Archived Information

# Empowering People with Disabilities Through Vocational Rehabilitation Counseling

John F. Kosciulek, Ph.D., CRC

Dr. Kosciulek is an Associate Professor and Coordinator of the M.A.
Program in Rehabilitation Counseling, Office of Rehabilitation and
Disability Studies, Department of Counseling, Educational Psychology,
and Special Education, 237 Erickson Hall, Michigan State University,
East Lansing, MI 48824. Telephone: 517-353-9443.
E-mail: jkosciul@msu.edu.

As a result of systemic "castification"1 processes and the rapidly
changing world of work, assisting people with disabilities with
obtaining and maintaining high-quality employment is an increasingly
difficult task. Vocational rehabilitation (VR) counseling thus can be
instrumental for enhancing the career success and quality of life of
consumers with disabilities. In this article, a framework that describes
how effective VR counseling promotes the empowerment of consumers with
disabilities is presented. Following a description of the primary model
constructs of working alliance, informed choice, self-determination, and
empowerment, the implications of the framework for VR counselor training
and practice are discussed.

The world of work is changing at a rapid pace, and the changes are
likely to accelerate during the 21st century. Employment arrangements
such as temporary employment, short-term hires, contractual positions,
leased workers, and on-call and part-time workers have and will continue
to influence the career development of all workers (Institute on
Rehabilitation Issues, 1999). These changes are having a substantial
impact on the life roles of individuals with disabilities, the settings
in which they live and work and the events that occur in their lives. At
the same time, current disability policy in the United States focuses on
the inclusion, independence and empowerment of people with disabilities
(Kosciulek, 2000). Thus, vocational rehabilitation (VR) counseling with
people with disabilities must be a dynamic, creative and highly
individualized process. Effective VR counseling can be instrumental for
empowering the life choices, inclusion and independence of people with
disabilities. In turn, empowerment, inclusion and independence will lead
to high-quality employment and fulfilling careers for individuals with
disabilities (O'Day, 1999).

Employment and Career Challenges Encountered by People With Disabilities

The ever-changing nature of work presents new problems for people with
disabilities in finding and maintaining suitable employment. Major
trends such as globalization of the American economy, technology and
population shifts are changing the nature of work and worker skill
requirements (Ryan, 1995). Despite rehabilitation efforts, a majority of
Americans with disabilities between the ages of 16 and 64 are not
employed and that disparity has not changed since 1986, despite the fact
that a majority of non-employed people with disabilities in the working
age population want to work (National Organization on Disability, 2000).
In general, the vocational adjustment of people with disabilities has
been characterized by limited salable work skills, low income,
underemployment and unemployment (Bruyere et al., 2002; Curnow, 1989).

In addition, according to Harrington (1997), high school students with
disabilities frequently leave school without marketable skills or the
ability to function independently. Given that work is a central force in
people's lives, dramatically high rates of unemployment and
underemployment can adversely affect not only the economic and social
status of individuals with disabilities, but also their self-image. A
distinct set of employment and career challenges encountered by many
people with disabilities that can be used as a reference point for VR
counselors includes:

• limitations in early life experiences,

• career decision-making difficulties, and

• a negative worker self-concept (Kosciulek, 2003).

Limitations in Early Experiences. Frequently, people with disabilities
arrive at adulthood with few career options (Chubon, 1995). Limited
early vocational and social experiences encountered by people with
disabilities restrict the array of career options they perceive, impede
decision-making ability and impair future vocational development. The
effect of limited early vocational experiences has been described by
Holland (1985) as a precursor to the development of career-related
problems. Such problems may include failing to develop a consistent and
differentiated personality pattern and a clear vocational identity and
trying to make a career of a job that does not match their abilities or
experiences (Holland, 1985). Unfortunately, such developmental patterns
are not unusual among people with disabilities.

Decision-Making Ability. Lack of opportunities to participate in
decision making, to form a perception of oneself as a worker and to test
self-competencies can be the outcome of limited early experiences and
can impede career development. The poorly defined self-concept,
ambivalence about obtaining work and limited occupational information
reported by people with disabilities is indicative of distortions that
could result in unrealistic vocational aspirations or decisions.
Harrington (1997) and Parent (1993) have aptly described how many
individuals with disabilities have had little opportunity for successful
experience in decision making and, therefore, lack competence in making
decisions.

Negative Worker Self-Concept Resulting from Castification Processes.
Lack of experience and difficulty in decision making are not solely the
result of disability, but also an outcome of social attitudes and
stereotypes. Social attitudes toward disability may be as important as
the disability itself in that the negative attitude of others plays a
part in shaping the life role of the individual with disability (Fitch,
2002). The outcome of this long-term exposure to prejudicial attitudes
may result in a negative self-appraisal and a negative worker
self-concept.

Society generally holds diminished expectations for people with
disabilities (Schroeder, 1995). These attitudes are pervasive; they
influence all of us to some degree. As a class, people with disabilities
have suffered discrimination. Individuals with disabilities face common
social problems of stigma, marginality and discrimination, similar to
those faced by members of racial and ethnic minority groups (Fine &
Asch, 1988). Further, given that disability rates among racial and
ethnic minority group members are proportionally higher than rates in
the U.S. population overall, many individuals with disabilities face
double jeopardy (Trueba, 1993).

Szymanski and Trueba (1994) maintained that at least some of the
difficulties faced by people with disabilities are not the result of
functional impairments related to the disability, but rather are the
result of castification processes embedded in societal institutions for
rehabilitation and education and enforced by well-meaning professionals.
Castification processes have their roots in a determinist view in which
people who are different are viewed as somehow less "human" or less
capable (Trueba, Cheng & Ima, 1993). Problems of castification plague
services to people with disabilities because the same categories of
impairment and functional limitation (constructed mostly by people
without disabilities) are used to determine eligibility for services, to
prescribe interventions and, on occasion, to explain failure. The
constructs and those who use them become agents of castification.

The disempowering nature of these classification systems is often all
too apparent to people with disabilities applying for rehabilitation
services in an effort to enhance self-sufficiency and personal
independence (Scotch, 2000). Rather than being treated as adults with
free or equal status, they may be confronted by persons asserting a
right to determine what kinds of services they need. Thus, it is
critically important that VR counselors reject paternalistic
castification processes and actively work to foster empowerment among
consumers with disabilities during the VR process (Kosciulek, 2003). To
accomplish this important task, we need conceptual frameworks useful for
understanding and guiding empowering VR counseling approaches.

Figure 1.

Vocational Rehabilitation Counseling Empowerment Framework

> Vocational Rehabilitation Counselor
>
> *and*
>
> Vocational Rehabilitation Consumer
>
> *which combine to*
>
> Counselor-Consumer Working Alliance
>
> *which leads to*
>
> Consumer Informed Choice
>
> *and*
>
> Consumer Self-Determination
>
> *which combine to*
>
> Consumer Empowerment

In this section, a framework that describes how VR counseling engenders
the empowerment of consumers with disabilities is presented. The key
constructs in this model include the VR counselor-consumer working
alliance, informed choice, self-determination and empowerment. Figure 1,
a visual depiction of the empowering VR counseling framework,
illustrates the following conceptualization:

A consumer with a disability enters the state-federal VR system. The
level and quality of the working alliance formed between the VR
counselor and consumer determines the level and quality of consumer
informed choice and self-determination during the VR process. Together,
informed choice and self-determination influence the level and quality
of consumer empowerment resulting from the VR process.

In this model, it is hypothesized that the development of an effective
counselor-consumer working alliance is a prerequisite for facilitating
consumer informed choice and self-determination during the VR process.
Further, the framework posits that proficient informed choice and
self-determination are necessary for increasing consumer empowerment. In
order to enhance reader understanding and application of the VR
counseling empowerment framework, each of the model constructs is
defined and described in detail below.

Counselor-Client Working Alliance. The central factor in all successful
counseling processes, including VR counseling, is an effective working
alliance. Researchers estimate that as much as 30 percent of the
variance in counseling outcome can be attributed to the counselor-client
working alliance (Lambert, 1992). As one of the essential components for
success in counseling, an effective working alliance is represented by a
positive collaboration between a consumer and a counselor (Kosciulek,
Chan, Lustig, Strauser & Pichette, 2001). The working alliance is
comprised of the following components: tasks, bonds and goals (Horvath,
1994).

Tasks are those in-counseling behaviors and cognitions that form the
substance of the counseling process.

Goals are the outcomes or target of the counseling process. In VR
counseling, the goal aspect of the working alliance is clear and
specific: the attainment of an employment outcome.

Bonds are the positive interpersonal attachments between a consumer and
counselor that include such aspects as mutual trust, acceptance and
confidence.

Consistent with the working alliance concept, counseling in VR is the
collaborative process between the individual consumer and counselor in
which they assess the individual's strengths, resources, priorities,
abilities, capabilities, interests and rehabilitation needs. In this
process, the counselor and consumer also explore, clarify and assess
employment and career options, address barriers to be overcome, and
develop and carry out a plan of action that will result in meaningful
employment for the individual based on his or her informed choice. In
discussing the working alliance in the VR process, Lustig, Strauser,
Rice and Rucker (2002) noted that the two most significant factors in
this realm are the quality of the consumer's participation and the
degree to which the consumer is motivated, engaged and joined in the VR
process. Consumers with disabilities who are engaged and connected with
counselors will benefit most from VR counseling (Chan, Shaw, McMahon,
Koch & Strauser, 1997).

The working alliance can be most beneficial and an excellent predictor
of outcome for consumers with disabilities when:

• counselors and consumers agree on goals and preferred outcomes,

• counselors collaborate with consumers on tasks to accomplish those
goals and preferred outcomes (Lustig et al., 2002), and

• consumers have a favorable view of the counselor-consumer relationship
(Bertolino & O'Hanlon, 2002).

An empowerment approach to forming an effective VR counselor-consumer
working alliance includes elements that both consumers and counselors
bring to the relationship. Primary elements for consumers include taking
responsibility for their own decision making and for their own actions
and consequences of their actions. Key elements for counselors include
the following: knowing and admitting their limitations (e.g., lack of
knowledge of a specific disability condition) and displaying
unconditional positive regard for the consumers they serve (National
Institute on Disability and Rehabilitation Research \[NIDRR\], 1994).

Specific counseling techniques that contribute to the development of an
effective working alliance and consumer empowerment include the
following:

• treating all consumers as adults regardless of the severity of the
disability,

• using age-appropriate language and techniques,

• placing emphasis on consumer strengths, and

• respecting consumer values and beliefs.

Consumer Informed Choice. As employment is a key to independence and
improved quality of life for people with disabilities, choice in the
selection of employment goals and rehabilitation services necessary to
meet those goals is a critical element for empowering persons with
disabilities (Kosciulek, 2000). In the VR counseling empowerment
framework it is hypothesized that an effective counselor-consumer
working alliance leads to productive informed choice in the VR process.
Consumer choice in vocational goals and services emerged as an important
component of VR in the 1990s. However, choice is not a new concept in
the field. Over 40 years ago, Levine (1959) described the partnership
between the consumer and counselor and the counselor\'s role in
assisting the individual in making choices and decisions. During this
same time period, Patterson (1960) encouraged counselors to facilitate
independence by helping consumers \"go through the process\" of deciding
what they should have and should do. He noted, \"The counselor can have
no stereotypes of occupational choices\" (p. 115). Both of these
examples focus on vocational choice and, although they go back more than
40 years, they are consistent with current principles related to
enhancing the counselor-consumer partnership, facilitating empowerment
and fostering choice and independence in the rehabilitation process.

The philosophy behind informed choice is that people with disabilities
should have control over the processes and services that affect their
lives, and that those who have control over their own VR planning will
experience better employment outcomes than those who do not. Informed
choice is practiced when VR counselors give consumers with disabilities

• the tools to learn how to make choices, and

• the information they need to make their own choices.

Informed choice is the process by which individuals participating in VR
programs make decisions about their assessment services, vocational
goals, the services and the service providers that are necessary to
reach those goals and how those services will be procured. The informed
choice process begins with the individual's values, interests and
characteristics and proceeds to an evaluation of availability of
resources and alternatives, including the labor market. Implementing
informed choice requires that the VR counselor listens carefully,
communicates clearly and gathers and analyzes information without bias.
The VR counselor works with the consumer to make choices and to evaluate
their impact. Finally, in an informed-choice model of VR, the counselor
supports the individual in setting goals, making plans and following
through with decisions, with the aim of achieving meaningful employment.

It is presumed that a consumer's skills and abilities to exercise
informed choice can be developed through use of self-assessment
techniques, training and experience in goal setting and decision making,
and consumer education. In this manner, skills in exercising informed
choice could grow in a parallel fashion along with growth of specific
vocational and employment skills, enabling the individual to continue
making important, informed life decisions following the completion of VR
services. The application of the concept of consumer informed choice in
the context of VR services involves a conscious process of choice making
with the following typical elements:

• analyzing needs,

• gathering information,

• evaluating the information,

• describing options,

• selecting from among the options and making a choice,

• accepting the risk of failure,

• assuming responsibility for the outcome of the choice, and

• evaluating the results of choice making and using the information in
future choice-making experiences.

Consumer Self-Determination. In addition to facilitating informed choice
in the VR process, an effective VR counselor-consumer working alliance
will enable the development of consumer self-determination skills.
Self-determination, a concept and process that has emerged from the
fields of rehabilitation counseling, special education and disability
studies, provides the basis for an empowerment approach to VR
counseling. Field, Hoffman and Spezia (1998) have defined
self-determination as a multidimensional concept that includes:

• attitudes, abilities and skills that lead people with disabilities to
define goals for themselves and to take the initiative to reach these
goals,

• the capacity to choose and to have those choices be the determinants
of one's actions,

• determination of one's own fate or course of action without
compulsion, and

• the ability to define and achieve goals based on a foundation of
knowing and valuing oneself.

Promoting self-determination should be a primary effort of VR counselors
working with consumers with disabilities. Self-determination can be
enhanced by helping consumers develop greater self-awareness and by
teaching decision making, goal-setting and negotiation skills, which
will enable them to exercise greater control during the VR counseling
process (Kosciulek, Bruyere & Rosenthal, 2002). The steps in the
self-determination development process for consumers include consumers
knowing and valuing themselves, consumer planning, consumer action,
experiencing outcomes and learning, and making adjustments. Consumer
self-knowledge can be facilitated by encouraging individuals to expand
their thinking about the possibilities in their life, deciding what is
truly important to them, having a keen sense of their strengths,
limitations and preferences and knowing what options are available. VR
counselors can promote consumer self-valuing by assisting consumers with
accepting themselves as they are, admiring their strengths that come
from uniqueness, and recognizing and respecting their rights and
responsibilities.

The next step in the consumer self-determination process is the
development of effective planning skills. Effective planning involves a
process of setting goals, identifying action steps to meet goals,
anticipating results and visually and orally rehearsing potentially
stressful events such as job interviews. In addition to planning, VR
counselors can facilitate consumer self-determination by encouraging
individuals to act. Consumer self-determined action may include dealing
directly with conflict and criticism (e.g., with a family member or
coworker) and accessing resources and supports such as assistive
technology devices and recreation and leisure services.

As a result of planning and acting, consumers with disabilities will
have the opportunity to experience positive outcomes and to learn more
about themselves. VR counseling that promotes self-determination can
enable individuals to compare performance and outcomes to their
expectations and realize successes. In the final step toward enhancing
consumer self-determination, VR counselors can assist individuals with
disabilities to adjust their self-perception and expectations with
regard to future planning and actions.

Consumer Empowerment. As illustrated in the VR counseling empowerment
framework (Figure 1), informed choice and self-determination influence
the level and quality of consumer empowerment resulting from the VR
process. Emener (1991) described the philosophical tenets necessary for
an empowerment approach to rehabilitation. These tenets provide a useful
foundation for the provision of VR counseling services to people with
disabilities. The four tenets are paraphrased as follows:

• Each individual is of great worth and dignity.

• Every person should have equal opportunity to maximize his or her
potential and is deserving of societal help in attempting to do so.

• Most people strive to grow and change in positive directions.

• Individuals should be free to make their own decisions about the
management of their lives.

Definition of empowerment. Empowerment is the process by which people
who have been rendered powerless or marginalized develop the skills to
take control of their lives and their environment (Lee, 1997). As such,
in order to begin to improve rehabilitation services and outcomes,
empowerment has become the operative term in disability policy
development and rehabilitation service delivery. The field of
rehabilitation continues to place an increasing emphasis on the
construct of empowerment as a conceptual cornerstone of identity (Banja,
1990; Zimmerman & Warschausky, 1998) and critical variable in
rehabilitation research (National Institute on Disability and
Rehabilitation Research \[NIDRR\], 1991).

Empowerment is conceptualized as involving both internal or
psychological aspects and situational or social aspects. Internal or
psychological factors include a sense of control, competence,
confidence, responsibility, participation, solidarity and community.
Additional psychological aspects of empowerment include flexibility,
initiative and future orientation (Stein, 1997). In this manner, the
psychological facet of empowerment entails the acquisition of values and
attitudes that are incorporated into the individual's worldview and
constitute a foundation for action (Bolton & Brookings, 1996).

Situational or social aspects of empowerment include control over
resources; interpersonal, work and organizational skills;
decision-making powers; self-sufficiency; mobility; and "savvy" or an
ability to "get around" in society (Stein, 1997). Additional situational
factors include improved living conditions, increased social status,
financial and social support, autonomy, access to information and
income. The situational aspects of empowerment are concerned with the
interdependence between people's behaviors and their environment. These
situational or social factors also suggest that the lack of social,
economic, or political resources in the environment is a major
contributor to human dysfunction (Rappaport, 1987). Thus, it is argued
here that when people with disabilities have control over important
resources, they are better able to determine the course of their lives,
solve their problems and develop adaptive social networks.

Empowering VR counseling. Empowerment of individuals with disabilities
means that they have the same degree of control over their lives and the
conditions that affect them as is generally possessed by people without
disabilities (Harp, 1994). It entails the transfer of power and control
over their lives from external entities, such as VR counselors, to the
individuals themselves (Bolton & Brookings, 1996). Thus, as hypothesized
and tested by Kosciulek and Merz (2001), the VR counselor committed to
an empowerment approach to service delivery should facilitate and
maximize opportunities for individuals with disabilities to have control
and authority over their own lives.

From an empowerment perspective, VR counseling is not something that can
be done to or for a consumer. Rather, it is a process in which consumers
must become active, informed participants who learn and control a
planning process that they use for short- and long-term career
development (Szymanski, Hershenson, Enright & Ettinger, 1996). In
addition, the lifelong, developmental nature of the process means
"unless we plan to work with an increasingly dependent consumer again
and again across the decades, our professional responsibility is to
assure that each person learns the \[career planning\] process" (Mastie,
1994, p. 37).

Active consumer involvement is the key element of successful VR
counseling interventions (Ettinger, Conyers, Merz & Koch, 1995). In an
empowerment approach to VR counseling, consumers are actively involved
in:

• gathering information, including self-assessment, and learning about
occupations and the labor market;

• generating alternative courses of action and weighing those
alternatives; and

• formulating a plan of action.

Implications for Vocational Rehabilitation Counselor Training and
Practice

The VR counseling empowerment framework suggests three important
implications for VR counselor training and practice.

First, in both pre-service counselor education and in-service counselor
training programs, curricula must focus on the development of effective
vocational counseling techniques. In this manner, new and practicing VR
counselors will possess the tools necessary for developing effective
working alliances with consumers with disabilities.

Second, both new and experienced VR counselors must be knowledgeable of
the state-federal VR system informed choice mandates. Further,
counselors must be fully informed regarding those models demonstrated to
be useful for enhancing informed consumer choice in the VR process. The
informed-choice/best-practice methods described in the Choice
Demonstrations Projects Operations Manual (InfoUse, 1999) may be helpful
in this regard.

Third, in accordance with the VR counseling empowerment framework, the
development of consumer self-determination skills must be a goal of the
VR counseling process. As such, VR counselor training programs of all
types should direct resources toward increasing counselor knowledge and
skill in the area of consumer self-determination. As described earlier
in the discussion of Consumer Self-Determination, Field et al. (1998)
provided a valuable guide that outlines the steps in the
self-determination development process.

Conclusion

Due to the ever-changing nature of the world of work and service-system
castification processes, assisting people with disabilities to achieve
positive, meaningful and stimulating career development can be a
challenging task. Effective VR counseling can be instrumental for
enhancing the career success and quality of life of consumers with
disabilities. Full implementation of the VR counseling empowerment
framework presented in this article will enable consumers with
disabilities to become active, informed participants who learn and
control a planning process that they use for both short- and long-term
career development. In this manner, VR counseling will promote the
empowerment of individuals with disabilities.

Note

1\. Castification is fundamentally an institutionalized way of
exploiting one social group (ethnic, racial, low-income or other
minority group), thus reducing this group to the status of a lower caste
that cannot enjoy the same rights and obligations possessed by the other
groups (Trueba, 1993, p. 30).

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