Article Details

Research Database: Article Details

Citation:  Iwanaga, K., Chan, F., Tansey, T. N., Strauser, D., Ritter, E., Bishop, M., & Brooks, J. (2018). Working alliance and stages of change for employment: the intermediary role of autonomous motivation, outcome rxpectancy and vocational rehabilitation engagement. Journal of Occupational Rehabilitation,
Title:  Working alliance and stages of change for employment: the intermediary role of autonomous motivation, outcome rxpectancy and vocational rehabilitation engagement
Authors:  Iwanaga, K., Chan, F., Tansey, T. N., Strauser, D., Ritter, E., Bishop, M., & Brooks, J.
Year:  2018
Journal/Publication:  Journal of Occupational Rehabilitation
Publisher:  Springer Science+Business Media, LLC, part of Springer Nature
Full text: 
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported

Structured abstract:

Background:  The goals of rehabilitation are achievable when clients are involved in the development, implementation, and use of all rehabilitation services. Toward this end, the use of a working alliance encourages clients to take ownership of their counseling and rehabilitation. Creating bonds of attachment between each of the individuals in the rehabilitation program leads both clients and therapists are responsible for outcomes. Clients with a stronger working alliance had a better perception of employment possibilities. While research has suggested that working alliance leads to positive outcomes; however, the number and breadth of studies is limited. The question for this study is: is the relationship between the working alliance and SOC for employment mediated by autonomous motivation, outcome expectancy, and VR engagement?
Purpose:  To reveal the possible correlations between working alliance, autonomous motivation, VR engagement, and employment outcomes for clients and agency support personnel.
Study sample:  277 individuals with CID from state VR agencies in Alaska, Kentucky, Florida, Michigan, New Mexico, Texas, Utah, and Wisconsin. 43% were white, 41% Hispanic, 10% Black, 4% Native American/Alaska Native, 1% Asian. 61% were women and 24% were married or cohabitating. 21% were in the age group 15-24, 67% were 24-54 years and 10% were above 55.
Data collection and analysis:  Working alliance was measured by the Working Alliance Inventory analysis. Stages of change for employment was measured using the Stages of Change for Vocational Rehabilitation Scale (SOC-VRS) and the Rehabilitation Research Training Center on Evidence-Based Practice in Vocational Rehabilitation (RRTC-EBP VR). Further the study examined client autonomy and a means of accessing autonomous motivation. Using the Vocational Rehabilitation Internal Motivation Scale (VRIMS), researchers examined autonomy among clients in this study. Further, outcome expectancy was assessed using the Positive Outcome Expectancy Survey (PVES), and, finally, vocational rehabilitation engagement was measured using the Vocational Rehabilitation Engagement Scale (VRES).
Findings:  From the detailed analysis of this data set, the researchers found that working alliance was related to autonomous motivation and outcome expectancy as well as the SOC for employment. In particular, autonomous motivation and outcome expectancy were highly correlated along with VR engagement. Ultimately, working alliance supports higher levels of SOC employment. The data revealed that VR engagement, autonomous motivation, and vocational outcome expectancy all were correlated in the study. Clearly positive outcomes are determined to a great extent on client’s direct involvement in their own care. Having autonomy in the decision-making process is a strong determinate for positive employment outcomes. Further, and as importantly, working alliance is one of the common factors that support the success of both counseling and rehabilitation approaches as well as in seeing autonomous motivation lead directly to positive employment outcomes. Autonomous motivation is linked to outcome expectancy and is further linked to VR engagement. Finally, this study uncovered the fact that autonomous motivation is a primary driver in the relationship between counselors and clients, and, further, that combined with a working alliance model leads to better employment outcomes from clients.
Conclusions:  The importance of working alliance on outcomes as well as autonomous motivation on client engagement are key takeaways. Using this data, counselors and administrators can develop inventions to help other counselors and clients develop better working relationships. Too, developing a client’s autonomous motivation leads to a stronger client/counselor relationships and better employment outcomes.

Disabilities served:  Chronic mental illness
Chronic pain
Multiple disabilities
Populations served:  Persons with multiple disabilities (e.g., deaf-blindness, HIV/AIDS, substance abuse)
Interventions:  Career counseling
Rehabilitation counseling
Vocational assessment
Vocational rehabilitation
Outcomes:  Employment acquisition