

  • National Work Programme for children rehabilitation
    • The rehabilitation programmes had been integrated into National Disability-related Development Programmes
  • National Work Programme 1991-1995—rehabilitation
    • Hearing and speech training for deaf children, surgery and rehabilitation for children and youth with polio and cataract
  • National Work Programme 1996-2000—rehabilitation for low vision, mental retardation, physical disability, development of assistive devices, and prevention to disability.
  • National Work Programme 2001-2005-rehabilitation
    • establishment of rehabilitation system for children, national days for eye care, ear/hearing care and prevention to shortage of Iodine, etc.
slide48

Rehabilitation for People with Disabilities in China: Approaches and Development

Key National Rehabilitation Projects (2001-2005)

  • Key Rehabilitation Projects
    • Functional training and assistive devices for children with low vision 0.1 million
    • Hearing and speech training for deaf children 0.8 million
    • Rehabilitation for CP 0.2 million
    • Rehabilitation for MR 0.8 million
  • Other projects:
    • Orientation walking/mobility training for the blind
    • Rehabilitation for children with autism
    • Assistive devices and services
    • Community Based Rehabilitation (CBR)
current state of rehabilitation in china
Current state of rehabilitation in China
  • 60 million disabled people, only 8 million received rehabilitation services
  • Rehabilitation goal: By 2015, every disabled person will receive rehabilitation services
  • Rehabilitation institutions: 24 at provincial level, 608 at city level, 3044 at community level
  • Professionals: 18,000 rehabilitation doctors, 300,000 PT, OT & ST.
  • It is vital for the development of rehabilitation to train professionals at different levels
rehabilitation medicine and related education
Rehabilitation Medicine and Related Education
  • Research oriented medical school
  • Diploma, B.S., M.S., Ph.D. education
  • On-job training of rehabilitation medicine education nationwide
  • Accreditation of professionals
rehabilitation and disability research
Rehabilitation and Disability Research
  • International Cooperation
    • WHO-ICF
    • ILO-Vocational Rehab.
    • Rehabilitation Counseling with ECU
    • Cooperative Project with others
  • National Project
    • Development of database of rehabilitation
    • National System of Assessment and evaluation of Disability
    • National System of Disability and Health for persons with disabilities
    • National System of Survey and Monitoring of Disability
    • Clinical Rehabilitation for Stroke patients
    • Clinical Rehabilitation for Spinal Cord Injury
slide52

Rehabilitation for People with Disabilities in China: Approaches and Development

The Challenges of Rehabilitation for People with Disabilities in China

  • Basic rehabilitation needs
  • Social and economic development, rehabilitation and education
    • Economic development
    • Categories of disability
    • Urban and rural development
    • Shortage of facilities and resources
    • Low capacity of services
  • Poverty rate among people with disabilities
  • High-tech rehabilitation
  • Human resource development in rehabilitation
slide53

Rehabilitation for People with Disabilities in China: Approaches and Development

The Strategies of Rehabilitation for People with Disabilities in China

  • To develop and mobilize social recourses nationwide.
  • To enhance rehabilitation practices for people in rural areas.
  • To develop rehabilitation interventions and therapies for people with different types of disabilities in different levels.
  • Early detection, early intervention, early rehabilitation, early education and continuing training.
  • To enhance the enrollment rate for children and youth with disability in education to improve their physical and intellectual functions, social and vocational skills.
  • To provide special support for people with disabilities and their families who live in poverty.
  • National Work Programme for next 5-years, coordination, management and implementation.
slide56

In Japan, the "Vocational Counselors" for individuals with disabilities provide vocational rehabilitation counseling services. 

  • The official professional title of this “professional”/“discipline” is"Vocational Counselors for the Disabled".
slide57

Those who pass the national exam by the Ministry of Health, Welfare, and Labor will be the candidates to become "Vocational Counselors for the Disabled" after receiving one year OJT at National Institute of Vocational Rehabilitation, NIVR, in Japan.

slide58

To support this type of rehabilitation services:

  • ”Law for Employment Promotion, etc. of the Disabled”
slide59

In addition to utilizing the International Classification of Functioning, Disability, and Health (ICF), Japan has its own classification system for the physical, intellectual, and psychiatric disabilities.

slide60

Type of services rehabilitation counselors provide in Japan

Case Management, Vocational Counseling and Guidance, Planning IPE, Coordinating VR Services, Job Development with Job Coaches, Job Placement, Providing Employer Assistance, Evaluation and Follow-up Services, etc.

slide61

One of the challenges in Japan is how we can systematize the full collaboration among vocational rehabilitation, special education, and social work, to work for the benefits of persons with disabilities.  Many individuals with disabilities have fallen into other types of service systems of education, welfare, and employment, and did not receive the adequate services they really need and deserve.

slide62

Little research has been conducted in the employment outcomes of rehabilitation services in Japan. Not everyone who has a disability gain full time competitive employment.  Many individuals with disabilities work at sheltered workshops and community workshops.

slide63

Family involvement, community participation, and professional qualification are important variables contribute to the rehabilitation success in Japan.

vocational rehabilitation association united kingdom gail kovacs vice chair

Vocational Rehabilitation Association / United Kingdom Gail Kovacs Vice Chair

Working Together to Get People Working

vocational rehabilitation counselling
Vocational Rehabilitation Counselling
  • Vocational Rehabilitation Association (VRA)
  • Case Management Society of the UK (CMSUK)
  • British Assoc. of Supported Employment (BASE)
  • British Association for Brain Injury CM (BABICM)
  • Others
the host report
The Host Report
  • A consultation survey and report of UK Employment & Disability Practitioners 2001
  • David Parsons – HOST Policy Research
  • Department for Work & Pensions, VRA, ENTO
  • An occupational and functional review
host core occupations
Host Core Occupations
  • Medical and healthcare –at or after medical / emotional stabilisation
  • Work profiling and preparation –assessment and skill development
  • Placement and brokerage –interface between preparing for and securing work
  • Workplace access –effective access to work
  • Workplace integration and retention –consultancy, specialist advice and technical support
professional disciplines
Professional Disciplines?
  • Occupational Health Physicians / Nurses
  • Other Nurses
  • VR Counsellors
  • Occupational Therapists
  • Physical Therapists
  • Psychiatrists
  • Psychologists (clinical and occupational)
  • Cognitive Behaviour Therapists
  • Ergonomists
  • Social Workers
  • Employee Assistance Counsellors
  • Unregulated Health Practitioners
professional title
Professional Title?
  • Occupational Health Advisors
  • Medical Case Managers
  • Vocational CMs
  • VR Consultants
  • VR Counsellors
  • VR Planners
  • Advocate
  • Job Brokers
  • Placement Specialists
  • VR Specialists
  • Vocational Trainer
  • Job Coach
  • Vocational Assessor
  • Job Profiler
  • Workplace Analyst
the occupational constituency core occupations
The Occupational Constituency – Core Occupations
  • Medical and Healthcare - 300 to 400
  • Work preparation - 3,450
  • Placement /brokerage - 1,800
  • Workplace access - 150 to 250
  • Workplace integration & retention - 3,750
  • Total = 9,600
the occupational constituency non core occupations
The Occupational Constituency – Non-Core Occupations
  • Medical and Healthcare - 58,000
  • Work preparation - 122,900
  • Placement /brokerage - 24,200
  • Workplace access - 29,000
  • Workplace integration & retention - 465,000
  • Total = 699,100
training requirements
Training Requirements?
  • Medical and Healthcare - As Regulated Health Practitioners
  • Work preparation - Nil
  • Placement /brokerage - Nil
  • Workplace access - Nil
  • Workplace integration & retention - Nil
academic credential
Academic Credential?
  • Medical and Healthcare - As Regulated Health Practitioners
  • Work preparation - Nil
  • Placement /brokerage - Nil
  • Workplace access - Nil
  • Workplace integration & retention - Nil
qualification breakdown
Qualification breakdown
  • Occupational health certificate / dip = 22%
  • Social Work = 5%
  • VR diploma / certificate = 7%
  • Disability Management dip / degree = 4%
  • Occupational Psychology = 4%
  • Clinical and other Psychology = 6%
  • Miscellaneous vocational training = 8%
  • Occupational Therapy = 6%
  • Other = 15%
  • and no qualifications = 27%
host recommendations
Host Recommendations
  • To develop competence based, practice-led and professionally oriented qualifications for VR.
  • To develop an infrastructure to support world class training in the UK. This includes certificate, diploma and masters levels.
  • To identify, develop and accredit assessors and trainers.
host recommendations77
Host Recommendations
  • To review:
  • Additional public funding
  • The contribution of evidence-based practice
  • The development of Centres of Excellence
  • The role of demonstrator projects
  • A potential evaluation strategy.
legislation
Legislation
  • Health and Safety at Work Act 1974 (HSWA)
  • Disability Discrimination Act (1995)
  • Data Protection Act 1998
  • Management of Health and Safety at Work Regulations (1999)
  • Employment Act 2002
case manager or counsellor
Case Manager or Counsellor
  • Both fall under the broader VR Scope of Practice much of which was adopted from the Commission for Rehabilitation Counsellor Certification (CRCC)
  • Professional Scope vs Individual Scope
scope of practice
Scope of Practice

The process is interdisciplinary by nature, and may involve functional, bio psychosocial, behavioural and / or vocational interventions. The techniques utilised within the process may include but are not limited to:

  • Assessment and appraisal
  • Goal setting and intervention planning
scope of practice81
Scope of Practice
  • Provision of health advice and promotion, in support of returning to work
  • Support for self management of health conditions
  • Career (vocational) counselling
scope of practice82
Scope of Practice
  • Individual and group counselling focused on facilitating adjustments to the medical and psychosocial impact of disability
  • Case management, referral and service coordination
  • Programme evaluation and research
scope of practice83
Scope of Practice
  • Interventions to remove environmental, employment, and attitudinal obstacles
  • Consultation services among multiple parties and regulatory systems
scope of practice84
Scope of Practice
  • Job analysis, job development, and placement services, including assistance with employment and job accommodations; and
  • The provision of consultation about and access to rehabilitation technology.
recent achievements
Recent Achievements
  • The definition
  • The Scope of Practice
  • The Standards of Practice
  • The FAQ
the challenges for the profession
The Challenges for the Profession
  • Putting teeth into the Standards
  • Working together as Associations to advance the field
  • Working with Regulated Health Practitioners’ Associations and Colleges (UK Rehab Council)
  • Developing professional education and training that meets the need and is fit for purpose
the challenges for the profession87
The Challenges for the Profession
  • Elevating the skills of existing practitioners
  • Encouraging funders and referral sources to select providers who adhere to Standards / codes
  • Introducing UK Certification / accreditation
  • Overcoming negative terminology
  • Maintaining momentum
  • Financing our efforts
statutory benefits
Statutory Benefits
  • Statutory Sick Pay
  • Incapacity Benefit
  • Income Support (disability premium)
  • Industrial Injuries Disablement Benefit
  • War Disablement Pension
  • Disability Living Allowance
  • Working Tax Credit
  • Severe Disablement Allowance
the challenges for service provision
The Challenges for Service Provision
  • Educating the Stakeholders
  • Restoring a solid reputation
  • Building trust in what we do
  • Demonstrating the business case
  • Getting acceptance for non-UK based research and best practices
the challenges for service provision90
The Challenges for Service Provision
  • Gaining acceptance of standardised assessments
  • Gaining acceptance of customised services – time and cost factors
best outcomes practices91
Best Outcomes / Practices
  • Job retention (prevention and safety)
  • Condition management programmes
  • Work entry and sustainability
  • Workplace wellbeing / health promotion
variables playing a role
Variables playing a role
  • A culture of inactivity
  • Non-mandatory services
  • Doing “to” and “for” clients instead of “with”
  • The lack of job matching
  • “Projects” instead of “programmes”
similarities with the u s
Similarities with the U.S.
  • History and evolution of VR
  • Case Management model
  • Various functions
  • Various work environments
  • ?????
differences from the u s
Differences from the U.S.
  • Case Manager and VR Counsellor not as distinct
  • Lack of professional status
  • Lack of certification / accreditation
  • Lack of training and education
  • Lack of objective assessment first
differences from the u s95
Differences from the U.S.
  • Lack of acceptance as part of a multi-disciplinary team
  • A long way to go to being a sustained profession
thank you gail kovacs@btinternet com www vocationalrehabilitationassociation org uk

Thank Yougail.kovacs@btinternet.comwww.vocationalrehabilitationassociation.org.uk

vocational rehabilitation counseling in taiwan

Vocational Rehabilitation Counseling in Taiwan

Presenters:

Ming-Hung Wang, Ph.D., CRC

Ming-Yi Wu, Ph.D., OTR/L

topics
Topics
  • Population Served by the System
  • Laws
  • Services and Resources
  • Profession and Practices
  • Challenges
population of individuals with disabilities
Population of Individuals with Disabilities
  • 2007
    • All population in Taiwan: 23 millions
    • Individuals with disabilities: 4.37% of all population; about one million
    • Working ages (15~65 y/o) disability population: 0.6 millions (60%)
    • PWD Employment rate: 27%
classification of disability
Classification of Disability
  • The present classification of disability is based on disability types.
  • However, the newly promulgated Protection Act for Rights and Interests of Physically and Mentally Disabled Citizens suggests a classification based on the ICF framework in order to focus on the service needed.
laws national legislation
Laws - National Legislation
  • To protect the legal rights, interests, and livelihood of people with disability, secure their opportunity to participate in the social life fairly, consolidate the governmental and private resources, plan and implement all measures of assistance and welfare, the Physically and Mentally Disabled Citizens Protection Act was amended in 1997.
laws national legislation104
Laws - National Legislation
  • On July 11, 2007, the PMDCPA had been amended to the Protection Act for Rights and Interests of Physically and Mentally Disabled Citizens to further manifest the spirits of protecting their rights instead of protecting the persons.
laws national legislation105
Laws - National Legislation
  • The Protection Act for Rights and Interests of Physically and Mentally Disabled Citizens consists of the following chapters:
    • General Principles
    • Rights and Interests of Medical Treatment and Rehabilitation
    • Rights and Interests of Education
    • Rights and Interests of Employment
    • Rights and Interests of Supported Services
    • Rights and Interests of Economic Security
    • Rights and Interests of Protective Services
    • Penal Provisions
    • Supplementary Provisions
quota system
Quota System
  • According to The Protection Act for Rights and Interests of Physically and Mentally Disabled Citizens
    • Public organizations with employees more than 34 must hire 3% of workers who have disabilities.
    • Private companies with employees more than 67 must hire 1% of workers who have disabilities.
laws regulation
Laws - Regulation
  • Under the guidance of the Protection Act, regulations had been draw up to provide VR services for people with disabilities, such as:
    • Regulations of Professionals Recruitment and Training of the Employment Institution for Individuals with Disabilities
    • Regulations of Professionals Recruitment and Training of the Vocational Training Institution for Individuals with Disabilities
    • Regulations of Employment Evaluation of Individuals with disabilities
    • Regulations of Allowance for the Assistance Equipment for the Employment of Individuals with Disabilities
    • Regulations of Management and Utilization of the Employment Fund for Individuals with Visual Impairments
    • Standards for the Establishment of Employment Service Institutions for Individuals with Disabilities
laws regulation108
Laws - Regulation
  • Standards for the Establishment of Employment Service Institutions forIndividuals with Disabilities
  • Rules of the Infrastructure of the Vocational Training Institutions and Allowances for Individuals with Disabilities
  • Regulations of Allowance for the Vocational Training for Individuals with Disabilities
  • Regulations of Establishment of Shelter Factories and Rewards for Individuals with Disabilities
  • Standards for the Arrangement of Infrastructure and Personnel of the Shelter Factory for Individuals with Disabilities
  • Regulations for Subsidizing and Awarding Employers for Hiring Unemployed Workers
  • Regulations of Loan Allowance for Business Creation of the Handicapped
official professional title
Official Professional Title
  • Based on the task performed, the professional titles can be:
    • Supervisor
    • Case Administrator/Manager (new)
    • Vocational Evaluator
    • Employment Service Staff
    • Vocational Training Counselor
roles and functions
Roles and Functions
  • Roles:
    • Case Manager
    • Evaluator
    • Job Developer
    • Counselor
    • VR Team Coordinator
  • Functions:
    • IWRP development
    • Vocational-related Assessment
    • Direct Employment Services
    • Counseling

(CHING-CHIANG CHEN )

services and resources112
Services and Resources
  • Vocational Rehabilitation Services
    • Job placement
    • Job training
    • Supported employment
    • Sheltered workshop
    • Vocational evaluation
    • Assistive technology and job accommodation
resources employment
Resources - Employment
  • Five national employment services centers
    • Job placement and administration supervision
  • Local counties and city employment services centers
    • Job placement and administration supervision
  • None profit organizations
    • Training
    • Job Placement
    • Supported Employment
    • Sheltered Workshop
resources vocational evaluation
Resources - Vocational Evaluation
  • Local vocational evaluation centers
    • Every county and city
    • Direct vocational evaluation
  • Three vocational evaluation resources centers
    • Research
    • Development of instruments
    • Supports for vocational evaluators
    • Training courses
individuals with disabilities served by employment services
Individuals with Disabilities Served by Employment Services
  • In 2006
    • Employment Centers: 33,000
    • Sheltered Workshop: 2,000
    • Supported Employment: 1,400
    • Vocational Training: 40,000
    • Vocational Evaluation: 1,600
profession and practice
Profession and Practice

Graduate Institute of RC, NKNU

professional disciplines117
Professional Disciplines
  • Before 2002
  • Not a specific academic discipline is intended to train professionals for vocational rehabilitation counseling services.
  • Employment service staffs and Vocational training counselor came from:
    • Untrained volunteers
    • Individuals with high school diplomas
    • College graduates from areas such as Social work, occupational therapy, psychology, special education, human resource, labor relations, etc.
training credential
Training Credential
  • Some training hours in advance or work experiences are required for those college graduates from other disciplines to work as vocational evaluators and case managers.
professional disciplines and academic credential
Professional Disciplines and Academic Credential
  • After 2003
  • the Department of Higher Education, Ministry of Education had funded three universities to establish master level graduate programs on rehabilitation counseling.
    • National Changhua University of Education (2003)
    • National Kaohsiung Normal University (2004)
    • National Taiwan Normal University (2004)
  • Graduates from these three programs will obtain a degree of master of science in RC.
professional association
Professional Association
  • In 2004, Taiwan Vocational Rehabilitation Association has been established by university professors and practitioners. The major missions are:
    • Publish the Taiwanese Journal of Rehabilitation Counseling (research articles)
    • Improve vocational rehabilitation services
    • Get funding and support for vocational rehabilitation counseling study from the government
    • Advocate for VR counseling Profession
best outcomes practice
Best Outcomes/Practice
  • Thought there is little evidence-based research to support for best practice of rehabilitation counseling in Taiwan, we have taken some efforts to make sure the people with disabilities will receive quality services.
    • There are regulations to define the qualifications for setting up institutes that provide VR services.
    • There are regulations to define the qualifications of professionals who can perform VR services.
    • There are plenty of on-the-job training opportunities for the VR professionals to better themselves.
    • There are annually or biannually program evaluations to oversee the quality and quantity of the VR services.
variables affecting the vr process
Variables Affecting the VR Process
  • Major variables could be:
    • Limited employment services resources in rural areas
    • Employers’ negative attitudes toward individuals with disabilities, particularly mental Illness
    • Lack in development of good work personality for individuals with disabilities
    • Family/societal values: protection vs. independent
    • Less trained employment service practitioners
welcome to taiwan
Welcome to Taiwan

The First Asian-Pacific Vocational Rehabilitation Conference

in Kaohsiung, Taiwan, November 2005.

slide125

Mahalo!

multumesc