Psychiatric rehabilitation training needs of state vocational rehabilitation counselors: a preliminary study

Journal of Rehabilitation, July-Sept, 2005 by Gloria K. Lee, Julie Chronister, Hector Tsang, Kirby Ingraham, Eugene Oulvey

Important knowledge domains within psychiatric rehabilitation that are considered important when working with this population is an understanding of financial benefits and psychopharmacology. Specifically, like many persons with severe disabilities, persons with severe and persistent mental illnesses are often reliant on SSI or SSDI benefits for their income. Unfortunately, the incentive to work while on these programs is not always clear, nor are the ramifications of working while receiving benefits typically known to recipients. As such, vocational counseling within psychiatric rehabilitation involves a solid understanding of the benefit programs and how work will affect payments. In addition, given the fundamental role of medication in the treatment of severe and persistent mental illnesses, knowledge of psychotropic medications, the symptoms to which these medications target, and an understanding of the vast array of potential side effects, is an important domain of knowledge to have when working with this population.

Conclusions and Implications

The present study suggest that VR counselors working in the state setting in this particular midwestern state are not well prepared to work with people with severe and persistent mental illnesses, as 16 out of 35 items (45.7%) were identified as important but poorly met training needs. The trend appears to be consistent with the results from prior studies (e.g., Chan et al., 2003). The present study finds two major areas to be particularly limited in training--case and caseload management in psychiatric rehabilitation, and principles and techniques of psychiatric rehabilitation. In addition, the remaining three training categories identified involved areas important to understanding the nature and treatment of mental illnesses including psychopathology, substance abuse, psychopharmacology, neuropsychological assessment, and types of therapies typically utilized when treating this population including cognitive-behavioral interventions and brief psychotherapy. Importantly, knowledge of state mental health services was identified as the most important training need item, indicating the need for a better understanding of, and collaboration with, state mental health services. Understanding the mental health system is critical for rehabilitation counselors working with persons with mental illnesses as state mental health services typically provide case management for this population and fund an array of ancillary support services necessary for stabilization. Moreover, the strength of the collaboration between VR and state mental health services can, without question, open up collaborative funding opportunities that are important for long-term vocational support, which can boost outcomes for this population.

These results suggest that state VR programs would need to provide more adequate in-service training in the area of psychiatric rehabilitation for their counselors--particularly those who carry caseloads of clients with severe and persistent mental illnesses. In addition, it is highly probable that traditional rehabilitation counseling training programs are not adequately preparing students in the areas identified in this study. As such, it is suggested that rehabilitation educators consider strengthening their curriculum to incorporate the training needs identified in the present study so as to adequately prepare students to meet the growing demands of a broader and more complex disability group, with particular emphasis on psychiatric disabilities. Given the well-established psychiatric rehabilitation model, it is strongly-suggested that the field of rehabilitation counseling draw on this model and practice area to meet these training needs.