Article Details

Research Database: Article Details

Citation:  Bolton, B. F., Bellini, J. L., & Brookings, J. B. (2000). Predicting client employment outcomes from personal history, functional limitations, and rehabilitation services. Rehabilitiation Counseling Bulletin, 44 (1), 10-21.
Title:  Predicting client employment outcomes from personal history, functional limitations, and rehabilitation services
Authors:  Bolton, B. F., Bellini, J. L., & Brookings, J. B.
Year:  2000
Journal/Publication:  Rehabilitiation Counseling Bulletin
Publisher:  Rehabilitiation Counseling Bulletin
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Yes
Research design:  Database mining

Structured abstract:

Background:  Since the 1950’s rehabilitation research has been try to find out which variables influence or predict successful employment outcomes for rehabilitation clients. The rationale behind such an investigation is that if we understand the determinants of successful outcomes, we can intervene to increase the likelihood of success for vocational rehabilitation (VR) clients. Consequently, research on the prediction of rehabilitation outcomes has been extensive, including examinations of numerous demographic, psychological, social, and service variables for a wide variety of client populations. The VR process consists of three service phases: (a) referral, (b) diagnostic evaluation and rehabilitation planning, and (c) service provision, all of which lead to some type of vocational outcome at case closure. Despite the fact that rehabilitation outcomes have been extensively researched, very few studies have attempted to assess the predictability of outcomes from variable sets that reflect the multiple phases of the VR service process while controlling for the effects of disability. Ideally, a comprehensive, quantitative investigation of rehabilitation outcomes should include, at minimum, the following data elements: (a) personal history information collected using the application for services form (referral phase), (b) diagnostic information summarized in a functional limitations profile (evaluation and planning phase), and (c) specific rehabilitation services provided to clients as stipulated in the rehabilitation plan. Despite efforts not one single investigation of the prediction of vocational outcomes has been reported in the rehabilitation literature that used data from all three phases of the VR process.This study was the first.
Purpose:  The purpose of the study was to quantify the major phases of the VR service process, using large samples of clients that enabled control for the influence of disability and statistical analysis of all variables simultaneously, thereby quantifying the VR service system. The research questions were: How much variance in employment outcomes can be explained by three sets of predictor variables that represent the three major phases of the VR service process? Which variables made the largest contributions to the explanation of employment outcomes? The study assessed vocational outcome at closure in two ways (a) Competitively employed clients were compared to clients who were not working, and (b) weekly salary was analyzed for the competitively employed clients.
Setting:  This study included individuals with disabilities served by the state of Arkansas' vocational rehabilitation agency in various settings.
Study sample:  The sample included 4,603 vocational rehabilitation (VR) clients who were closed as rehabilitated or not rehabilitated across five disability categories: orthopedic (N=1602), chronic medical (N=635), psychiatric (N=840), mental retardation (N=428), and learning disabilities (N=706), as well as clients with sensory disabilities, nervous disabilities, epilepsy, or other primary disabilities. Some of the descriptive statistics for the total sample and five primary disability groups are as follows. With the exception of chronic medical and pyschiatric labels, the majority of participants were male. The majority across disability groups were white. All five primary disability groups reported more than 90% of the participants had a severe disability.
Intervention:  The intervention was various vocational rehabilitation service types and intensity levels.
Control or comparison condition:  There was a comparison condition. The study compared outcomes across disability groups.
Data collection and analysis:  Four sets of variables: personal history, functional limitations, rehabilitation services and employment outcomes wre measured. The Scale of Social Disadvantage, was developed to predict competitive employment for VR clients from information collected on the applicaton form. THe FAI, a behaviorally anchored, counselor rated tool was used to measure a client's functional limitations and key environmental factors that are relevant to VR service planning. Three categories of rehabiliation service variables wre used. Two discrete services were job placement and personal adjustment training. Three aggregate service variables were vocational training, restoration, and maintenance. Two global measures of service intensity wre time in rehabilitation and total service costs. Various service variables were excluded from the analysis like counseling, diagnosis, support and transportation. Two criteria related to employment success, competitive employment versus not working. Weekly salary for competitive employment were used. Clients closed in other work statuses (ie. workshop, student, homemaker etc...) were excluded from the analysis. Hierarchical multiple regression analysis was used to assess predictive relationships between the variable representing the 3 phases of VR services and the two employment outcomes. The first set only included the SDD total score. The second set included the SSD score and six FAI factor scales. The third set consisted of the SDD score, the six FAI scales, and the seven rehabiliation service variables. The three sets of variables were used to predict the employment outcomes (competitive employment and weekly wages).
Findings:  The combination of personal history items in the Scale of Social Disadvantage predicted competitive employment and salary at closure. Job placement services was by far the greatest contributing factor to achieving competitive employment. The authors expected that Functional Assessment Inventory factors would also predict employment outcomes for VR clients. However, this investigation did not uphold this finding. There was a minimal relationship between functional limitations and employment outcomes.
Conclusions:  The study supported the following conclusions: 1) competitive employment is more predictable and thus more susceptible to improvement than salary at closure; 2) personal history information constitutes a quantitative basis for calculating an estimate of client case difficulty; 3) job placement services, the most important determiner of competitive employment, should receive greater emphasis in VR counselor education programs; and 4) functional limitations should continue to be evaluated by counselors in conjunction with the VR client diagnostic and service planning phase. The results should be used to improve counselor training and service delivery.

Disabilities served:  Developmental disabilities
Down syndrome
Learning disabilities
Medical impairment
Orthopedic impairments
Personality disorders
Spinal cord injury (SCI)
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Interventions:  Job search and placement assistance
Vocational rehabilitation
Outcomes:  Employment acquisition
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