This study investigated the relationship between cognitive, psychological and physical symptoms of multiple sclerosis (MS) and independent living optimism among a sample of 5,082 adults with MS (females = 77.8%; Whites = 96.1%, age range 20 to 91 years). Data on physical, cognitive and psychological function were collected utilising standardised clinical measures including the Multiple Sclerosis Impact Scale-29, Perceived Deficits Questionnaire-5-Item version, and the Independent Living Optimism scale. Multiple regression analysis indicated that specific physical, psychological and cognitive factors contributed to the overall prediction model. The combined variables explained approximately 33% of the variance in independent living optimism. This study enables a specific, item-level understanding of the relationship between MS-related symptoms and independent living optimism, and provides important information for the development of targeted rehabilitation interventions.

Despite the high prevalence of withdrawal from employment gained post-traumatic spinal cord injury (tSCI), relatively few studies have examined the factors that precipitate job withdrawal. Within the context of general systems theory, the aim of the present study was to identify and classify the factors that led to job withdrawal post-tSCI. Using purposive sampling and a structured proforma, 30 participants completed an in-depth telephone interview. Job withdrawal was precipitated more frequently by micro-system (person-centred) factors or meso-system (job-related) factors than macro-system (socio-economic) factors. Micro-system factors fell into five groups (SCI-related, psychological/psychosocial, mobility, general health and knowledge/skills/abilities) as did meso-system factors (job design, psychosocial climate, ergonomics, human resources and work cycles). Two groups of macro-system factors were identified (proximal and distal). Classifying job withdrawal factors within the context of general systems theory provides an integrated framework for intervention development and furnishes decision-makers with guidance as to whether a top-down or bottom-up approach would be more feasible/beneficial to address preventable job withdrawal post-tSCI.

This study examined the quality of life of compensable accident victims. The sample comprised 254 participants who completed the World Health Organization's EUROHIS Quality of Life scale as part of a vocational assessment. As hypothesised, there was substantially lower quality of life with a mean rating of 2.70 (SD = 0.74) on a five-point scale from very dissatisfied to very satisfied. There were statistically significant differences in quality of life, favouring those living in a rural vs city location, those living in areas of low unemployment and those with higher skill levels. Those who had a non-work accident had higher levels of quality of life as did those without a spinal cord injury or psychiatric sequelae. Participants who returned to work had the highest level of quality of life. The time since the personal injury averaged 3.58 years (SD = 3.61) and quality of life was not correlated positively with the effluxion of time (r = 0.057). A tentative process model of quality of life was proposed based on the significant factors from this study and divided the factors into three stages based on their occurrence across time as early, intermediate or late in relation to the injury.

This study investigated pain coping profiles using the Coping Strategies Questionnaire-24 (CSQ-24) in a sample of 171 workers’ compensation clients with chronic musculoskeletal pain from Canada. Cluster analysis identified three distinct coping profiles: mixed coping, catastrophising, and positive coping. Multivariate analysis of variance (MANOVA) results revealed that the positive coping group had lower levels of activity interference and depression as well as higher levels of quality of life than the mixed coping and catastrophising groups. Study findings indicate clients with chronic musculoskeletal pain can be categorised according to pain coping strategies, and pain coping strategies used are related to rehabilitation outcomes. The implications of these pain coping profiles for rehabilitation counselling practice are discussed.

People diagnosed with psychotic illness continue to be underrepresented in the workforce despite the widespread provision of vocational rehabilitation services for people experiencing mental illness. A systematic literature review was undertaken using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify psychological predictors of successful return to work for this population. The databases searched were PsycARTICLES, PsycINFO, PubMed, ProQuest, Cumulative Index of Nursing and Allied Health (CINAHL), and Taylor & Francis Online. A total of 4,076 articles were located and of these, 29 articles were analysed as part of this review. The data extracted was synthesised using a narrative approach. A number of psychological factors were identified which are predictive of successful return to work. These factors include but are not limited to identity, self-management of illness, social cognition, hope and self-esteem and motivation. On the basis of the reviewed literature, practice guidelines are proposed which support the psychological processes identified as pivotal to vocational success for people diagnosed with psychotic illness.

Background: Self-determination theory (SDT) has increasingly been used as a theoretical framework for evaluating key elements of the recovery paradigm in rehabilitation and mental health services research and policy-making for people living with severe mental illnesses. Purpose: The purpose of this study was to validate the Behavioral Regulation in Work Questionnaire (BRWQ), an adaptation of the Behavioral Regulation in Exercise Questionnaire-2, as a measure of self-determined work motivation for use in psychiatric rehabilitation settings. Methods: One hundred and twenty-four individuals with severe mental illness were recruited from eight Clubhouse programmes in Hawaii. Factorial validity of the BRWQ was evaluated using exploratory factor analysis. Findings: Principal components analysis of the BRWQ yielded four factors (amotivation, external regulation, introjection and autonomous motivation). The autonomous motivation factor was found to be significantly related to other SDT constructs, including competency, relatedness, outcome expectancy and vocational rehabilitation engagement. Conclusions: The BRWQ is a psychometrically sound SDT measure for assessing self-determined work motivation and could contribute to the use of self-determination as a paradigm for improving recovery and employment outcomes of people with severe mental illness in rehabilitation settings.

Post-injury return to work (RTW) is an important rehabilitation outcome regardless of injury type. With Spinal Cord Injury (SCI), the odds of successful RTW are lower than for the general population of work-injured. Australians living with a SCI have a higher RTW rate than many other developed countries, including the United States. Important influences on relatively higher post-injury RTW rates in the Australian context include its universal disability care policy, Australia's suite of no-fault accident insurance systems that allow for multi-faceted rehabilitation services to be provided to eligible individuals in addition to appropriate rewards for rehabilitation service providers. A combination of these systemic factors is important when delivering comprehensive rehabilitation services to those with catastrophic injuries, such as SCI. The empirical evidence on drivers of successful RTW post SCI is, however, limited in comparison to the evidence on interventions for enhanced coping following SCI. Future studies could consider the relative merits of specific RTW interventions with SCI contrasting policy and capitation systems as well as utilising study designs that take into account pre-morbid work participation and secondary health conditions.

This article examines whether Motivational Interviewing (MI) can be truly integrated with Carl Rogers' person-centered approach (PCA) to counselling. While the ‘spirit’ of MI has much in common with PCA, it is argued that the theory and practice of MI indicates several fundamental differences with PCA that distinguishes the ways that each perspective may contribute to rehabilitation counselling. These differences are discussed in relation to the unique aspects of their underlying assumptions, how they define clients' problems, and how they articulate the role of counsellor and successful outcome. Recent meta-analyses have indicated the beneficial aspects of both approaches. Empirical evidence for the efficacy of both MI and PCA is strong across a diverse range of client groups and health care settings. However, the highly variable effectiveness of both MI and PCA suggests that further process-outcome research is needed. Implications for rehabilitation counsellors are discussed.