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American Rehabilitation Counseling Association ARCA 50th Educational Conference

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Title: American Rehabilitation Counseling Association ARCA 50th Educational Conference


1
American Rehabilitation Counseling Association
(ARCA) 50th Educational Conference
  • Tampa, Florida U.S.A.
  • November 2007

2
  • 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

3
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

4
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

5
International Panel
  • Jun Yaeda, Rh.D.
  • University of Tsukuba, Japan
  • Dal Yob Lee, Ph.D.
  • Taegu University, Korea

6
Rehabilitation Counselling in Australia
7
Voc Rehab Counselling Services
  • Vocational rehabilitation counselling services
    are provided in several systems
  • Social security - Federal
  • Workers compensation - State
  • Motor accident State

8
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

9
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

10
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

11
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

12
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

13
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

14
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

15
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

16
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

17
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

18
  • THANKS!

19
Responses in context of Canada Rehabilitation
Counselling
  • Hal. M. Cain, Ph.D., CRC
  • Queens University
  • Kingston, ON
  • Rehabilitation Counselling Association of Canada

20
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

21
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)

22
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 masters 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.

23
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

24
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.

25
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/evaluati
    ons, manage cases, provide counselling, provide
    expert testimony, conduct research, etc.

26
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.

27
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

28
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.

29
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

30
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.

31
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.

32
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

33
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).

34
Rehabilitation and Disability in China
  • Li Jian Jun, MD
  • Qiu Zhuoying, Ph.D.
  • Shi HongMei, M.S.
  • China Rehabilitation Research Center
  • Beijing, China 100068

35
Rehabilitation for People with Disabilities in
China Approaches and Development
Background Information on China
  • History
  • China is the one of the worlds 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.

36
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.

37
Rehabilitation for People with Disabilities in
China Approaches and Development
Statistics of Disability and Birth Defects
Disability statistics 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.

38
Composition of Disability
Rehabilitation for People with Disabilities in
China Approaches and Development
39
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

40
Rehabilitation and Disability System
Rehabilitation for People with Disabilities in
China Approaches and Development
  • 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

41
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

42
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)

43
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

44
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.

45
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.

46
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)
47
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 1991-1995rehabilitation
  • Hearing and speech training for deaf children,
    surgery and rehabilitation for children and youth
    with polio and cataract
  • National Work Programme 1996-2000rehabilitation
    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.

48
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)

49
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

50
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

51
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

52
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

53
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.

54
  • THANK YOU

55
  • Rehabilitation Counseling in Japan

56
  • 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".

57
  • 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.

58
  • To support this type of rehabilitation services
  • Law for Employment Promotion, etc. of the
    Disabled
  •  

59
  • 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.

60
  • 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.

61
  • 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.

62
  • 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.

63
  • Family involvement, community participation, and
    professional qualification are important
    variables contribute to the rehabilitation
    success in Japan.

64
(No Transcript)
65
Vocational Rehabilitation Association / United
Kingdom Gail Kovacs Vice Chair
  • Working Together to Get People Working

66
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

67
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

68
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

69
Professional Disciplines?
  • Psychologists (clinical and occupational)
  • Cognitive Behaviour Therapists
  • Ergonomists
  • Social Workers
  • Employee Assistance Counsellors
  • Unregulated Health Practitioners
  • Occupational Health Physicians / Nurses
  • Other Nurses
  • VR Counsellors
  • Occupational Therapists
  • Physical Therapists
  • Psychiatrists

70
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

71
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

72
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

73
Training Requirements?
  • Medical and Healthcare - As Regulated Health
    Practitioners
  • Work preparation - Nil
  • Placement /brokerage - Nil
  • Workplace access - Nil
  • Workplace integration retention - Nil

74
Academic Credential?
  • Medical and Healthcare - As Regulated Health
    Practitioners
  • Work preparation - Nil
  • Placement /brokerage - Nil
  • Workplace access - Nil
  • Workplace integration retention - Nil

75
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

76
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.

77
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.

78
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

79
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

80
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

81
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

82
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

83
Scope of Practice
  • Interventions to remove environmental,
    employment, and attitudinal obstacles
  • Consultation services among multiple parties and
    regulatory systems

84
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.

85
Recent Achievements
  • The definition
  • The Scope of Practice
  • The Standards of Practice
  • The FAQ

86
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

87
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

88
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

89
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

90
The Challenges for Service Provision
  • Gaining acceptance of standardised assessments
  • Gaining acceptance of customised services time
    and cost factors

91
Best Outcomes / Practices
  • Job retention (prevention and safety)
  • Condition management programmes
  • Work entry and sustainability
  • Workplace wellbeing / health promotion

92
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

93
Similarities with the U.S.
  • History and evolution of VR
  • Case Management model
  • Various functions
  • Various work environments
  • ?????

94
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

95
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

96
Thank You gail.kovacs_at_btinternet.com www.voca
tionalrehabilitationassociation.org.uk
97
Vocational Rehabilitation Counseling in Taiwan
  • Presenters
  • Ming-Hung Wang, Ph.D., CRC
  • Ming-Yi Wu, Ph.D., OTR/L

98
Topics
  • Population Served by the System
  • Laws
  • Services and Resources
  • Profession and Practices
  • Challenges

99
Population Served by the System
100
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 (1565 y/o) disability population
    0.6 millions (60)
  • PWD Employment rate 27

101
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.

102
Laws
103
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.

104
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.

105
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

106
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.

107
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

108
Laws - Regulation
  • Standards for the Establishment of Employment
    Service Institutions for Individuals 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

109
Services and Resources
110
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

111
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 )
112
Services and Resources
  • Vocational Rehabilitation Services
  • Job placement
  • Job training
  • Supported employment
  • Sheltered workshop
  • Vocational evaluation
  • Assistive technology and job accommodation

113
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

114
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

115
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

116
Profession and Practice
Graduate Institute of RC, NKNU
117
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.

118
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.

119
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.

120
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

121
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.

122
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

123
Challenges
124
Welcome to Taiwan
The First Asian-Pacific Vocational Rehabilitation
Conference in Kaohsiung, Taiwan, November 2005.
125

Mahalo!
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