Who Gets to Choose: A Primer for Increasing Rehabilitation Counselors' Awareness for Navigating “Paternalistic” Interventions

Abstract

Information aimed at increasing rehabilitation counselors' awareness of personal values influencing paternalistic interventions is presented. The potential compromise of rehabilitation consumers' autonomy is the chief reference point for understanding the impact of rehabilitation counselors' paternalistic interventions. Strategies for recognizing the influence of personal value systems are presented with the intention of optimizing positive paternalistic interventions.

Putting Advocacy Back Into Rehabilitation: A Discourse on Needs Identified in the Field

“…One large caveat to all this intended progress is that clearly many of these policies were developed without input from, or understanding of, people with disabilities and vocational rehabilitation processes. As explained by Keferl et al (2004), these forms of legislation can be labeled as paternalistic, despite the fact that they attempt to rectify the inequalities encountered by the disability community. Without having a voice at the table, it compromises autonomy by prescribing policy that is believed to be in the best interest of a constituency without input.…”

“…CDTE is an excellent example of a scholar utilizing their platform and skills for advocacy work, within the academic space that ultimately prepares students as rehabilitation counselors. However, these efforts are restrained by the structural nature of vocational rehabilitation, which has paternalistic tendencies because of the power dynamic that inherently exists between the counselor and client (Keferl et al, 2004). Moreover, rehabilitation counselors increasingly indicate they are overworked, and are experiencing such levels of occupational stress that they consider leaving their positions (Tabaj et al, 2015).…”

Consumers With Major Depressive Disorder: Factors Influencing Job Placement

“…Within the rehabilitation services literature, TPB-based research addresses employer's ATs toward hiring persons with disabilities (Fraser, Ajzen, Johnson, Hebert, & Chan, 2011), job-seeking behavior (Hooft, van Born, Taris, & Flier, 2006), adults with intellectual disabilities and physical activity (Martin, McKenzie, Newman, Bowden, & Morris, 2011), job placement of consumers with HIV/AIDS (Hergenrather & Rhodes, 2008;Hergenrather, Rhodes, & McDaniel, 2005), job placement of consumers with substance abuse ( Hergenrather & Rhodes, 2006), job placement of consumers with bipolar disorder ( Hergenrather, Rhodes, & Gitlin, 2011), job placement of consumers with MDD ( Hergenrather et al, 2013;Hergenrather & Rhodes, 2004), AT toward prosthetic use (Callaghan, Johnston, & Condie, 2004), physical activity among persons with chronic disease (Eng & Martin-Ginis, 2007), support for persons with intellectual disabilities (Rimmerman & Chen, 2012), and mobility impede the autonomy of the consumer. However, the concept that rehabilitation counselors may unknowingly contribute to negative consumer outcomes because of their ATs toward disabilities, transferring their values to their consumers, is critical to understand and has not been fully explored in the rehabilitation research (Keferl, La Forge, & Toriello, 2004;Kersten, 2002;Wong et al, 2004).…”

“…The intentions of rehabilitation counselors influence the power differential between the counselor and the consumer, resulting in positive or negative ATs influencing consumer employment outcomes (C. Chan, Lee, Yuen, & Chan, 2002;Livneh & Antonak, 1994;Keferl et al, 2004;Wang, Thomas, Chan, & Cheing, 2003). Through the exploration of public rehabilitation placement, professionals' intentions and ATs toward placement, employment outcomes for consumers with MDD may be enhanced.…”