Lecture # 504:
What is Vocational Rehabilitation?

copyright 2008 Cheryl K. Hosken, BSN, MS Psych.


Rehabilitation is a process to help a person attain usefulness and satisfaction in life. The person's handicap may be the result of any type of disablement (i.e., physical, mental, or emotional) and from various causes (e.g., birth defects, sickness, industrial or road accidents, the stresses of war, work, and daily life). People can also be handicapped by cultural disadvantages due to social, financial, or educational reasons. For example, a child who is a refugee may be handicapped from the stress of war and loss of parents or family. He may also be socially handicapped since he probably has lost the social structure that made it possible for him to live in safety with enough money, and he probably is not sufficiently educated due to his changed social system. Rehabilitation tries to help such persons have equal status with others in the world to have opportunity for normal life attainments.

The early Christians were serious about earning their own living. Paul did not want his disciples to be dependent on others for their living. Apparently some of the Thessalonians were neglecting work and relying on others to support them.

Meditate Word By Word On These Verses:
1 Thess. 4:11-12.

Rewarding activity, not just employment and financial gain, may also be the goal of rehabilitation. A grandmother who is dying of cancer may feel she may work on a story or do special handwork so that her family remembers her after her death. This process is also rehabilitation since it gives her a reason for living even though her body is dying. To overcome a handicap, rehabilitation provides individual service to a person that includes assessment of his situation and/or problems, counseling, and planning with the client about how he will begin to solve his problems. Medicine, education, and employment are most often needed, but other assistance may be given.

Unfortunately, a substantial portion of the world's population is disabled due to war, poverty, and government attitudes. Even the most advanced nations have populations of handicapped people who need rehabilitation to achieve productivity and independence. Since disability affects only part of a person's functions or body, most people can be made suitable for some kind of work. Often the greatest barriers to rehabilitation are ignorance, stigma, and prejudice toward disabled persons. These attitudes often come from employers, family, friends, and even the person himself.

Question:
1. List two attitudes that you have about disabled persons.

Question:
2. List two attitudes that people you know have about disabled persons.

 


 

Contrast those attitudes with Jesus' ministry. He did not shrink from the Samaritan woman at the well. His disciples asked what he was doing talking to her. She was an outcast, a woman from a discriminated group of society in those days. Jesus' conversation with the woman changed her and the whole town. In the same way, Jesus healed the sinner and non-sinner alike. The pharisees criticized Jesus for associating with lower classes of people, and Jesus' response was to say that these people needed help. Today, we have powerful weapons to make war so that people come to an understanding of what we want them to do. If we sent people to help an enemy to have enough to eat, live in a stable society and be educated, what kind of result would we have?

The success of rehabilitation depends on people who want to make rehabilitation happen. In some countries it is the government and/or private company planning and funding. It is technological development and the ways in which it is used. Many space travel technologies have been applied to rehabilitation making life easier for a handicapped person. Rehabilitation also depends on people who are willing to work with handicapped persons. Success in rehabilitation depends on the person we work with. He is just not a target of our work, but he becomes responsible for his own life and what he does with it.

More than anything else, rehabilitation is intended to help handicapped persons help themselves - to know and use their assets. It is not always easy or successful, but we have an example to follow - Jesus, the One who changed many people’s lives and asked us to also change people’s lives through the power He gives us from God the Father. Jesus didn't just heal people physically, but also spiritually. Thus we cannot assume that if a person becomes a Christian, all of his physical problems are solved. There whole other spheres of his life that need changing so that he becomes all that God wants him to be. We know that we have been successful if a person's lifestyle toward family and others changes as a result of knowing God's Word. That is what rehabilitation is about. Just as God gives us His Word to change out spiritual lives, there is practical knowledge of research and technology that can help us in the other spheres of life. You might say that rehabilitation is the joint knowledge of God and practical knowledge of how to help people.

Question:
3. Give an example of a person whose life has changed because of his conversion and change in life as he knows Jesus better.

 


 

Vocational rehabilitation was started to help persons find work in the competitive market. Over the years the goals has been broadened to include any remunerative work or gainful employment. In the 1980's vocational rehabilitation defined in even broader terms that included independent living for persons who cannot work but can have some responsibility for self-care and self-determination. The latest expansion of the definition of vocational rehabilitation was included because it means that a person is less dependent on others.

The Meaning of Rehabilitation
Rehabilitation means restoration of the handicapped person to the fullest physical, mental, social, and economic usefulness they are capable of doing. There are three fundamental courses of action available when a disability imposes limitations on a person:

  1. remedy the cause of the handicap by restoring ability,
  2. compensate for the handicap by enhancing other characteristics of the person,
  3. change environmental circumstances so that the impact of disability is negated

The best foundation for rehabilitation uses all these approaches.

Total rehabilitation includes physical, mental, economic, familial, social, environmental, personal and vocational goals of life. In practice, however, it is found that improvement in the ability to work (vocational rehabilitation) and to live independently bring about a concurrent adjustment in other areas of a person's life.

Despite the type of handicap or the services provided, the goal of rehabilitation is to help each person achieve whatever life adjustment he is capable of attaining. For some people that means being able to progress from lying in bed to moving about in a wheelchair. At the other extreme the goal is to restore a person so that he can return to work. The first example mentioned is called "independent living" and the second example is called "vocational rehabilitation". These two categories and the life adjustment that a person makes are on a continuum from self-determination to self support. Adjustment includes the concepts of independence and productivity.

Belief in the right of independence and productivity is deeply ingrained in rehabilitation. An extension of this concept of self-sufficiency is the right of people to be themselves, to work out their own problems, and make personal decisions. This does NOT mean that we leave them to sort out their own problems. We help them to find the information they need, make a decision about that information, help them make a plan they are going to follow, and be sure that they finish their plan. Rehabilitation can be seen as a method through which handicapped people are enabled to mobilize their own resources, decide what they want to be, and achieve goals through their own efforts. "The object of all help is to make help superfluous."

There are several types of rehabilitation. Match the type of rehabilitation with the definitions below:
A. Economic,   B. Social,   C. Familial,   D. Personal,   E. Mental.

4. Helping a person learn to greet and meet other people according to society's rules.
A, B, C, D, E.

5. Assisting a person to learn how to make a budget.
A, B, C, D, E.

6. Helping a person make an appointment with a psychiatrist or group counselor.
A, B, C, D, E.

7. Encouraging parents to let their disabled child do as much as possible for himself.
A, B, C, D, E.

8. Helping a person arrange his schedule so that he gets to work on time.
A, B, C, D, E.

 


 

The client is the primary person who makes decisions about his own life. A client needs to accept full responsibility for his decisions. The implication is that the client needs to overcome dependency on others. Rehabilitation is an individualized process because every person is different. In the rehabilitation process, we first advise, then guide, then counsel. This means that gradually, the client takes charge of his own life. The client gradually increases his awareness of his own responsibility for his own life.

There are basic concepts about people in the process of rehabilitation:

  1. It is not possible to divide a person into parts, and a person changes as he matures. This means that disability does not appear as a single entity. The highest incidence of disability occurs among the unemployed, socially disadvantaged, and those in unhealthy physical environments. We have to see a whole person, not just his work. In the hospital was a young man who had an amputation of his leg. He had a job and family, but liked to drink with his friends. He was drunk when his accident occurred. When we saw him, he was worried about his family, job, and relationship with his wife. The primary problem was drinking, but that led to all his other worries.
  2. Each person needs to contribute to his society for the good of his country. I know this is a concept that is often repeated, but not necessarily believed in Russia and other countries. However, the productivity and success of a country is related to how well people work. Work usually means security for a family, and if families are secure, the country prospers.
  3. People have a right to be equal with others. Although this may be a basic idea often repeated, it is not necessarily so in the world. However, Jesus did not consider any person too small for his attention. Therefore, handicapped persons have the right to work and be like others as much as possible. As Christians, we may pray for the healing of the handicapped.
  4. We focus on the assets a person has following a disability. It is ability that counts, not disability. Even handicapped persons can participate in sports or learn a new trade.
  5. Physical environments have an impact on the disabled. We need to be creative, especially in Russia, about how to help the disabled overcome the limits of the world around him. If he cannot learn because he is limited to his house, perhaps he can learn via computer classes.

The rehabilitation process is a planned sequence of services to help the disabled person. For example, a stroke patient learns to sit, stand, and walk. The client is usually faced with a set of problems that make life very difficult for him. The counselor helps him identify the problems and they work together on how to solve them. That is why in the first semester of our courses we show you an evaluation and ask you do such an evaluation for a person with a disability.

9. A person's problems are solved by:
(Only one of the following answers is correct.)
a) sitting in the kitchen and drinking tea,
b) making a list of problem areas and deciding what to do about them,
c) trying to find a person with money who will do something for the disabled person.

 


 

The rest of this course will focus on vocational rehabilitation or helping the medically and psychologically stable person to find work.