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This Is to certify that the
dissertation entitled

PERCEIVED IMPORTANCE, EDUCATOR PROFICIENCY
AND STUDENT PREPAREDNESS IN DISABILITY
MANAGEMENT KNOWLEDGE DOMAINS

presented by

Wendy Coduti

has been accepted towards fulﬁllment
of the requirements for the

PhD. degree in Rehabilitation Counselor
Education

 

 

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5/08 K‘IProlechresICIRC/Dateoue.indd

 

PERCEIVED IMPORTANCE, EDUCATOR PROFICIENCY AND STUDENT
PREPAREDNESS IN DISABILITY MANAGEMENT KNOWLEDGE DOMAINS

By
Wendy Coduti

A DISSERTATION
Submitted to
Michigan State University
in partial fulﬁllment of the requirements
for the degree of
DOCTOR OF PHILOSOPHY
Rehabilitation Counselor Education

2009

ABSTRACT

PERCEIVED IMPORTANCE, EDUCATOR PROFICIENCY AND STUDENT
PREPAREDNESS IN DISABILITY MANAGEMENT KNOWLEDGE DOMAINS

By
Wendy Coduti

The purpose of this quantitative study was to determine how rehabilitation
counselor educators perceived identiﬁed disability management tasks in relation
to importance to the ﬁeld of rehabilitation counseling, their own proﬁciency to
teach as well as student preparedness. This study also looked at whether
importance, proﬁciency and preparedness differed across three disability
management domains according to participant demographics. Originally, 697
individuals with the rank of assistant, associate, professor, adjunct instructor or
instructor rank as members of the National Council on Rehabilitation Education
(NCRE) or faculty of NCRE member institutions were identiﬁed as potential
participants. Of the initial 697 individual email invitation sent to potential
participants, 101 were returned as invalid or undeliverable email addresses. An
additional 16 declined to participate as they were not involved in the ﬁeld of
rehabilitation counseling and 16 opted out of the survey (no reason given). Of
the total 564 potential participants, 89 responded. Of those 89 15 were deemed
not valid due to participants not completing any further questions past the ﬁrst. In
the end a total of 67 surveys were deemed usable, for a response rate of 12%.

Empirical data was gathered using a modiﬁed web based version of the

Certiﬁcation of Disability Management Specialists Commission Role and
Function Study. Quantitative data was obtained for three Likert-type sales,
importance, proﬁciency and preparedness, for each of the 26 disability
management tasks. These tasks were part of the three disability management
domains, domain I (disability case management), domain ll (disability prevention
and workplace intervention) and domain lll (program development, management
and evaluation). Overall survey participants ranked all 26 items as important to
the ﬁeld of rehabilitation counseling, ranked themselves as proﬁcient to teach 22
of the 26 tasks and identiﬁed students as prepared on only 6 of the 26 tasks.
Signiﬁcant demographic differences were identiﬁed on a few of the
characteristics across some, or all, of the domains. A high correlation was found
between an educators perceived importance of a task (or domain) and their
perceived proﬁciency to teach. Implications for rehabilitation counselor practice,

education and future research are discussed.

To Kurt, Cale and Kenzie. Without your love, support, patience and

understanding, none of this would have been possible. I love you

iv

ACKNOWLEDGEMENTS

This dissertation would not have been possible without the help and
guidance of my dissertation committee, Dr. Michael Leahy, Dr. John Koscuilek,
Dr. Timothy Tansey and Dr. Virginia Thielsen. Special recognition goes to my
advisor and dissertation committee chairperson, Dr. Leahy, for both his direction
and guidance throughout this entire process as well as encouraging me to ﬁnd
my own way through the rehabilitation counselor education program.
Acknowledgment also goes to the NCRE research committee for approving this

study.

Table of Contents

TABLE OF CONTENTS ......................................................................... vi
LIST OF TABLES ................................................................................ viii
CHAPTER I ........................................................................................ 1
INTRODUCTION ................................................................................... 1
Statement and signiﬁcance of the Problem ........................................ 4
Purpose of the Study .................................................................... 8
Deﬁnition of Terms ...................................................................... 11
Assumptions and Limitations ......................................................... 13
CHAPTER II ........................................................................................................ 16
LITERATURE REVIEW ...................................................................................... 16
Disability Management ............................................................................. 16
Components of Successful Disability Management Programs ................ 19
Disability Management Role and Function Research .............................. 24
Disability Management and Rehabilitation Counseling ............................ 35
Rehabilitation Counselor Education ......................................................... 38
The Aging Workforce ............................................................................... 39
CHAPTER III ....................................................................................................... 43
METHODOLOGY ................................................................................................ 43
Participants .............................................................................................. 44
Instrumentation ........................................................................................ 44
Procedures ............................................................................................... 47
Design ...................................................................................................... 48
Data Collection ......................................................................................... 50
Data Analysis ........................................................................................... 50
CHAPTER IV ...................................................................................................... 53
RESULTS ........................................................................................................... 53
Response Rate ........................................................................................ 53
Characteristics of Sample ........................................................................ 54
Disability Management Tasks .................................................................. 62
Perceived Importance ................................................................... 62
Perceived Proﬁciency .................................................................... 71
Student Preparedness ................................................................... 80

Demographic Differences in Importance, Proﬁciency and Preparedness
.................................................................................................................. 92
Demographic Variables and Importance ....................................... 93
Demographic Variables and Proﬁciency ....................................... 96
Demographic Variables and Preparedness ................................... 99

Relationship Between Perceptions of Importance and Proﬁcency
..................................................................................................... 103

vi

CHAPTER V ..................................................................................................... 106

DISCUSSION .................................................................................................... 106
Perceived Importance ............................................................................ 108
Perceived Proﬁciency ............................................................................. 114
Perceived Preparedness ........................................................................ 119
Limitations .............................................................................................. 123
Implications ............................................................................................ 124

Implications for the Profession .................................................... 124
Implications for Rehabilitation Education .................................... 126
Implications for Research ............................................................ 127
Conclusions ............................................................................................ 128

APPENDICES ................................................................................................... 131
Appendix A: Certiﬁcation of Disability Management Specialists
Commission Role and Function Analysis Survey ................................... 131
Appendix B: Survey Transmittal Letter ................................................... 143
Appendix C: Follow Up Transmittal Letter .............................................. 144

REFERENCES ................................................................................................. 145

vii

LIST OF TABLES

Table 1 - Demographic Characteristics of the Sample ....................................... 58
Table 2 — Demographic Characteristics of the Sample ....................................... 59
Table 3 — Demographic Characteristics of the Sample ....................................... 60
Table 4 - Demographic Characteristics of the Sample ....................................... 61
Table 5 — Importance Domain I: Disability Case Management ........................... 65

Table 6 - Importance Domain II: Disability Prevention and Workplace
Intervention ......................................................................................................... 67

Table 7 - Importance Domain II: Program Development, Management and
Evaluation ........................................................................................................... 69

Table 8 — Proﬁciency Domain I: Disability Case Management ........................... 74

Table 9 -- Proﬁciency Domain ll: Disability Prevention and Workplace Intervention

............................................................................................................................. 76
Table 10 - Proﬁciency Domain III: Program Development, Management and
Evaluation ........................................................................................................... 78
Table 11 — Preparedness Domain I: Disability Case Management .................... 83
Table 12 — Preparedness Domain II: Disability Prevention and Workplace
Intervention ......................................................................................................... 85

Table 13 - Preparedness Domain III: Program Development, management and

Evaluation ........................................................................................................... 87
Table 14 - Overall Scale Means for Combined 26 Items ................................... 89
Table 15 - Reliability Importance, Proﬁciency and Preparedness Scales ......... 91

Table 16 — Reliability Importance, Proﬁciency and Preparedness Scales by
Disability Management Domain .......................................................................... 91

Table 17 - One Way Analysis of Variance for Disability Management Emphasis
and Overall Importance ....................................................................................... 95

Table 18 — One Way Analysis of Variance for Disability Management Emphasis

viii

And Domain I Importance ................................................................................... 95

Table 19 - One Way Analysis of Variance for Disability Management Emphasis
and Domain I| Importance ................................................................................... 95

Table 20 — One Way Analysis of Variance for Disability Management Emphasis
and Domain I|| Importance .................................................................................. 96

Table 21 — Once Way Analysis of Variance for Disability Management Emphasis
And Overall Proﬁciency ....................................................................................... 98

Table 22 — One Way Analysis of Variance for Disability Management Emphasis
and Domain I Proﬁciency .................................................................................... 98

Table 23 — One Way Analysis of Variance for Disability Management Emphasis
and Domain || Proﬁciency ................................................................................... 99

Table 24 — One Way Analysis of Variance for Disability Management Emphasis
and Domain III Proﬁciency .................................................................................. 99

Table 25 — One Way Analysis of Variance for Disability Management Emphasis
and Overall Preparedness ................................................................................ 101

Table 26 — One Way Analysis of Variance for Disability Management Emphasis
and Domain l Preparedness ............................................................................. 102

Table 27— One Way Analysis of Variance for Disability Management Emphasis
and Domain II Preparedness ............................................................................ 102

Table 28 — One Way Analysis of Variance for Disability Management Emphasis

and Domain III Preparedness ........................................................................... 102
Table 29 — Correlation Overall Importance and Proﬁciency ............................. 104
Table 30 — Correlation Domain I Importance and Proﬁciency .......................... 104
Table 31 — Correlation Domain II Importance and Proﬁciency ......................... 105
Table 32 - Correlation Domain III Importance and Proﬁciency ........................ 105

Table 33 - Importance, Proﬁciency and Preparedness Item Means by Domain
........................................................................................................................... 107

ix

Chapter I
Introduction

Disability management, as deﬁned by the Certiﬁcation of Disability
Management Specialists Commission (2008), “is a workplace program that seeks
to reduce the impact of injury and disability and to accommodate employees who
experience functional work limitations (p.1). Disability management utilizes
services, people and materials to reduce the impact and costs of disability to both
the employer and employee and promotes return-to-work as soon as possible
(Schwartz, Watson, Galvin, & Lippoff, 1989).

Efforts to control disability costs began in the mid 1980’s which led to the
development of disability management programs (Flynn, 2001 ). Disability
management programs were self-insured employers’ response to the increasing
costs in healthcare, workers’ compensation and other disability costs (Habeck,
1999). These costs still challenge employers today. The Census Bureau
estimates for the year 2000 the total costs of disability (medical, income
replacement, and productivity related costs) were more than $340 billion (Watson
Wyatt, 1998).

Since the mid 1980’s, many companies have incorporated some aspect of
disability management into their organization. The Washington Business Group
conducted a survey in 1999 which reported that out of 178 companies with 1000
or more employees, virtually all had some form of a disability management
component in place to deal with work injury issues (Leahy, Chan, & Saunders,

2003). Since direct and indirect costs of disability in the workplace add up to

about 18% of payroll costs, disability management programs are a great way to
assist in reducing and/or eliminating some of those costs for employers
(Scardellette, 2003). Disability management programs are intended to achieve a
win-win solution for employers and employees, if implemented and administered
effectively (Habeck, Leahy, Hunt, Chan, & Welch, 1991 ).

Rehabilitation counseling has been identiﬁed as a profession practicing in
the area of disability management (Goodwin, Taylor, Chan & Currier, 2000).
Habeck and Kirchner (1999) identiﬁed two separate levels on which disability
management can operate. Level I, or big disability management, is described as
being administrative and managerial in nature and with more of an organizational
focus. Level II, or little dm, is more human service orientated and involves the
direct provision of services to individual clients.

Major areas'of study were recognized for the professionals working on the
Level I disability management practice. These included: rehabilitation
counseling, industrial and organizational psychology, risk management and
insurance, human resource management, medicine (occupational health
specialty), business administration and nursing (occupational health specialty).
Areas of study identiﬁed for professionals operating on Level II dm practice
included: rehabilitation counseling, occupational health nursing and rehabilitation
psychology (Habeck et al., 1999).

For Certiﬁed Disability Management Specialist (CDMS) eligibility criteria,
rehabilitation counseling has been recognized as one of the accepted degrees

that are “in a ﬁeld directly related to disability management” (Certiﬁcation of

Disability Management Specialists Commission, 2008, p.3). However, there
have been no studies to determine whether or not students in rehabilitation
counseling education programs are being taught the identiﬁed knowledge areas
necessary for disability management. In fact “little has been done to examine the
preservice or continuing education training needs speciﬁc to rehabilitation
professionals practicing disability management” (Goodwin, et al., 2000, p. 231 ).
Szymanksi, Linkowski, Leahy, Diamond, 8 Thoreson (1993) report that speciﬁc
knowledge is the source for successful service delivery in any occupation or
specialty area.

Rehabilitation counselors are practicing more often in areas of disability
management in private rehabilitation settings (Leahy, et al., 2003). The ﬁeld of
rehabilitation counseling has changed dramatically and has been drastically
affected by trends, such as the emerging disability management models in
private rehabilitation (Chan, Leahy, Saunders, Tarvydas, Ferring & Lee, 2003).
Leahy et al., (2003) reports that “many of the emerging knowledge areas (e.g.,
disability management) may not even be emphasized in many current
rehabilitation counselor education curricula” (p. 83).

Deﬁciency of knowledge is an obstacle to effective disability management
practice (Goodwin, et al., 2000). The ﬁeld of rehabilitation counseling cannot
afford to be ill prepared in the ﬁeld of disability management if it wants to remain
a pertinent profession. Jenkins 8. Strauser (1999) contend that in order for
rehabilitation counselors to be competitive in the future, the Counsel of

Rehabilitation Educators (CORE) should expand career development (0.2.4) and

job development and placement (0.2.6) educational standards. Jenkins 8
Strauser (1999) also recommend including topics such as “disability
management, stafﬁng (speciﬁcally employee recruitment and selection), work
motivation, organizational culture, psychological effects of unemployment, human
resource management, economics and job design” (p. 10). These issues will
become even more critical based on the unprecedented workforce changes we
are about to encounter.
Statement and Signiﬁcance of the Problem

Today’s workforce is changing dramatically. Wrth the aging of the baby
boomer generation we are about to experience an unparalleled shift, which some
have referred to as a “demographic and aging tsunami” (The Aging Workforce,
2007, p. 3). Critchley (2004) has stated that “there is a tidal wave of change
occurring within today's workplace due to dynamic demographic changes, yet
many organizations and their leaders are oblivious to the consequences and are
not implementing necessary strategies for future survival” (p. xi).

According to Dychtwald, Erickson & Morison (2006) those over the age of
50 will account for 80% of the native-born workforce growth in North America
over the next 15 years. Those in the age group between 55-64 will increase by
11 million persons between 2000-2010, more than any other group, while
persons age 35-44 will decline by 5.1 million. Additionally, labor force
participation is expected to be the greatest for those aged 65-74 from 2000-2010.

(Fullerton & Toossi, 2001).

Rising life expectancy and lower fertility rates have also been factors in
the demographic changes affecting the workforce (Brooke, 2003). Toossi (2002)
reports that the labor force growth rate will remain steady at 1.1% during the
2000—2010 period, falling to 0.6% in 2010-2015 and 0.2% between 2015-2020.
Thus employers should be preparing to double the proportion of employees aged
ﬁfty-ﬁve and above (Dychtwald, et al., 2006).

Workers’ have also been remaining in the workforce longer, increasing the
number of older workers. Reasons for workers’ remaining employed include:
decreased retirement savings, a need for health care beneﬁts, increase in the
age requirements needed to collect Social Security as well as the elimination of
mandatory retirement by some employers (Hursh, Lui, & Pransky, 2006). In
addition, changes in the stock market, either positive or negative, impact older
workers” assets along with their decisions to retire, or not (National Institute on
Aging, 2007). The recent volatility of the stock market will more than likely hinder
more people’s ability to retire in the near future.

As workers age the incidence, severity and duration of disability also
increases (Bruyere, 2006). In relation to chronic illness and the impact on the
ability to work, only 1.9% of those aged 18-24 are unable to work while the rate
dramatically increases to 18.6% for those age 65-69 (Stoddard, Jans, Ripple &
Kraus, 1998). Remaining employed is “far more desirable for individuals with
disabilities, their families, and society-at-Iarge, than a life of relying on private or
public disability beneﬁts as a substitute for wages” (National Institute of Disability

Management and Research, 2005, p. 6).

Vargo & Grzanowicz (2002) reports it will become even more imperative to
identify proven strategies to return employees to work after an injury or illness.
Employers are seeking ways to keep their costs down. Due to challenges
employers are facing, including rising medical costs associated with disability, the
aging workforce and increased foreign competition, more employers are seeking
strategies to return employees to work and reduce their costs related to disability
(Gottlieb, Vandergoot & Lutsky, 1991).

One such strategy is disability management. Over 95% of all disabilities
are acquired during working life and with increasing age the likelihood of
acquiring a disability sharply escalates. Disability management strategies assist
in assuring productivity of workers during all phases of life, especially in an aging
society (National Institute of Disability Management and Research, 2005).
Bnryere (2006) reports that “disability management and accommodation policies
and practices readily lend themselves to addressing the challenges employers
will face with an aging workforce, and the increasing prevalence of disability that
these demographics bring” (p. 149).

Disability management is an “active process of minimizing the impact of
an impairment (resulting from injury, illness or disease) on the individual’s
capacity to participate competitively in the work environment (Shrey & Lacerte,
1995, p. 5). Unfortunately disability management has been conceptualized at so
many levels by various parties (e.g., medical providers, claims managers,

insurance carriers, rehabilitation professionals), that each party uses the term

disability management for its’ own interest, leaving it as one of the most broadly
deﬁned and distorted terms in health care (Shrey et al., 1995).

Since there is no formal educational degree program for disability
management and the interplay between so many concepts of what disability
management actually is and who is involved, the process of disability
management has been diluted. Without a concrete educational program in
place, with speciﬁcs related to the separate professions involved and the
responsibilities of each profession in the disability management process, it is
difﬁcult to determine the best way to disseminate knowledge, skills and abilities
required to practice disability management successfully.

Speciﬁc disability management knowledge and skills have been identiﬁed
through various role and functions studies involving disability management
experts. One such study was conducted to establish an empirical basis for the
main certiﬁcation in disability management, the Certiﬁed Disability Management
Specialist (Rosenthal, Hursh, Lui, lsom, 8 Sasson, 2007). This study identiﬁed
three disability management knowledge domains: (a) disability case
management; (b) disability prevention and workplace intervention; and (c)
program development, management and evaluation.

While organizations are grappling with an aging workforce, professions
directly involved with disability management should be preparing as well, such as
rehabilitation counseling. Szymanski (1985) deﬁned rehabilitation counseling as
“a profession that assists persons with disabilities in adapting to the environment,

assists environments in accommodating the needs of the individual, and works

toward full participation of persons with disabilities in all aspects of society,
especially work” (p.3).

Although rehabilitation counseling is a resource in assisting employers
with regards to an aging workforce through disability management programs,
there is “little information to guide rehabilitation professionals in the areas with
which employers seem most to need assistance” (Gottlieb, et al, 1991 p. 23).
Rosenthal, et al., (2007) contend that “as employers, insurers, and other
stakeholders become more knowledgeable about the range of services and the
knowledge and expertise needed to improve productivity, and reduce the impact
of illness, injury, and disability, the demand for evidence-based practice will
increase” (p. 83). This research project will look at identifying rehabilitation
counseling educators’ perceptions of identiﬁed disability management knowledge
tasks (within three domains) in relation to perceived importance, educator
proﬁciency to teach these tasks, and overall student preparedness.

Purpose of the Study

Multiple studies have been conducted to identify knowledge and skills
necessary for working in the disability management ﬁeld (Habeck, 1991; Currier,
Chan, Taylor, & Wood, 1997; Habeck 8. Kirchner, 1999; Currier, et al., 2001;
Castle Worldwide Psychometries, 2004; Rosenthal, et al., 2007). There have
been no studies however surveying rehabilitation counseling educators to
determine the level at which identiﬁed disability management knowledge is being

taught within rehabilitation counseling programs.

This study examined empirically based knowledge areas speciﬁc to
disability management and surveyed rehabilitation counseling educators to
determine participants perceived: (a) importance of disability management tasks
for rehabilitation counseling practice; (b) educators perceived proﬁciency to teach
disability management tasks for rehabilitation counseling practice; and (0) overall
student preparedness in identiﬁed disability management tasks upon completion
of a Master’s level rehabilitation counseling program.

A quantitative survey, based on a modiﬁed version of the Certiﬁcation of
Disability Management Specialists Commission (CDMSC) Role and Function
Analysis Survey for the Certiﬁed Disability Management Specialist (CDMS)
constructed for the 2004 study to determine the prevailing domains of disability
management practice was used (Rosenthal, et al., 2007). A descriptive ex post
facto research design was used to identify which disability management
knowledge tasks rehabilitation counseling educators perceived as important to
the ﬁeld of rehabilitation counseling, their own proﬁciency to teach in these areas,
and overall student preparedness. A demographic questionnaire was included to
determine how demographic characteristics among participants related to
responses to the research questions below.

The research questions of interest in this study are as follows:
1. According to rehabilitation counselor educators, how important are disability
management tasks for effective rehabilitation counseling practice?

a) Does the level of importance differ across the three disability

management domains?

b) Are there differences in the level of importance in the components of
the three disability management domains relative to speciﬁc demographic
characteristics of faculty (i.e. gender, years of experience as a
rehabilitation counselor educator, engaged in paid disability management
activities)?
2. How do rehabilitation counselor educators’ perceive their own instnrctional
proﬁciency to teach disability management tasks for rehabilitation counseling
practice?
a) Are there differences in the level of perceived proﬁciency in the three
disability management domains relative to speciﬁc demographic
characteristics of educators (i.e. gender, years of experience as a
rehabilitation counselor educator, engaged in paid disability management
activities)?
b) Do the perceptions of rehabilitation counselor educators’ own
instructional proﬁciency to teach disability management tasks differ across
the components of the disability management domains?
c) What is the relationship between educators’ perceptions of the
importance and their perceived instructional proﬁciency to teach disability
management tasks?
3. How do rehabilitation counselor educators perceive overall student
preparedness in identiﬁed disability management tasks?
a) Are there differences in the perceived overall student preparedness in

the three disability management domains relative to speciﬁc demographic

10

characteristics of faculty (i.e. gender, years of experience as a
rehabilitation counselor educator, engaged in paid disability management
activities)?

b) Are there differences in the perceived overall student preparedness

across the components of the disability management domains?

Deﬁnition of Terms

Disabiliy Management: Operationally deﬁned, disability management is an
“active process of minimizing the impact of an impairment (resulting from injury,
illness or disease) on the individual’s capacity to participate competitively in the
work environment (Shrey et al., 1995, p. 5). Disability management includes
prevention, early intervention and return to work, and individuals working in
disability management areas must provide services to both worker and employer
(Certiﬁcation of Disability Management Specialists, 2008).

Certiﬁmtion of DMD Magagement Specialists Commission: The nationally
accredited and independent organization that certiﬁes disability management
specialists that analyze, prevent and mitigate the human and economic impact of
disability for employees and employers.

QQBE; Council on Rehabilitation Education which accredits graduate programs
which provide academic preparation for professional Rehabilitation Counselor
Education (RCE).

Older Workers: The US. Bureau of Labor Statistics identiﬁes older workers as

those aged 65 and older.

11

Rehabilitation Counseling: Practitioners with a master‘s degree who assists
persons with physical, mental, developmental, cognitive and emotional
disabilities to achieve their personal, career, and independent living goals in the
most integrated setting possible through the application of the counseling
process. Techniques and modalities used by rehabilitation counselors may
include, but are not limited to: (a) assessment and appraisal; (b) diagnosis and
treatment planning; (0) career or vocational counseling; (d) individual or group
counseling; (e) case management, referral, and service coordination; (f) program
evaluation and research; (9) interventions to remove attitudinal, employment or
environmental barriers; (h) consultation services among multiple parties,
regulatory bodies, or about access to technology; (i) job analysis, job
development,'or job placement services; and (j) the provision of consultation
about and access to rehabilitation technology (Scope of Practice for
Rehabilitation Counseling, 2009). '

Certiﬁed Disability Management Specialist: The certiﬁcation in the ﬁeld of
disability management that is seen as the standard for measuring the level of
knowledge, competence and professional experience needed to practice in this
area. The area of disability management has a speciﬁc focus on workplace
issues, emphasizing the role of the disability manager in returning ill and injured
employees to the workplace as quickly as possible to promote healing, restore
the individual’s earning power, and contribute to the company’s productivity

(Certiﬁcation of Disability Management Specialists, 2008).

12

'f.

Assumptions and Limitations

The principal assumption undertying this study pertained to the validity of
rehabilitation counselor educators (university faculty and adjunct instructors) self
reporting their perceived importance of disability management tasks for the ﬁeld
of rehabilitation counseling, perceived proﬁciency in teaching disability
management tasks and overall student preparedness. Self report based survey
research is used to deﬁne competencies that are not directly observed or that
can be reﬂected in multiple forms of behavior (Boyalzis, 1980). Disability
management is such a broad term educators may have different perspectives of
what aspects of this process are more critical than others, which may also be
related to the type of practice setting their experience comes from (public, not-
for-proﬁt, private). An educators’ perceived proﬁciency to teach disability
management may also be misaligned due to the marked changes in the ﬁeld of
disability management. Proﬁciency at one point in time does not equate to
proﬁciency with today’s ever changing labor market and global economy.

Participant response to overall student preparedness may have also been
jaded if they were not current with the recent studies related to the identiﬁed
disability management knowledge tasks, or do not have a lot of students
interested in practicing in this area. While rehabilitation counseling programs
may be aligned with the Council on Rehabilitation Educations requirements to
include disability management in their program curriculum, the education being
provided may not be aligned with what employers are seeking. Employers,

insurers and other stakeholders are not only looking for disability management

13

professionals who can reduce the impact of illness, injury and disability but they
also want “practitioners to be informed consumers of current and relevant
research, including justifying the return on investment in what they do in terms of
reducing direct and indirect costs, decreasing beneﬁt consumption, and
improving workplace productivity“ (Rosenthal, et al., 2007, p. 83). ’

A limitation of this study was surveying only rehabilitation counseling
educators, which was deﬁned as faculty that have attained the rank of Assistant
Professor, Associate Professor, Professor, adjunct professors or instructors who
were currently involved in teaching or clinical supervision from accredited
programs list from the National Council of Rehabilitation Education (NCRE).
These survey results cannot be generalized to rehabilitation counseling
educators who do not meet the above criteria.

An additional limitation was using the knowledge domains of disability
management as identiﬁed through the Certiﬁcation of Disability Management
Specialists Commission (CDMSC) role and function study of 2004. While this
was a follow up study to a previous 1999 role and function study it still provides
newer research that educational programs may not have weaved into their
cuniculum yet. Another limitation was using the results of the CDMSC study
which has its own inherent limitations including a low return rate (20%).

Another assumption was that the ease of electronic surveys would yield more
successful response rates. While educators were more at ease with completing
electronic surveys, web based studies often have a higher rate of drop out and

repeated participation. Shannon, Johnson, Searcy and Lott (2002) reported that

14

surveys conducted on the World Wide Web (with a link to the site fonlvarded
through an email) offer great advantages related to data analysis as responses
can be easily downloaded into spreadsheets or statistical analysis software
programs. Bimbaum (2005) also compared studies where data was obtained in
web versus lab studies and found these methods usually yielded the same

conclusions.

15

Chapter II

Literature Review

Disability Management

Disability management has been deﬁned as a process of minimizing
impacts of impairments, including injury, illness or disease, on a person’s
capacity to remain in a work environment competitively (Shrey, 1995). Others
have deﬁned disability management as a proactive approach to help injured or ill
employees to return to safe and productive work activities as soon as medically
possible with a primary focus of minimizing the impact of injuries or illnesses
(Workplace Health, Safety and Compensation Commission, 2005). Habeck et al.
(1991) go further to describe disability management as a process that is
proactive, employer based, and designed to prevent the occurrence of injury and
disability and includes early intervention to mitigate disability risks and
coordinated services for cost effective restoration and retum-tO-work.

Disability management materialized during the 1980’s when employers,
insurers, policy makers and service providers recognized the negative impacts
that health care costs, the aging workforce, and the increasing occurrence of
disability in the workplace were having on the “bottom line” of business (Galvin,
1991)’

Almost thirty years later these issues still face employers. Due to the
increases in global competition they are more impactful on an employer’s ability

to remain competitive, or even remain in business as the direct and indirect costs

16

of disability average about 18% of a company’s payroll (Scardellette, 2003).
These issues also affect the ability of a person with a disability to obtain or
sustain employment.

For this reason it is critical that professionals involved with disability
management stay abreast of trends within the workplace, and within the
workforce, to ensure that they are able to meet the demands of stakeholders. For
the ﬁeld of rehabilitation counseling, speciﬁcally those involved with the private
for-proﬁt sector of rehabilitation counseling, this means knowing and
understanding the needs of industry and employers.

Rehabilitation counseling has been deﬁned as “a profession that assists
persons with disabilities in adapting to the environment, assists environments in
accommodating the needs of the individual, and works toward full participation of
persons with disabilities in all aspects of society, especially work” (Szymanski,
1985, p. 3). The private for-proﬁt sector of rehabilitation counseling has
historically served industrially injured workers and individuals receiving private
long-term disability insurance payments, and the “increasing cost of medical care
and workers’ compensation insurance, gave rise to private (insurance)
rehabilitation in the mid-1970’s (Strensnrd 8 Gilbride, 2004, p. 222).

Initially disability management focused on the retum-to-work of an
employee after an injury or disability was incurred, mainly within state workers’
compensation systems. Private for-proﬁt rehabilitation was best ﬁt, out of the
other rehabilitation counseling service provider settings (i.e. public and non-

proﬁt), for working in the area of disability management. Private sector

17

rehabilitation counseling is more versatile, quicker to initiate and more cost-
effective (Shaw 8 Betters, 2004).

As Berkowitz 8 Berkowitz (1991) report “rehabilitation services were
designed, not to make the worker better off, but to restore the worker, as closely
as possible, to the position enjoyed prior to the injury” (p. 184). However as
these initial retum-to-work programs began to show positive return on
investment, as well as ﬁnancial savings and positive return to work outcomes for
injured workers, disability management practices and programs grew in value
(Habeck 8 Kirchner, 1999).

Employers and disability management service providers moved beyond
initial interventions of reactive protocols (i.e. return-to-work after a work injury) to
more proactive strategies which included safety/prevention, health/wellness
programs, ergonomics, ecological assessments, and specialized case
management strategies (Hursh, 1997; Rosenthal, Hursh, Lui, Zimmerman 8
Pruett, 2005).

Such expansion of services of disability management programs has made
the preliminary service approach “migrate from the vocational rehabilitation
model originally used within the workers’ compensation system to a workplace-
based approach that was inclusive of many disciplines, including organizational
development, safety, risk management, and case management” (Rosenthal, et
al., 2007, p. 77). Habeck et al., (1991) reiterate that “the negative human
consequences of work injuries and subsequent unemployment compel

rehabilitation professionals to Ieam how to assist employers in the adoption of

18

company practices that can prevent injury and maintain employment when
disability occurs“ (p. 213).
Components of successful DM programs

Companies with low claim rates (for workplace injuries) include safety and
prevention interventions, procedures to prevent and manage disability, and an
open managerial style and human resource orientation (Amick, Habeck, Hunt,
Fossel, Chapin, Keller, 8 Katz, 2000). Disability management providers, such as
rehabilitation counselors, must be aware of an organization’s culture, in relation
to disability management issues and their importance to that organization, if they
are going to be effective at working within that organization.

Habeck 8 Hunt’s (1999) review of the literature regarding successful
disability management programs suggest essential components including:

1. Company-wide commitment to reduce disability costs and provide
needed assistance to encourage retum-tcwork.

2. Analysis and modiﬁcation of related beneﬁts and policies to support
disability management objectives.

3. Comprehensive assessment of corporate needs, experiences and
responses to injury and illness occurrences.

4. Organization of the disability management initiative across all levels
and locations with clearly assigned responsibilities and accountability among all

necessary people and operating units.

19

5. Creation of an integrated, useable and effective information system to
document, analyze, manage, and evaluate relevant data pertaining to incidence,
employees, costs, services and impact.

6. Educational efforts directed toward managers, supervisors and line
workers to create understanding and involvement in disability management
efforts.

7. Active use of safety and prevention strategies/techniques to avoid
disability occurrence.

8. Early intervention and ongoing monitoring for health risks and disability
cases.

9. Positive contact with the injured/ill employee and the treating physician
within 24 hours of onset.

10. Facilitating early retum-to-work of disabled workers through an
organized return-to-work process that provides modiﬁcations in assignments,
hours and/or duties.

11. Systematic procedures for effective use of healthcare and
rehabilitation services.

12. Writing an individual plan of service and return-to-work by the
responsible case manager with the participating employee.

13. Using professionals with expertise to design accommodations that
permit workers with disabilities to perform work in a satisfactory manner.

14. Collaboration with public and private agencies to provide necessary

mental health and rehabilitation services.

20

15. Use of incentives in beneﬁt design, cost accounting and performance
evaluation to encourage participation of employees, supervisors and manager
(p.24).

Effective disability management programs must incorporate stakeholders’
involvement as well as make all stakeholders accountable (Dyck, 2000).
Successful management of disability costs has been attributed to changing
corporate culture, restructuring monetary incentives and implementing
preventative programs, such as disability management, which involve
cooperation of employees and managers (Tweed, 1994). Tweed (1994) also
stated that the culture of a company, and whether management demonstrates it
cares about employees, is the key factor inﬂuencing the potential for injury and
lost time. The proactive nature of disability management programs is critiaal as
the most succesle timeframe for bringing employees back to work from an
absence is 30 days (Dyck, 2000). Poor relations between management and
employees can discourage employees from following safety practices at work,
and even their returning to work after an injury (T weed, 1994).

Disability management programs deliver a variety of beneﬁts to multiple
stakeholders involved in the process. Below are some of those beneﬁts, for
employers, employees, unions and healthcare industries as stated in “Workplace
disability management: A guide to establishing a program in your workplace”
(WHSCC, 2005, p.5). Employer beneﬁts of disability management programs
include:

1. Managing workplace costs.

21

3.

4.

illness.

@WNP’S"

. Creating safer, more cooperative and more productive workplaces.

Reducing employee turnover and lost time.

Increasing employee awareness of costs associated with injuries and

Reduce accident and workers’ compensation costs.
Reduce hiring and/or training costs.

Retain experienced employees.

Improve employee relations and morale.

Boost overall productivity and company image.

10. Participate in the rehabilitation and retum-to-work process.

11. Develop a retum-to-work process that can be utilized for work and

non-work injury or illness.

Employee beneﬁts include:

1.

7.

2
3
4.
5
6

Avoid long term absences from work.

. Maintain income.

. Retain productive employment and job security.

Maintain job skills.

. Retain beneﬁts and insurance eligibility by retuming to work.

. Retain pension and beneﬁt packages.

Resume routine life activities sooner.

Union beneﬁts include:

1.

members.

Preserve jobs, seniority, beneﬁts, etc. for employees and union

22

2. Promote cooperative labor/management relations.

3. Facilitate participation in the retum-to-work process.
Health care provider beneﬁts include:

1. Assist in promoting the beneﬁts of returning to all possible functional
activities as soon as possible after an injury and/or illness.

2. Increase awareness and understanding of their patients’ work
activities.

3. Allow for increased opportunity for employment-related activities to
form part of the patients’ rehabilitation.

4. Increase their influence on the activities their patient undertakes at
work.

5. Improves opportunity for their patients’ recovery.

Beneﬁts of disability management also include costs savings. Habeck et
al., (1991) report that “despite the lack of data to fully substantiate the impact of
disability prevention and management efforts, rising disability costs have created
sufﬁcient incentives to motivate many (especially large) employers to increase
their capacity to effectively manage disability factors” (p. 213). Habeck 8 Hunt
(1999) state that “virtually every major insurer and most self-insured employers
boast some sort of disability management effort“ (p. 19). Disability costs for
company’s can be cut by as much as 50% by better management of disability
programs (Lucas, 1987). With global competition, economic uncertainty and an
aging workforce all challenging employers today, disability management is an

effective resource for business as well as employees with disabilities. “The

23

rehabilitation service delivery system is a natural partner with business and labor
in the success of such cost-effective approaches in the reduction of human pain,
suffering and loss of work potential in the American work force (Bruyere 8 Shrey,
1 991 , p. 240).

Disability management role and function research

Multiple studies have been conducted in relation to disability management.
However, in order to best understand rehabilitation counseling’s ability to
successfully work in the ﬁeld of disability management, research must be
reviewed regarding role and function requirements. Professional competency,
role and function, knowledge validation, and job analysis research are language
used to clarify the practice of studying practitioners in a particular area and
classify central functions and tasks, or knowledge and skills, related to that area
of practice (Leahy, 1994).

There have been distinctions in the literature regarding the difference
between employer based and private rehabilitation (Habeck 8 Munrowd, 1987).
Private rehabilitation was seen as an external professional hired to provide
services to injured workers, often in the area of disability management.
Employer based rehabilitation was developed by organizations to promote and
retain the productivity of employees and prevent job loss for those who were
injured, disabled or ill. Since the majority of disability management programs
were actually utilizing services of private rehabilitation, it was difﬁcult to draw
many distinctions (Habeck 8 Munrowd, 1987). In 1996 Habeck stated again that

disability management could be distinguished from private-sector rehabilitation

24

practice. She delineated the two by stating disability management was
differentiated by direct access to the workplace, intervention at the time of
injuryﬁllness, employer-based and proactive. Habeck (1996) reported private
rehabilitation as providing services to injured workers after the fact, and when
return-to-work was prevented by the disability. In reviewing the research on
disability management, early studies began by looking at the knowledge and
skills areas in private rehabilitation, which will be discussed in the next section.

Studies speciﬁc to role and functions of disability management providers
arose from the deﬁnition of disability management practice by Habeck 8 Kirchner
(1999) which identiﬁed disability management programs on two levels, Level I
(Big DM) and Level II (little dm). Habeck 8 Kirchner (1999) describe Level I as
more focused on the organization and workplace as a whole, with little direct
service to individual clients, while Level II focus is more human-service oriented,
involving services directly to individual clients.

From Habeck 8 Kirchners (1999) delineating disability management on
two levels, a study was conducted to identify functions and knowledge domains
for the levels of disability management (Level I and Level II), as well as what
educational requirements were viewed as best to administer programs at each
level (Currier, Chan, Berven, Habeck 8 Taylor, 2001). This research was
sponsored by the Certiﬁcation of Disability Management Specialists Commission
(CDMSC) which is the only nationally accredited and independent organization
that certiﬁes disability management specialists. Research in this area was

necessary as “research to empirically deﬁne the standards and qualiﬁcations

25

requisite to effective practice, along with credentialing criteria, has been limited”
in the area of disability management (Currier, et al., 2001, p. 134).

For this study two groups of experts in disability management were
selected. The ﬁrst was a project advisory committee consisting of seven
Individuals. These participants were selected as “participants for the advisory
committee on the basis of expertise in disability management as indicated by
exemplary direct service practice in disability management; contributions as
facilitators and presenters in continuing education programs; service on
certiﬁcation commissions and in leadership positions within professional
associations; and research and scholarship” (Cum‘er et al., 2001, p. 134).

The second group, the expert panel, consisted of 44 individuals (64 were
invited initially but 44 actually participated), which were selected by the advisory
committee. Those participants completing a master’s degree in rehabilitation
counseling equaled 43.2% of the participants. The other most common areas of
study cited were rehabilitation psychology, vocational rehabilitation and human
rehabilitation. Other majors included organizational, development/behavior, risk
management, occupational therapy, nursing, health care administration,
psychology, economics, kinesiology/physiology, counseling and business
administration (Currier, et al., 2001).

There were tvvo phases to this study. The ﬁrst included developing a
questionnaire based on input from the advisory committee which, after revision,
included 76 items listing 31 job functions and 45 knowledge items at each

practice level which represented the major disability management practice

26

domains (Level I DM and Level II DM). Respondents were asked to rate
according to degree of importance for job performance using a ﬁve-point Likert-
type scale for each of the disability management practice levels (Currier, et al.,
2001).

The second phase of the study included using the Delphi procedure to
“achieve consensus of expert opinion on the importance of the functions and
knowledge domains for both practice levels, Level I and Level II” (Currier, et al.,
2001, p. 135). The Delphi technique is used to attain consensus among experts
by asking respondents to compare their responses to the questionnaire items
against the overall group median and then reconsider their response if they deem
applicable (Currier, et al., 2001). The revised questionnaire from Part I was sent
to the 64 participants who had agreed to be on the initial expert panel, of which
44 responded for a response rate of 68.8%.

The top ﬁve functions identiﬁed as being more important to Level I
included: (a) conducting corporate analyses to determine the impact of
disabilities on costs and performance; (b) developing a methodology to measure
disability management outcomes relevant to the organization; (c) designing
disability management policies, programs, coordinating structures, protocols, and
retum-to-work plans; (d) motivating the organization and partners with regard to
disability management; and (e) establishing disability management goals related
to corporate mission, strategies, and goals. The top ﬁve functions more
important to Level II included: (a) performing case management functions; (b)

performing retum-to-work functions; (c) providing retum-to-work coordination

27

services; ((1) evaluating, purchasing, and coordinating assistive technologies for
accommodations; and (e) conducting job analyses and job accommodation to
facilitate prevention.

Included in this study were the functions that were common to both Level I
and Level II practice. These included: (a) monitoring and evaluating the impact
of disability management on treatment, retum-to-work, and program outcomes;
(b) training labor and management regarding best practices in disability
management; (c) professional development to keep abreast of state-of-the-art
disability management practices; (d) developing the capacity within the company
to conduct early intervention for retum-to-work; and (e) promoting and marketing
the disability management program internally (Currier, et al., 2001, p. 138-139.)

Results demonstrated that the top ﬁve knowledge domains listed for Level
I disability management practice included: (a) program evaluation and research;
(b) integrated beneﬁts systems and design; (c) cost containment procedures,
strategies, and analysis; (d) integrated beneﬁt systems; and (e) human resource
management principles (Currier et al., 2001). Currier et al., (2001) list the top
ﬁve knowledge domains for Level II disability management to include: (a) medical
aspects of acute and chronic illness and disability; (b) vocational/career
counseling; (c) work adjustment, work transition, and work hardening resources
and strategies; ((1) vocational/career assessment and evaluation; and (e) medical
case management. Knowledge areas common to both Level I and Level II
practice were: (a) rationale for disability management; (b) business practices and

operations; (c) deﬁnition of components of disability management and disability

28

management models; (d) employment and disability-related legislation,
compliance strategies, and program interventions; and (e) corporate lexicon.

Also included in the above study were the minimum educational
requirements for administering programs at each level, as determined by the
expert panel. Rehabilitation counseling was the most frequently given response
as a major for both levels of practice, although other majors were indicated as
well (i.e., human resource management, occupational health nursing, risk
management and insurance, for example) (Currier et al., 2001). A master‘s
degree was indicated for the minimum education level for each level, but it is
important to note that for level II disability management, 45.5% felt a master’s
was the minimum, while 43.2% indicated a bachelor’s degree (Currier et al.,
2001).

Currier et al., (2001) report the above ﬁndings show there are a common
set of functions and knowledge domains that cross Level I and Level II practice
areas of disability management. As reflected in Habeck 8 Kirchner (1999) those
practitioners practicing on Level I provide services more centered on the
employing organization while Level II practitioners are more in line with traditional
vocational rehabilitation and clinical services, i.e. individually based. Since there
were function and knowledge domains that were common to both Level I and
Level II practice'areas, practitioners on either level need to function within the
whole scope of the disability management arena including both the employer and

the workplace (Currier, et al., 2001).

29

Those functions that were selected as being “most essential” emphasized
internal analysis, planning, implementation, marketing, and evaluation signify that
Level II practitioners have an important role to play within disability management,
although they would require additional preparation in management and business
administration (Cunier, et al., 2001). Currier et al., (2001) report that “important
additional content areas would include business concepts, organizational
behavior, risk management, human resource management, insurance and
beneﬁt principles, accounting, business management, and information systems”
(p. 142).

Even though rehabilitation counselors can be viable within Level I, or
employer formulated disability management, further training to fulﬁll important
functions at the organizational level would open an additional venue for
rehabilitation counseling professionals (Currier, et al., 2001). What is not clear is
how rehabilitation counselor educators perceive these roles and functions within
disability management and if they feel prepared to teach students in these areas.

Another study sponsored by CDMSC was conducted by Chan, Taylor,
Currier, Chan, Wood and Lui (2000) to establish job dimensions and knowledge
domains of disability management practice speciﬁcally to determine the work
behaviors of Certiﬁed Disability Management Specialists (CDMS), or Level II
disability management professionals. Participants for this study included
CDMS’s as well as other professionals who practiced in the ﬁeld of disability
management. Respondents work backgrounds included rehabilitation counseling

(31%), general nursing (19%), occupational health nursing (15%), rehabilitation

30

nursing (10%) and human resources (10%). Approximately 23% of the
respondents worked for internal disability management programs, 28% worked
for insurance based, 42% for external disability management vendors and 7% did
not report their work setting (Chan et al., 2000).

The survey instrument created for this study was the Disability
Management Direct Service Providers’ Job Task and Knowledge Inventory,
which was developed by the authors through reviewing disability management
literature, and adopting items from previous studies, including the previous study
mentioned by Currier et al., (2001). The study conducted by Chan et al., (2000)
consisted of 53 items in the job dimension section and 71 items in the knowledge
domain section. A ﬁve-point Likert-type scale was used and participants were
asked to respond to each job task or knowledge statement in regards to its
importance in their practice as a disability management professional.

The Chan et al., (2000) study further built upon the Currier et al., (2001)
study in validating the job dimensions and knowledge domains relevant to Level
II disability management practice. The study also found disability management
professionals attributed different levels of importance for job functions and
knowledge domains based on practice setting and professional background, is.
rehabilitation counselors’ rate vocational rehabilitation job functions higher than
O nurses, while nurses rate the medical case management function as more
important.

Chan et al., (2000) state that “although fundamental training in

rehabilitation is still very important for disability management practice, new

31

knowledge and skills appear to be required, even at the pre-service level of
education” (p. 55). They go further to state that disability management will
continue to be an area of potential growth opportunity for many rehabilitation
disciplines (including rehabilitation counseling) and that ﬁndings from this study
“can assist educators and trainers in the design and implementation of curricula
and materials that address nationally validated knowledge and skill domains in
disability management” and that “this information could beneﬁt pre-service as
well as continuing education programs to organize and prepare curricular training
materials or clinical experiences” (Chan et al., 2000, p. 55).

A follow up role and function study was conducted on behalf of CDMSC in
2004 to determine the prevailing domains of disability management practice and
to ascertain an empirical basis for a certiﬁcation exam for disability management
specialists which would be consistent with changing standards of practice in the
ﬁeld of disability management (Rosenthal, et al., 2007). Rosenthal et al., (2007)
state that “in this rapidly developing ﬁeld (disability management) with a
broadening diversity of interventions and providers’ programs, in-depth research
is essential for standardization, proper credentialing, and emergence of
evidence-based practices to guide further advances in the ﬁeld” (p. 78).

For this study CDMSC gathered a panel of 13 experts in disability
management from government, business, education, health care, insurance, and
public and private practice throughout the United States. From there these
experts utilized the previous CDMSC role and function study conducted by

Currier et a., (2001) as a starting point for updating domains of practice and task

32

statements and for developing a questionnaire. The experts identiﬁed three
corresponding knowledge domains. Domain I, disability case management,
consists of a practitioner working one-on-one with ill/injured employees in
returning them to productive work. Domain ll, disability prevention and
workplace intervention, consists of a more proactive approach in reducing
workers’ compensation claims and costs through early intervention and
remediation. Domain III, the newest domain called “Program development,
management and evaluation”, consists of the design, implementation and
evaluation of programs and utilizing expertise in broader absence management
and health and productivity initiatives (Lui 8 Rosenthal, 2008, p. 10-11).

Both CDMS and non-certiﬁcants were surveyed. Rosenthal et al., (2007)
reported mat “given that a predominant theme generated by the subject matter
experts was that disability management practice has changed considerably over
the past several years, surveying nonparticipants who were practicing disability
management was very important” (p. 79). Scales used in other role and function
studies were reviewed by the expert panel. Three scales seemed the most
central in evaluating the tasks associated with each of the three disability
management knowledge domains including: importance, criticality and frequency
(Rosenthal et al., 2007).

The response rate for this survey was 20% (304 out of 1500), of which
19% of CDMS responded and 22% of non—certiﬁcants responded. Approximately
87.4% of respondents worked full time in the ﬁeld of disability management,

consisting of nurse case managers (40.1%), rehabilitation counselors (19.4%)

33

and disability management consultants (8.8%). Respondents reported that the
quantity of time spent doing speciﬁc work activities included: disability case
management (39.55%), retum-to-work coordinators (26.05%);
managerial/consultive roles in disability management (18.31%) and vocational
counseling, assessment, and job placement/job development (16.09%)
(Rosenthal, et al., 2007).

Changes in how disability management is practiced have been uncovered
in this study through the three domains identiﬁed by the experts and validated by
the respondents (Rosenthal, et al., 2007). This study showed that individual
practices (Level II) and organization practices (Level I) involving disability
management are being blended, especially in the second disability management
domain, disability prevention and workplace intervention. Rosenthal, et al.,
(2007) state that “although past disability management practice has involved a
distinction in function between direct service-oriented function (Level II) and
administration or managerial-oriented function (Level I), employers now place
greater expectations on disability managers to demonstrate a broader range and
more specialized practice that includes an understanding of such advanced
concepts as absence management, presenteeism, integrated beneﬁt practice,
productivity enhancement, and health and wellness paradigms” (p. 82). Due to
these additional knowledge domains in disability management through the
addition of domain lll, practitioners will be expected by employers to be able to
use evidence based practices to demonstrate their accountability (Rosenthal et

al., 2007).

34

While the above study may have had a below expected response rate,
speciﬁcally of CDMS certiﬁcants, it still yields critical information, especially for
rehabilitation counseling educators. Lui 8 Rosenthal (2008) argue that
“educators must encourage more students to broaden their academic pursuits,
such as with courses in human resource management, organizational
development, and business management” and “ﬁeld study to gain practical
experience will also prove necessary for many students who will need to
demonstrate a working knowledge of program design, implementation and
evaluation in order to practice disability management” (p. 10). Disability
management for employers, in a large part, has been attributed to cost savings.
Employers will require evidence and research to validate disability management
services. While rehabilitation counseling has a good foundation, it must go
beyond current rehabilitation certiﬁcation and licensure requirements if
rehabilitation counseling will remain a piece of the disability management ﬁeld

(Lui & Rosenthal, 2008).

DM and Rehabilitation Counseling

Rehabilitation counselors in the private sector have been progressively
practicing in disability management settings (Leahy et al., 2003). Leahy et al.
(2003) also state that rehabilitation counseling, as a whole, has “witnessed
signiﬁcant changes in the delivery of rehabilitation counseling services in the

United States in response to evolving federal legislative mandates, changes in

35

state workers’ compensation laws, the generation of new knowledge, and
changes in the larger business and economic communities” (p. 80).

Shrey et al. (1995) contend that with the recent trends in rehabilitation, the
economy, and workplace show that rehabilitation counselors can play an integral
role in the management of injury and disability in the workplace. Rehabilitation
counselors can practice disability management in a variety of work settings. A
counselor may work as: (a) an employee of a company which is providing
disability management services for its employees; (b) part of an insurance
company offering disability management services; (c) a counselor within a
private-for-proﬁt rehabilitation company offering disability management services;
or (d) an owner of a rehabilitation company offering disability management
services (Brodwin, 2001).

As shown above there are a variety of settings in which rehabilitation
counselors can practice disability management. Due to this it is difﬁcult to
determine the actual number of rehabilitation counselors, yet alone all
professionals practicing in this ﬁeld. Chan et al., (2000) state there are “tens of
thousands of practitioners that describe their work as DM, including professionals
from many educational and experiential backgrounds” (p. 54). However, they
also state that disability management will continue to grow for many rehabilitation
disciplines, including rehabilitation counseling.

Bruyere and Shrey (1991) further acknowledge the role rehabilitation
counseling has in the ﬁeld of disability management as the “development,

implementation, and evaluation of industry-based disability management services

36

requires extensive coordination among employers, labor organizations, attorneys
and health care-allied health professionals in the community“ and “counseling,
case management, and assessment skills are important assets when facilitating
disability resolution services among injured workers” (p. 238). Rehabilitation
counseling holds these assets (counseling, case management, assessment) as
core professional functions.

Habeck et al. (1991) reported that employers will be at different stages of
disability management program implementation, and acceptance and their needs
will vary based on industry and their workforce. It is vital that rehabilitation
counselors consider each organization, and where they fall on the disability
management continuum, in order to effectively assist organizations as a whole,
as well as individual employees (Habeck et al., 1991). In order to do this,
rehabilitation counselors must have an extensive knowledge, and understanding
of disability management.

Rehabilitation counseling must also revisit some models of placement for
people with disabilities. Moving from a “supply side” placement model (serving
individuals with disabilities) to a “demand side” model (understanding the needs,
perspectives, and concerns of employers) will ultimately lead to rehabilitation
counselors Successfully placing more people with disabilities into the labor force
(Rosenthal 8 King, 2008). Rosenthal 8 King (2008) also state that “the demand-
side approach is supported by best practices in disability management” and

disability management “addresses employers’ desires to minimize the cost

37

impact of employee absence and disability, while improving the health and

productivity of employees” (p. 7).

Rehabilitation Counselor Education

Rehabilitation counseling has a long history of empirically deﬁning its’
profession (Emener 8 Rubin, 1980; Leahy, Shapson, 8 Wright, 1987; Leahy et
al., 2003) and the foundation of a profession, such as rehabilitation counseling, is
determined through classifying and deﬁning precise knowledge and skills which
are essential for successful service provision (Szymanski, et al., 1993). However
due to the vibrant rehabilitation environment and expanding areas of research
within rehabilitation counseling it has become increasingly challenging for
rehabilitation educators to remain informed about the profession of rehabilitation
counseling (Emener, Rasch 8 Spector, 1983).

While the accreditation standards for Council on Rehabilitation Education
(CORE) “say very little about employer knowledge as an important skill for
rehabilitation counselors to have”, CORE standards “do acknowledge the need
for rehabilitation counseling students to have an understanding about the
workplace, including business and human resources concepts and terminology;
workplace culture and environment; and employer practices that affect the
employment or return to work of people with disabilities” (Rosenthal 8 King,
2008, p. 8).

Lui 8 Rosenthal (2008) disagree in that “the training and curricula

associated with a CORE accredited program may not be adequate at this time to

38

enable graduates from such programs (rehabilitation and/or vocational
counseling) to enter the labor market with the capacity to provide the complex
array of services associated with domain I" of disability management“ (p. 12).

Zanskas 8 Leahy (2007) further reiterate by stating “although employment
in managed care and disability management settings appears to incorporate
aspects of the knowledge and skill base acquired through traditional rehabilitation
counselor education programs, the literature review suggests these emerging
settings require unique skill sets not previously emphasized or addressed in the
traditional graduate curriculum” (p. 208).
The Aging Workforce

Disability management programs, along with the partnership of
rehabilitation counseling, will become invaluable tools to employers as the
workforce ages. Shrey et al. (1995) reported that before the year 2010 there will
be 74 million people (26% of the US. population) age 55 or older, and 39 million
(14%) over the age of 65. The median age will rise from 33 years old in 1990 to
39 years old in 2010, and this aging workforce will bring with it cumulative trauma
conditions, age related diseases, and occupational diseases, many of which will
become work-related compensable impairments (Shrey et al, 1995). These
work-related compensable impairments will add to an already expensive cost for
employers because payments for workers’ compensation exceed payments for
“state and federal unemployment insurance, food stamps, supplemental security
income, veteran programs or housing programs” (Hester, Decelles 8 Keeper,

1989, p. 213-214).

39

By the year 2020, one in three Americans will be over the age of 50, and
as the workforce ages these disability costs if not attended to will soar (Akabas,
Gates, Galvin, 1992, p. 8). With the age of workers increasing, the incidence,
severity, and duration of disability will increase as well (Vargo 8 Grzanowicz,
2002). To deal with these changes, employers will need to align administrative
procedures, plan designs, and employer culture to support and retain older
workers (Vargo et al., 2002, p. 24). Habeck et al. (1991) agree stating that “as
demographic changes in the labor force threaten proﬁtability, companies are
compelled to maintain the health and productive employment of current skilled
workers and to accommodate older workers with chronic impairments, in
preference to seeking new hires, who may not be available or may not have the
necessary skills” (p. 211).

Many employers once believed that older workers meant higher costs in .
terms of beneﬁts, were absent more due to illness, were not productive and had
more accidents (Corthell, Corthell 8 McAlees, 1991). Corthell et al., (1991)
explained that, except for health insurance which is still being studied, the other
factors listed were not true and that other employers have recognized insurance
costs for older workers are less expensive as they typically have fewer
dependents, don’t need pregnancy insurance, and may have other health
insurance.

Corthell et al. (1991) bring to light three areas regarding older workers
which need to be considered by disability management and rehabilitation

counseling. First, more attention will need to be given in designing jobs and

40

working conditions which are tailored to the unique capabilities, limitations, needs
and preferences of older workers remaining employed. Second, and as
mentioned earlier, employers are realizing the value older workers bring to the
workplace in terms of their experience, knowledge, work habits and attitudes.
Third, many retirees are returning to work to supplement social security income,
even though the laws put heavy restrictions on their earnings (Corthell et al.,

1 991 , p. 29).

I This last point may be the most signiﬁcant, as the major source of income
for older Americans (35%) is Social Security (US. GAO, 2001). In addition,
Habeck (1999) noted that one of the characteristics of some disability
management programs was when retum—to-work was not successful, individuals
were assisted in applying for Social Security Disability Insurance (DI) beneﬁts.
Thus, if disability management programs were not successful, employees were
shifted to public programs (Habeck, 1999).

Unfortunately, shifting individuals from one program to another is a great
disservice, to both the individuals and the programs involved. Additionally, the
Social Security system is facing many problems of its’ own, which may lead to an
increase of older individuals re-entering, or remaining, in the workforce.

In January 2001, the United States General Accounting Ofﬁce released a
report on the Social Security Administration Disability programs. It has reported
that each month the Social Security Administration pays nearly $6 billion in cash
beneﬁts to people with disabilities who are beneﬁciaries of Disability Insurance

(DI) and Supplemental Security Income (SSI). The size of the number of

41

recipients has grown over the past 10 years by 65%, to its current size of 7.5
million (U.S.G.A.O, 2001). The report states that this growth has contributed to
the DI trust fund’s projected insolvency in 2023, and a signiﬁcant increase in
expenditures for SSI beneﬁts, which are paid out of general revenues. The above
ﬁgures show that we an no longer view disability management, rehabilitation
counseling, and public programs (i.e. SSI,,DI) as independent of one another. In
actuality, they are interdependent and will become even more so in the future.
For rehabilitation counseling to remain a viable profession it must move
beyond focusing on disability management as solely a component for returning
people with injuries or disabilities to competitive employment. Rehabilitation
counseling must begin to embrace and understand the challenges employers are
facing and incorporate those ﬁndings into practice through education. However
this cannot be done until we ﬁrst research how rehabilitation counselor
educators” rate identiﬁed disability management knowledge domains on scales of

importance, their own proﬁciency in teaching and student preparedness.

42

Chapter III
Methodology

The purpOse of this quantitative study was to gather data to better
understand which identiﬁed disability management knowledge tasks rehabilitation
counseling educators perceived as important for the ﬁeld of rehabilitation
counseling, how they perceived their own proﬁciency to teach in these areas, as
well how they perceived overall student preparedness. This quantitative
research was obtained through a survey using rating scales with an online
questionnaire which included descriptive and ex post facto design components.
Descriptive statistics were computed for the rehabilitation counseling educators
characteristics based upon the demographic portion of the online questionnaire
(Leedy 8 Orrnrod, 2005). A power analysis was conducted prior to the start of
this study to determine the best sample size of participants needed to run
selected analysis, which was determined to be 197 using a 5% margin of error,
95% conﬁdence level and population size of 400. The ﬁndings from this study will
help better understand educator perceptions of identiﬁed disability management
knowledge tasks and assist in determining potential changes needed in
rehabilitation counseling curriculum.

The research questions this study will address include: (a) rehabilitation
counseling educators perceived importance of identiﬁed disability management
tasks; (b) perceived proﬁciency to teach these tasks; and (c) perceived overall

student preparedness.

43

Participants

The population of interest in this study was rehabilitation counseling
educators. A national sample of participants was drawn using the listing of
accredited member institutions, programs and certiﬁed individual members
obtained through the National Council of Rehabilitation Education (NCRE) 2005-
2006 directory. These names were then cross referenced with institutions
websites to update staff changes and/or email addresses. Faculty participants
were eligible if they obtained the rank of Assistant Professor, Associate
Professor, Professor, adjunct instructor or instructor who was currently involved
in teaching and/or clinical supervision. Based on the above a total of 697 names
and email addresses were obtained for this study.

Instrumentation

For this study a modiﬁed version of the Certiﬁcation of Disability
Management Specialists Commission (CDMSC) Role and Function Analysis
Survey for the Certiﬁed Disability Management Specialist (CDMS) constructed for
the 2004 study to determine the prevailing domains of disability management
practice was used (Rosenthal, et al., 2007).

The 2004 CDMSC Role and Function Analysis Survey was based on
expert panel input. The 13 member panel of experts were from across the
country in government, business, education, health care, insurance, and public
and private practice with criteria for selection based on number of years of
practice in DM or related ﬁelds, management experience in DM, and noteworthy

contributions to the ﬁeld (Rosenthal, et al., 2007). From there, in order to update

44

the domains of practice and task statements, the prior CDMSC role and function
study (Currier et al., 2001) was used as a starting point.

The panel of experts identiﬁed three knowledge domains: (a) disability
case management; (b) disability prevention and workplace intervention; and (c)
program development, management and evaluation. Within domain I there are
10 associated tasks, domain II has 7 tasks and domain III has 9 tasks, for a total
of 26 tasks associated with identiﬁed disability management knowledge domains.
The population sampled included certiﬁed Disability Management Specialists,
lntemational Association of Rehabilitation Professionals, Certiﬁed Occupational
Health Nurses, Certiﬁed Case Managers, Certiﬁed Professional Disability
Managers, and individuals from the database of the Disability Managers
Employers Coalition. A rating for each task statement included a ﬁve point
Likert-type scale for Importance, Criticality, Difﬁculty, Acquisition and Frequency.
These sales were selected as they are often used in practice analysis and other
role and function validation studies (Rosenthal, et al., 2007). '

For this study the 26 tasks related to the three disability management
knowledge domains remained in tact while three, ﬁve point Likert-type scales
were used. The scales used were importance, proﬁciency and preparedness, in
order to address the research questions posed in this study.

The ﬁrst question identiﬁed rehabilitation counselor educators perceived
importance of the 26 identiﬁed disability management knowledge tasks for the
ﬁeld of rehabilitation counseling using the 5-point Likert scale. Participants were

asked to rate the importance of each disability management task using the

45

following 5-point Likert-type scale: 1=not important; 2=somewhat important;
3=important;4=very important; and 5=extremely important.

The second question asked the sample of rehabilitation counselor
edumtors to rate their own perceived instructional proﬁciency to teach the 26
disability management tasks. A modiﬁed scale used by Ebener, Berven 8 Wright
(1993) was used by Zanskas (2007) asking “participants to rate each speciﬁc
area of competence according to their self-perceived ability to teach that
competency” (p. 46). This study modiﬁed that scale and asked participants to
rate their self-perceived proﬁciency to teach each speciﬁc disability management
task by rating each of the 26 tasks in terms of “your own perceived instructional
proﬁciency in teaching these tasks” using the following 5-point Likert-type scale:
1=not proﬁcient; 2=somewhat proﬁcient; 3=proﬁcient; 4=very proﬁcient; and

=extremely proﬁcient.

The third question asked the sample of educators’ to rate perceived
overall student preparedness in the 26 disability management tasks. Overall
student preparedness was linked to educators’ perceived ability of students to
successfully carry out the 26 disability management tasks upon completion of a
Master’s degree in rehabilitation counseling. Participants were asked to rate
overall student preparedness using the following 5-point Likert—type scale: 1=not
prepared; 2=somewhat prepared; 3=prepared; 4=very prepared; and

=extremely prepared.

46

Demographic Questionnaire

Participant attributes were acquired through the use of an 18 item
demographic questionnaire. Information was gathered pertaining to four broad
demographic categories of participants. These included: (a) identifying
characteristics; (b) professional characteristics; (c) participant’s graduate
program disability management content characteristics; and (d) disability
management experience.

Procedures

Since rehabilitation counselor educators represent a small population and
the goal of this study was to generalize the results within the ﬁeld of rehabilitation
counselor education, participation in this web-based survey represented a non-
probability, convenience method of sampling. Participants for this study were
petitioned through individual emails sent to faculty and educators listed in the
2005-2006 NCRE member institution and program membership directory, which
were veriﬁed against institutions websites for accuracy. Participants were sent
details of the study along with an invitation to participate and a link to the web
site containing the survey (Appendix B). In addition, a follow up invitation to
participate, along with a link to the web based survey, was sent to participants
two weeks after the initial invitation was sent (Appendix C). The Research
Committee of the National Council on Rehabilitation Educators approved this
study and gave consent for distribution to the rehabilitation counselor educators

selected to participate.

47

Design

The intent of this web-based quantitative study was to use a modiﬁed
version of the Certiﬁcation of Disability Management Specialists Commission
(CDMSC) role and function study of 2004, and an 18 question demographic
questionnaire, to discover how rehabilitation counselor educators perceived the
importance, their own proﬁciency to teach and student preparedness in 26
disability management tasks (Appendix A). A pilot study, using the modiﬁed
CDMSC survey and demographic questionnaire was conducted with 4 individuals
in the ﬁeld of rehabilitation counseling education to ensure the survey tools were
clear and understandable by survey participants.

. The dependent variables for this investigation were: (a) importance of
identiﬁed knowledge tasks in disability management for the ﬁeld of rehabilitation
counseling; (b) proﬁciency to teach disability management knowledge tasks, and
(c) overall student preparedness in the disability knowledge tasks. The
independent variables for this study were: (a) age; (b) gender; (c) degree; (d)
years of experience as a rehabilitation counselor", (e) previous occupation, and (f)
current RCE curriculum’s emphasis on disability management knowledge and
skill preparation.

This study was approved by Michigan State University’s Institutional
Review Board and classiﬁed within the Exempt 2 category (IRB# - x09-264).
This study fell into the Exempt 2 status as it was a survey interview, education
research and intemet based research. Shannon et al., (2002) study of

experienced survey researchers found that the use of electronic surveys, “were

48

most positive in terms of the reduction of costs (i.e., postage, phone charges)
associated with electronic surveys, the use of electronic mail for pre-notiﬁcation
or follow-up purposes as a complement to other survey delivery methods, and
the compatibility of data with existing software programs” and that “the lack of a
tangible reward would not prevent individuals from responding and that they
would respond to a web-based survey it all they had to do was click on the HTML
address from an email message” (p.1).

Since this study did not have a sponsor there was no risk of conﬂict of
interest. The participants selected for this study were not employees or students
of this researcher, which reduced the threat of coerced participation. Participants
studied were not compensated for their participation and were able to withdraw
from this study at any point in time as this study was voluntary. No vulnerable
populations were engaged in this study as this was a descriptive study focused
on the opinions of rehabilitation counselor educators.

lnfonned consent was addressed through a written form included in the
instructions accompanying the survey questionnaire (Appendix A). The consent
forms were written in the second person, in order to remove any coercive tone
that may have existed. The rehabilitation counselor educator participants were
informed that by selecting to proceed with the survey they were giving their

consent and had agreed to participate.

49

Data Collection

Upon obtaining the dissertation committee’s approval the proposal was
forwarded to the NCRE Research Committee and Michigan States Institutional
Review Board seeking their approval. Upon approval, an email was sent to
eligible educators identiﬁed from the NCRE 2005-2006 directory and veriﬁed
through institutions web sites, with an invitation explaining the study and a link to
the web-based survey site. A follow up email was sent to participants two weeks
after the initial invitation, thanking those who had participated and requesting
participation for those that did not.

This research design also attended to possible participant apprehensions
concerning conﬁdentiality. Survey Monkey was used as the web based
automated survey instrument and even though demographic information was
collected in order to allow this researcher the ability to generalize results, no
personally identifying information was required. Individual survey results were
maintained on Survey Monkey and demographic information obtained was
viewed in aggregate and pulled from a population of rehabilitation counselor
educators, further protecting the privacy of responses. The only potential direct
contact participants in this study could have had with the researcher would be
initiated by the participants themselves to address a question about the study or

request a synopsis of the aggregate ﬁndings of this study.

Data Analysis
Descriptive statistics were calculated for participant characteristics based

on the demographic segment of the questionnaire. Age was a continuous

50

variable. Group means, medians, and standard deviations were calculated and
exhibited in tables for the continuous variables in the entire sample.

In order to further depict this population of rehabilitation counselor
educators, frequencies and percentages were computed for the following
categorical variables: (a) gender; (b) professional certiﬁcation; (0) degree major;
(d) years of experience as a rehabilitation counselor educator; (9) professional
memberships held; (f) years of experience in paid disability management
activities; (h) forms of disability management training received; (i) authored or co-
! authored articles regarding disability management; (i) grants or rfp’s written
related to disability management; (k) the availability of a course emphasizing
disability management knowledge and skill preparation; (I) amount disability
management is emphasized in the curriculum; (m) current faculty rank; (n)
accredited by NCRE; (o) NCRE membership region; (p) number of credit hour
requirements for programs Masters degree in Rehabilitation Counseling; and (q)
who teaches disability management courses for their program.

Exploratory factor analysis was not used in this study as the subject to
item ratio was too low. Research questions one, two and three addressed
rehabilitation counselor educators” perception of the importance of disability
management tasks for rehabilitation counseling practice, their self-perceived
instructional proﬁciency for teaching these tasks and overall student
preparedness. Descriptive statistics were computed for each disability
management task item listed on the questionnaire, the three respective a priori

disability management domains: (a) disability case management; (b) disability

51

prevention and workplace intervention, and (c) program development,
management and evaluation, and total sample scores. Descriptive statistics
were computed based on participant responses to the ﬁve point Likert-type
scales of importance, proﬁciency and preparedness. Group means and standard
deviations were calculated for each item and displayed in a table format.
Reliability coefﬁcients were calculated using Cronbach’s alpha to obtain the
internal consistency and reliability of the items identiﬁed within the three
respective a priori disability management domains.

Multiple analysis of variance (MANOVA) and analysis of variance
(ANOVA) were used to compare the responses of deﬁned subgroups identiﬁed in
the research questions. These included questions 1.a., 2b., and 3.b., which
identiﬁed any differences in level of importance, perceived proﬁciency and
student preparedness across the components of the three disability management
domains. Additional subgroups included questions 1.b., 2.a., and 3.a., which
identiﬁed differences relative to speciﬁc demographic characteristics of faculty
(i.e. gender, years of experience as a rehabilitation counselor educator and
number of years in paid disability management) in relation to perceived
importance, proﬁciency and preparedness. To answer question 2.c., what is the
relationship between educators’ perceptions of the importance and their
pedagogical proﬁciency to teach disability management tasks, Pearson’s product
moment correlation was used to determine any correlation between these two
variables. Post hoc Bonfenoni adjustments were conducted following signiﬁcant

ﬁndings through MANOVA analysis.

52

Chapter IV
Results
Response Rate

Of the original 697 email invitations requesting participation in this study,
101 (14%) were returned as invalid or undeliverable email addresses, 16 (2%)
declined to participate, as they were not involved in the ﬁeld of rehabilitation
counseling and didn’t feel able to respond, and an additional 16 (2%) opted out of
the survey (no reason given).

A second email invitation to participate was sent to the remaining 564
participants, which 89 responded (overall 16% response rate). Of the 89
responses 15 (17%) did not complete any questions past the “Complete
Questionnaire” selection. A total of 3 (3%) did not answer enough questions
throughout the survey to be determined of use by this researcher and 4 (4%) did
not answer any of the questions in Domain III of the survey (program
development, management 8 evaluation). Of the 564 participants a total of 67
(12%) survey responses were deemed usable.

Overall, survey response rates have been on the decline (Groves 8
Couper, 1998). Although many researchers comment positively about the
response rate and speed of email surveys (compared to traditional mail surveys),
most online/electronic surveys have not met the response rate set by traditional
mail techniques (Schaefer 8 Dillman, 1998). One reason for low response rate
can be attributed to the importance of the subject of the study itself, as seen by

participants. Sheehan 8 McMillan (1999) found that “issue salience had a

53

stronger impact on response rate than did any other issue or research-design
decision including advance notice, follow-up contacts, or monetary incentives” (p.
47).

Due to the low response rate caution was taken in analyzing and
interpreting the statistical results of this survey. The initial power analysis
revealed a sample size of 197 was needed. Since the number of usable surveys
was only 67, limited analysis could be conducted.

Characteristics of the Sample

The ﬁnal sample of this study consisted of 67 faculty, instructors and
adjuncts that were either members of NCRE, or were employed by NCRE
member institutions or programs. Tables 1 through 4 displays particlpants’
demographics as well as professional and programmatic characteristics. Age of
participants ranged from 32-65, with a median age of 51.59 years. The sample
consisted of 34 females (50.7%) and 32 males (47.8%). Regarding professional
certiﬁcations (participants could report more than one), 57 (85.1%) reported
being certiﬁed rehabilitation counselors (CRC), 17 (25.4%) indicated they were
national certiﬁed counselors (NCC), 2 (3.0%) listed being certiﬁed case
managers (COM), 3 (4.5%) reported being certiﬁed disability management
specialists (CDMS) and other 8 (11.9%) licensed professional counselor (LPC), 4
i (6.0%) certiﬁed vocational evaluators (CVE) and 3 (4.5%) as licensed
psychologists.

Participants reported their own degree major as: 29 (43.3%) rehabilitation

counselor education, 13 (19.4%) rehabilitation psychology, 9 (13.4%) counselor

54

education, 2 (3.0%) rehabilitation doctorate and 15 (22.4%) listed other as an
option. In regards to the number of years as a rehabilitation counselor educator,
participants reported 1 year or less at 1.5% (n=1), 2-5 years at 21.5% (n=14), 6-
10 years at 26.2% (n=17), 11-15 years at 13.8% (n=9), 16-20 years at 9.2%
(n=6), 21-25 years at 6.2% (n=4), and 26 or more years as a rehabilitation
counselor educator at 21.5% (n=14).

Multiple professional memberships were reported, but only those that had
two or more participants reporting a membership were included in this data.
Professional memberships included, Association for Counselor Education and
Supervision (ACES) 4.5% (n=3), International Association of Rehabilitation
Professionals (IARP) 11.9% (n=8), American Psychological Association (APA)
20.9% (n=14), National Rehabilitation Counseling Association (NRCA) 20.9%
(n=14), American Rehabilitation Counseling Association (ARCA) 35.8% (n=24),
National Rehabilitation Association (NRA) 35.8% (n=24), American Counseling
Association (ACA) 44.8% (n=30) and the National Counsel of Rehabilitation
Educators (NCRE) 55.2% (n=37).

Participants were also asked if they engaged in paid disability
management activities. A total of 30 (44.8%) said yes, while 35 (52.2%) said no.
Of those that stated yes, the number of years reported working in paid disability
management activities were, 1-5 years at 16.4% (n=11), 20 or more years at
11.9% (n=8), 6-10 years and 11-15 years both at 4.5% (n=3), 16-20 years at
3.0% (n=2) and less than one year at 1.5% (n=1). The most reported type of

formal disability management training detailed by participants was workshops at

55

62.7% (n=42) followed by coursework 41.8% (n=28), on-the-job training 38.8%
(n=26), practicum/intemship 31.3% (n=21) and not applicable 16.4% (n=11). Of
those answering yes, 3% (n=1) selected participating in none of the disability
management trainings, 6% (n=2) reported participating in one, 30% (n=9)
reported two, 33% (n=10) reported three and 27% (n=8) reported participating in
all four formal disability management trainings.

Additional questions were asked of participants regarding publications and
grant writing or RFP’s related to disability management. In response to authoring
publications in disability management, participants that reported no were 65.7%
(n=44) and yes 29.9% (n=20). In response to grant writing or RFP’s related to
disability management, 79.1% (n=53) of respondents stated no while 17.9%
(n=12) stated yes.

Current rank of participants included assistant professor 31.3% (n=21),
associate professor 23.9% (n=16), professor 26.9% (n=18), adjunct professor
11.9% (n=8), and professor emeritus, instructor and other (executive director)
were 1.5% (n=1). Additional program questions were asked related to disability
management in participants’ institution. When asked how much disability
management was emphasized in cuniculum 38.8% (n=26) stated it was
somewhat emphasized, 25.4% (n=17) reported not emphasized, 22.4% (n=15)
emphasized, 6.0% (n=4) very emphasized, and 3.0% (n=2) stated extremely
emphasized. Regarding how participants programs offered disability
management curriculum, 74.6% (n=50) reported it was part of another course,

11.9% (n=8) was reported for both required course and an elective, 7.5% (n=5)

56

not applicable, and 3.0% (n=2) for required interdepartmental course and
currently developing course. In relation to who teaches disability management
courses, full time faculty RCE 73.1% (n=49), adjunct or PT faculty 26.9% (n=18),
not applicable 11.9% (n=8), human resources/labor relations or organizational
behavior faculty 3.0% (n=2), and full time interdisciplinary faculty 1.5% (n=1).
Respondents reported master’s degree rehabilitation counselor education
program credit hour requirements to complete the degree at: 48 credit hours
34.4% (n=23), 60 credit hours 31.3% (n=21), 48 or 60 credit hours 13.4% (n=9),
49-59 credit hours 13.4% (n=9), and other 6.0% (n=4). When asked if the
respondents’ college/university was a member of the National Council of
Rehabilitation Educators (NCRE), 94% (n=63) stated yes while 1.5% (n=1)
reported no. Finally, participants were asked to report the NCRE Region they
belonged to. Region IV (19.4%, n=13), Region III (16.4% n=11), and Region V
(13.4%, n=9) were the largest reported. It should be noted that Region X was

accidentally left out as a response available for participants on the web survey.

57

Table 1 - Demographic Characteristics of the Sample

 

 

Variable N Valid %
‘Age
30-35 2 3.1
36-40 9 14.1
41 -45 7 10.9
46-50 9 14.1
51-55 12 18.8
56—60 13 20.3
61-65 12 18.8
Gender
Male 32 47.8
Female 34 50.7
Professional Certiﬁcations*
CRC 57 85.1
NCC 17 25.4
COM 2 3.0
CDMS 3 4.5
Other, LPC 8 1 1 .9
Other, CVE 4 6.0
Other, License Psychologist 3 4.5
Degree Major
Counselor Education 9 13.4
Psy.D. 0 0
Rehabilitation Counselor Education 29 43.3
Rehabilitation Psychology 13 19.4
Rh.D. 2 3.0
Other 15 22.4
Years as a RCE
1 year or less 1 1.5
2-5 years 14 21.5
6-10 years 17 26.2
11-15 years 9 13.8
16-20 years 6 9.2
21-25 years 4 6.2
26+ years 14 21.5

 

*Participants could report more than one.

58

Table 2 — Demographic Characteristics of the Sample

 

 

Variable N Valid %
Professional memberships“ (n>2)
ACES 3 4.5
IARP 8 1 1.9
APA 14 20.9
NRCA 14 20.9
ARCA 24 35.8
NRA 24 35.8
ACA 30 44.8
NCRE 37 55.2
Engaged in paid disability management activities
Yes 30 44.8
No 35 52.2
Years in paid disability management activities
Less than one 1 1.5
1-5 years 11 16.4
6-10 years 3 4.5
1 1-15 years 3 4.5
16-20 2 3.0
20+ years 8 11.9
Not applicable 39 58.2
Types of disability management formal training*
Workshops 42 62.7
Practicum/lntemship 21 31 .3
Coursework 28 41.8
On-the-job training 26 38.8
Not applicable 11 16.4
Authored publications in disability management
Yes 20 29.9
No 44 65.7
Grant writing or RFP’s related to disability management
Yes 12 17.9
No 53 79.1

 

*Participants could report more than one.
Note: N’s do not sum to 67 due to missing data.

59

Table 3 - Demographic Characteristics of the Sample

 

 

Variable N Valid %
Current Rank
Assistant Professor 21 31.3
Associate Professor 16 23.9
Professor 18 26.9
Professor Emeritus 1 1.5
Adjunct Professor 8 11.9
Instructor 1 1.5
Other, Executive Director 1 1.5
Disability management emphasized in curriculum
Not emphasized 17 25 .4
Somewhat emphasized 26 38.8
Emphasized 15 22.4
Very emphasized 4 6.0
Extremely emphasized 2 3.0
Program disability management curriculum offered“
Required course 8 11.9
Required interdepartmental course 2 3.0
Elective 8 1 1 .9
Part of other courses 50 74.6
Currently developing course 2 3.0
Not applicable 5 7.5
Disability management course instructor
Full time faculty RCE 49 73.1
FT faculty interdisciplinary 1 1.5
Adjunct or PT faculty 18 26.9
FT faculty other department 0 0
HR/LR or OB faculty 2 3.0
Not applicable 8 1 1 .9

 

*Participants could report more than one.
Note: N’s do not sum to 67 due to missing data.

60

Table 4 - Demographic Characteristics of the Sample

 

 

Variable N Valid %
Required credit hours for Masters’ degree
48 23 34.3
60 21 31.3
48 or 60 9 13.4
Between 49-59 9 13.4
Other 4 6.0
College/university member of NCRE
Yes 63 94.0
No 1 1.5
NCRE Region
Region I 4 6.0
Region II 3 4.5
Region III 11 16.4
Region IV 13 19.4
Region V 9 13.4
Region VI 5 7.5
Region VII 1 1.5
Region VIII 3 4.5
Region IX 3 4.5

 

*Participants could report more than one.

Note: ResearCher inadvertently left out NCRE Region X from the survey.

61

Disability Management Knowledge Tasks

To address research questions number one, and establish which disability
management knowledge tasks rehabilitation counselor educators perceived as
important for effective rehabilitation counseling practice, the mean and standard
deviation for each item was calculated. Within each a priori domain, each item
was ranked and ordered. A mean score and standard deviation was calculated
for each of the three domains. To signify an item as important, based on group
mean scores, an a priori criterion level of (23.00) was utilized, which is the mid-
point of the Likert-type scale on the Certiﬁcation of Disability Management
Specialists Commission (CDMSC) Role and Function Analysis Survey for the
Certiﬁed Disability Management Specialist (CDMS). Importance of these
disability management knowledge tasks, for effective rehabilitation counseling
practice, will bebdiscussed using this measure. Additionally, four a priori criterion
levels were developed for the aggregate means for each item to illustrate
educators’ perceived level of importance: very important (24.00), important
(M=3.00—3.99), somewhat important (M=2.00-2.99), and not important ($1.99).
Domain and item means and standard deviations are shown in Tables 5 through
7.

Perceived Importance

The ﬁrst domain, disability case management (Table 5), consists
of 10 items associated with a practitioner working one-on-one with ill/injured
employees in returning them to productive work. On the importance scale,

participants rated all 10 items as important (M=3.00-3.99) to very important

62

(M=4.00-4.99), and met the criterion set (23.00), along with the overall mean
score (M=4.05). Cronbach’s alpha coefﬁcient for the importance scale in domain
I for the total sample was .860, which signiﬁes very good internal consistency for
the items in this scale. Pallant (2007) states that Cronbach’s alpha values
“above .7 are considered acceptable; however, values above .8 are preferable”
(p. 98).

The second importance domain, disability prevention and workplace
intervention (Table 6), consists of 7 items related to tasks associated with more
proactive approaches in reducing workers’ compensation claims and costs
through early intervention and remediation. Participants rated all 7 items as
important (23.00) with an overall mean score (M=3.52) for domain Il. These
scores show participants view these tasks as important for effective rehabilitation
counseling practice. Cronbach’s alpha coefﬁcient for the importance scale in
domain II for the total sample was .897, which signiﬁes high internal consistency
for the items in this scale for domain II. I

The third importance domain, program development, management and
evaluation (Table 7), consists of 9 items related to tasks associated with the
design, implementation and evaluation of programs and utilizing expertise in
broader absence management and health productivity initiatives. Participants
rated 8 out of the 9 items as important (23.00). Item 7 (M=2.98) fell below the
criterion set (23.00) for an important rating. The overall mean score (M=3.27) for
domain III shows participants view these tasks as important for effective

rehabilitation counseling practice. Cronbach’s alpha coefﬁcient for the importance

63

scale for domain III for the total sample was .923 which signiﬁes high intemal
consistency for items in this scale for domain III.

In relation to research question number one part a), regarding whether the
levels of importance differed across the three disability management domains,
there were differences among the three domains. Educators rated domain
importance as follows: domain I (M=4.05), domain ll (M=3.52) and domain lll
(M=3.27). While all three domains were important (23.00) the ﬁrst domain was
seen by educators as “very important” while domain II and domain III were seen

as important.

64

Table 5 - Importance Domain I:Disability Case Management

Means and Standard Deviations

 

Disability Case Management Item Means

1. Perform comprehensive individual case analysis and
beneﬁts assessments using accepted practices in order
to develop appropriate interventions.

2. Review disability case management intervention
protocol using standards of care in order to promote
quality care, recovery, and cost effectiveness.

3. Promote collaboration among stakeholders using
communication strategies to optimize functional recovery.

4. Perform worksitefjob analyses using observation,
interview, and records review in order to determine the
requirements of the job.

5. Develop individualized retum-to-work plans consistent
with standards of practices and procedures by
collaborating with relevant stakeholders in order to
facilitate employment.

6. Implement interventions using appropriate counseling
and behavior change techniques in order to optimize
functioning and productivity.

7. Coordinate beneﬁts, services, and community

Resources (e.g., orthotics, prosthetics, FCE, IME, durable
medical, home care, and vocational rehabilitation) through
strategic planning in order to facilitate optimal functioning.

8. Monitor progress for achievement of targeted
milestones through ongoing comparison with established
best-practice guidelines in order to make
recommendations, optimize functional recovery, and
provide needed follow-up.

4.05

4.12

3.74

4.19

3.97

4.24

4.35

4.02

3.61

SD
.59

.87

.88

.89

.83

.81

.69

.95

1.07

 

65

Table 5 (cont'd)

Means and Standard Deviations

 

 

M SD
9. Manage caseload using ethical strategies in order to 4.46 .725
enhance effectiveness and efﬁciency.
10. Prepare case notes and reports using applicable 3.90 .86

forms and systems in order to document case activities
in compliance with standard practices and regulations.

 

66

Table 6 - Importance Domain llzDisability Prevention and Workplace Intervention

Means and Standard Deviations

 

Disability Prevention and Workplace Intervention

1. Implement disability prevention practices (i.e. risk
mitigation procedures such as job analysis, job
accommodation, ergonomic evaluation, health and
wellness initiatives, etc) through training, education,
and collaboration in order to change organizational
behavior and integrate prevention as an essential
component of organizational culture.

2. Develop a comprehensive transitional work program
through consultation with all relevant stakeholders in
order to facilitate optimal productivity and value in the
workplace.

3. Develop an interactive process for job site
modiﬁcation, accommodation, or job task assignment
incorporating appropriate resources (e.g., ergonomics
and assistive technologies) in order to facilitate optimal
functioning in the workplace.

4. Support employment practices that align work abilities
with essential job functions by serving as a resource for
employees and management in order to prevent
disabilities and optimize productivity.

5. Recommend strategies to identify ergonomic, safety,
and risk factors using available resources (e.g., data
and assessment tools) in order to mitigate exposure and
improve employee health.

6: Recommend strategies that integrate beneﬁt plan
designs and related services (e.g., employee assistance
programs, community resources, and medical services)

by evaluating and coordinating delivery in order to promote

prevention, optimal productivity, quality care, and cost
containment.

3.52

3.64

3.56

3.98

3.82

3.32

3.41

SD
.81

1.10

1.01

.92

1.05

1.10

.99

 

67

Table 6(cont‘d)

Means and Standard Deviations

 

7. Recommend health and wellness interventions by
targeting the speciﬁc needs of employees and the
organization in order to increase organizational health

and productivity while demonstrating measureable value.

3.12

SD

1.06

 

68

Table 7 - Importance Domain lllzProgram Development, Management and
Evaluation

Means and Standard Deviations

 

Program Development, Management and Evaluation
Means 3.27 .83

1. Analyze workplace practices (e.g., beneﬁt design; 3.22 1.09
policies and procedures; regulatory and compliance

requirements; employee demographics; and labor

relations) using a needs assessment to establish

baselines and design effective interventions.

2. Present the business rationale for a comprehensive 3.29 .99
disability management program using baseline data,

best practices, evidence-based research, and

benchmarks and incorporating cultural and

environmental factors to secure stakeholder investment

and commitment.

3. Collaboratively develop and manage the disability 3.21 .95
management program by specifying essential procedures

and training components consistent with pertinent

regulations and identifying appropriate services and

metrics in order to offer effective services for stakeholders.

4. Champion individual and organizational behavioral 3.29 1.04
change by assigning responsibility to stakeholders at all

levels of the organization in order to achieve strategic

outcomes.

5. Procure internal and external services using commonly 3.36 1.07
accepted selection criteria to maximize consistency and
desired program outcomes.

6. Manage service providers using stakeholder-deﬁned 3.31 .93
performance standards in order to maximize the quality
of services and the return on investments.

 

69

Table 7 (cont’d)

Means and Standard Deviations

 

 

M SD
7. Facilitate the exchange of data and metrics by 2.98 1.08
integrating information systems for disability
management programs in order to achieve and
report desired program outcomes.
8. Conduct ongoing formative and summative program 3.58 .97
evaluations using qualitative and quantitative methods
to improve process and measure outcomes.
9. Create disability management performance reports 3.09 1.01

and other communication vehicles targeted to relevant
stakeholders using variety of media in order to
promote stakeholder awareness and collaboration.

 

70

Perceived Proﬁciency

To address research question number two, and establish how educators
perceived their own instructional proﬁciency in teaching disability management
tasks, the mean and standard deviation for each item was calculated. Within
each a priori domain, each item was ranked and ordered. A mean score and
standard deviation was calculated for each of the three domains. To signify an
item as important, based on group mean scores, an a priori criterion level of
(23.00) was utilized, which is the mid-point of‘the Likert-type scale on the
Certiﬁcation of Disability Management Specialists Commission (CDMSC) Role
and Function Analysis Survey for the Certiﬁed Disability Management Specialist
(CDMS). Educators’ perceived proﬁciency in teaching these tasks will be
discussed using this measure. Additionally, four a priori criterion levels were
developed for the aggregate means for each item to illustrate educators’
perceived proﬁciency to teach: very proﬁcient (24.00), proﬁcient (M=3.00—3.99),
somewhat proﬁcient (M=2.00-2.99), and not proﬁcient ($1.99). Domain and item
means and standard deviations are shown in Tables 8 through 10.

The ﬁrst proﬁciency domain, disability case management (Table 8),
consists of 10 items related to tasks associated with a practitioner working one-
on—one with ill/injured employees in returning them to productive work.
Participants perceived themselves as proﬁcient on all 10 items (23.00). The
overall mean score (M=3.77) for domain I shows participants perceive

themselves as proﬁcient to teach these tasks. Cronbach’s alpha coefﬁcient for

71

the proﬁciency scale in domain I for the total sample was .849, which signiﬁes
very good internal consistency.

The second proﬁciency domain, disability prevention and workplace
intervention (Table 9), consists of 7 items related to tasks associated with more
proactive approaches in reducing workers’ compensation claims and costs
through early intervention and remediation. Participants rated themselves as
proﬁcient to teach (23.00) in 6 out of the 7 tasks. Task 5 (M=2.98) educator
proﬁciency was rated as “somewhat proﬁcient” to teach these tasks. The overall
mean score (M=3.26) for domain II shows participants view themselves as
proﬁcient in teaching these tasks. Cronbach’s alpha coefﬁcient for this
proﬁciency scale in domain II for the total sample was .889, which signiﬁes high
internal consistency for the items in this scale for domain ll.

1 The third proﬁciency domain, program development, management and
evaluation (Table 10), consists of 9 items related to tasks associated with the
design, implementation and evaluation of programs and utilizing expertise in
broader absence management and health productivity initiatives. Participants
rated themselves proﬁcient on 6 out of the 9 items (23.00). Item 1 (M=2.95), item
3 (M=2.65) and item 7 (M=2.60) were below the proﬁcient rating cutoff (23.00).
The overall mean score (M=3.03) for domain III shows participants view
themselves as proﬁcient to teach these tasks. Cronbach’s alpha coefﬁcient for
the proﬁciency scale for domain III for the total sample was .923 which signiﬁes

high internal consistency for items in this scale for domain III.

72

In relation to research question number two part b), regarding whether the
levels of perceived proﬁciency to teach differed across the three disability ‘
management domains, there were differences among the three domains.
Educators rated their proﬁciency to teach as follows: domain I (M=3.77), domain
ll (M=3.26) and domain III (M=3.03). Educators rated themselves proﬁcient to
teach on all three domains (23.00) and rated their proﬁciency to teach in the

same order as importance (domain I, domain II, domain Ill).

73

Table 8 - Proﬁciency Domain I:Disability Case Management

Means and Standard Deviations

 

M SD
Disability Case Management Item Means 3.77 .62

1. Perform comprehensive individual case analysis and 3.47 1.08
beneﬁts assessments using accepted practices in order
to develop appropriate interventions.

2. Review disability case management intervention 3.12 1.09
protocol using standards of care in order to promote
quality care, recovery, and cost effectiveness.

3. Promote collaboration among stakeholders using 4.16 .86
communication strategies to optimize functional recovery.

4. Perform worksitefjob analyses using observation, 3.93 .94
interview, and records review in order to determine the
requirements of the job.

5. Develop individualized retum-to-work plans consistent 3.77 .96
with standards of practices and procedures by

collaborating with relevant stakeholders in order to

facilitate employment.

6. Implement interventions using appropriate counseling 4.24 .73
and behavior change techniques in order to optimize
functioning and productivity.

7. Coordinate beneﬁts, services, and community 3.65 .95
Resources (e.g., orthotics, prosthetics, FCE, IME, durable
medical, home care, and vocational rehabilitation) through
strategic planning in order to facilitate optimal functioning.

8. Monitor progress for achievement of targeted 3.52 .99
milestones through ongoing comparison with established

best-practice guidelines in order to make

recommendations, optimize functional recovery, and

provide needed follow-up.

 

74

Table 8(cont’d)

Means and Standard Deviations

 

 

M SD
9. Manage caseload using ethical strategies in order to 4.30 .87
enhance effectiveness and efﬁciency.
10. Prepare case notes and reports using applicable 4.01 .93

forms and systems in order to document case activities
in compliance with standard practices and regulations.

 

75

Table 9— Proﬁciency Domain "Disability Prevention and Workplace Intervention

Means and Standard Deviations

 

Disability Prevention and Workplace Intervention

1. Implement disability prevention practices (i.e. risk
mitigation procedures such as job analysis, job
accommodation, ergonomic evaluation, health and
wellness initiatives, etc) through training, education,
and collaboration in order to change organizational
behavior and integrate prevention as an essential
component of organizational culture.

2. Develop a comprehensive transitional work program
through consultation with all relevant stakeholders in
order to facilitate optimal productivity and value in the
workplace.

3. Develop an interactive process for job site
modiﬁcation, accommodation, or job task assignment
incorporating appropriate resources (e.g., ergonomics
and assistive technologies) in order to facilitate optimal
functioning in the workplace.

4. Support employment practices that align work abilities
with essential job functions by serving as a resource for
employees and management in order to prevent
disabilities and optimize productivity.

5. Recommend strategies to identify ergonomic, safety,
and risk factors using available resources (e.g., data
and assessment tools) in order to mitigate exposure and
improve employee health.

6: Recommend strategies that integrate beneﬁt plan
designs and related services (e.g., employee assistance
programs, community resources, and medical services)

by evaluating and coordinating delivery in order to promote

prevention, optimal productivity, quality care, and cost
containment.

3.26
3.29

3.26

3.72

3.72

2.98

3.02

SD

1.08

1.06

1.02

1.23

1.14

 

76

Table 9 (cont’d)

Means and Standard Deviations

 

7. Recommend health and wellness interventions by
targeting the speciﬁc needs of employees and the
organization in order to increase organizational health

and productivity while demonstrating measureable value.

3.00

SD

1.07

 

77

Table 10: Proﬁciency Domain lllzProgram Development, Management and
Evaluation

Means and Standard Deviations

 

Program Development, Management and Evaluation
Means 3.03 .90

1. Analyze workplace practices (e.g., beneﬁt design; 2.95 1.17
policies and procedures; regulatory and compliance

requirements; employee demographics; and labor

relations) using a needs assessment to establish

baselines and design effective interventions.

2. Present the business rationale for a comprehensive 3.02 1.14
disability management program using baseline data,

best practices, evidence-based research, and

benchmarks and incorporating cultural and

environmental factors to secure stakeholder investment

and commitment.

3. Collaboratively develop and manage the disability 2.65 1.08
management program by specifying essential procedures

and training components consistent with pertinent

regulations and identifying appropriate services and

metrics in order to offer effective services for stakeholders.

4. Champion individual and organizational behavioral 3.23 1.19
change by assigning responsibility to stakeholders at all

levels of the organization in order to achieve strategic

outcomes.

5. Procure internal and external services using commonly 3.16 1.13
accepted selection criteria to maximize consistency and
desired program outcomes.

6. Manage service providers usingstakeholder—deﬁned 3.03 1.03
performance standards in order to maximize the quality
of services and the return on investments.

 

78

Table 10 (cont’d)

Means and Standard Deviations

 

 

M SD
7. Facilitate the exchange of data and metrics by 2.60 1.30
integrating information systems for disability
management programs in order to achieve and
report desired program outcomes.
8. Conduct ongoing formative and summative program 3.77 1.06
evaluations using qualitative and quantitative methods
to improve process and measure outcomes.
9. Create disability management performance reports 3.11 1.16

and other communication vehicles targeted to relevant
stakeholders using variety of media in order to
promote stakeholder awareness and collaboration.

 

79

Student Preparedness

To address research question number three, and establish how educators
perceived overall student preparedness in these disability management tasks
upon completion of a Master’s level rehabilitation counseling program, the mean
and standard deviation for each item was calculated. Within each a priori domain,
each item was ranked and ordered. A mean score and standard deviation was _
calculated for each of the three domains. To signify an item as prepared, based
on group mean scores, an a priori criterion level of (23.00) was utilized, which is
the mid-point of the Likert-type scale on the Certiﬁcation of Disability
Management Specialists Commission (CDMSC) Role and Function Analysis
Survey for the Certiﬁed Disability Management Specialist (CDMS). Student
preparedness, will be discussed using this measure. Additionally, four a priori
criterion levels were developed for the aggregate means for each item to
illustrate student preparedness: very prepared (24.00), prepared (M=3.00-3.99),
somewhat prepared (M=2.00-2.99), and not prepared ($1.99). Domain and item
means and standard deviations are shown in Tables 11 through 13.

The ﬁrst preparedness domain, disability case management (Table 11),
consists of 10 items related to tasks associated with a practitioner working one-
on-one with ill/injured employees in returning them to productive work.
Participants perceived students as prepared on 6 of the 10 items (23.00).
Student preparedness was rated as somewhat prepared (M=2.00-2.99) on item 1
(M=2.70), task 2 (M=2.42), item 7 (M=2.86) and task 8 (M=2.89). The overall

mean score (M=2.90) for domain I shows participants perceive students as

80

somewhat prepared in these tasks. Cronbach’s alpha coefﬁcient for this
preparedness scale in domain I for the total sample was .864, which signiﬁes
very good internal consistency for the items in the scale for domain I.

The second preparedness domain, disability prevention and workplace
intervention (T able 9), consists of 7 items related to tasks associated with more
proactive approaches in reducing workers’ compensation claims and costs
through earty intervention and remediation. Participants rated student as
prepared (23.00) on 0 out of the 7 tasks. Educators’ rated students as somewhat
prepared (M=2.00-2.99) on all of these tasks. The overall mean score (M=2.25)
for domain II shows participants view students as somewhat prepared in these
tasks. Cronbach’s alpha coefﬁcient for this preparedness scale in domain II for
the total sample was .898, which signiﬁes high internal consistency for the items
in this scale for domain II.

The third preparedness domain, program development, management and
evaluation (Table 13), consists of 9 items related to tasks associated with the
design, implementation and evaluation of programs and utilizing expertise in
broader absence management and health productivity initiatives. Participants did
not rate students as prepared (23.00) on any of these 9 items. Participants rated
students as somewhat prepared (M=2.00-2.99) on tasks 5 (M=2.27), task 6
(M=2.19) and task 8 (M=2.14). The other tasks students were rated as not
prepared (M=1.00-1.99) including task 1 (M=1.94), task 2 (M=1.73), task 3
(M=1.74) and task 4 (M=1.97). The overall mean score (M=1.88) for domain III

shows participants view students as not prepared (M=1.00-1.99) for these tasks.

81

Cronbach’s alpha coefﬁcient for this preparedness scale for domain III for the
total sample was .903 which signiﬁes high internal consistency for items in this
scale for domain "I.

In relation to research question number three part b) regarding whether
the levels of student preparedness differed across the three disability
management domains, there were differences among the three domains.
Educators rated student preparedness as follows: domain I (M=2.90), domain ll
(M=2.25) and domain I" (1.88). Again, educators rated student preparedness in
the same order as importance, and educator proﬁciency (domain I, domain ll,

domain Ill).

82

Table 11 - Preparedness Domain I:Disability Case Management

Means and Standard Deviations

 

SD

 

Disability Case Management Item Means

1. Perform comprehensive individual case analysis and
beneﬁts assessments using accepted practices in order
to develop appropriate interventions.

2. Review disability case management intervention
protocol using standards of care in order to promote
quality care, recovery, and cost effectiveness.

3. Promote collaboration among stakeholders using
communication strategies to optimize functional recovery.

4. Perform worksitefjob analyses using observation,
interview, and records review in order to determine the
requirements of the job.

5. Develop individualized retum-to-work plans consistent
with standards of practices and procedures by
collaborating with relevant stakeholders in order to
facilitate employment.

6. Implement interventions using appropriate counseling
and behavior change techniques in order to optimize
functioning and productivity.

7. Coordinate beneﬁts, services, and community

Resources (e.g., orthotics, prosthetics, FCE, IME, durable
medical, home care, and vocational rehabilitation) through
strategic planning in order to facilitate optimal functioning.

8. Monitor progress for achievement of targeted
milestones through ongoing comparison with established
best-practice guidelines in order to make
recommendations, optimize functional recovery, and
provide needed follow-up.

2.90
2.70

2.42

3.03

3.18

3.02

3.43

2.86

2.89

.52

.91

.79

.97

 

83

Table 11 (cont’d)

Means and Standard Deviations

 

 

M SD
9. Manage caseload using ethical strategies in order to 3.47 .98
enhance effectiveness and efﬁciency.
10. Prepare case notes and reports using applicable 3.23 .93

forms and systems in order to document case activities
in compliance with standard practices and regulations.

 

84

Table 12- Preparedness Domain II:Disability Prevention and Workplace
Intervention

Means and Standard Deviations

 

Disability Prevention and Workplace Intervention 2.25 .61

1. Implement disability prevention practices (i.e. risk 2.25 .94
mitigation procedures such as job analysis, job

accommodation, ergonomic evaluation, health and

wellness initiatives, etc) through training, education,

and collaboration in order to change organizational

behavior and integrate prevention as an essential

component of organizational culture.

2. Develop a comprehensive transitional work program 2.43 1.00
through consultation with all relevant stakeholders in

order to facilitate optimal productivity and value in the

workplace.

3. Develop an interactive process for job site 2.75 .87
modiﬁcation, accommodation, or job task assignment

incorporating appropriate resources (e.g., ergonomics

and assistive technologies) in order to facilitate optimal

functioning in the workplace.

4. Support employment practices that align work abilities 2.85 .94
with essential job functions by serving as a resource for

employees and management in order to prevent

disabilities and optimize productivity.

5. Recommend strategies to identify ergonomic, safety, 2.13 .98
and risk factors using available resources (e.g., data

and assessment tools) in order to mitigate exposure and

improve employee health.

6: Recommend strategies that integrate beneﬁt plan 2.23 1.04
designs and related services (e.g., employee assistance

programs, community resources, and medical services)

by evaluating and coordinating delivery in order to promote

prevention, optimal productivity, quality care, and cost

containment.

 

85

Table 12 (cont’d)

Means and Standard Deviations

 

7. Recommend health and wellness interventions by
targeting the speciﬁc needs of employees and the
organization in order to increase organizational health

and productivity while demonstrating measureable value.

2.09

SD

1.04

 

86

rpm"? . 6‘

Table 1’3—Preparedness Domain IllzProgram Development, Management and

Evaluation

Means and Standard Deviations

 

SD

 

Program Development, Management and Evaluation
Means

1. Analyze workplace practices (e.g., beneﬁt design;
policies and procedures; regulatory and compliance
requirements; employee demographics; and labor
relations) using a needs assessment to establish
baselines and design effective interventions.

2. Present the business rationale for a comprehensive
disability management program using baseline data,
best practices, evidence-based research, and
benchmarks and incorporating cultural and
environmental factors to secure stakeholder investment
and commitment.

3. Collaboratively develop and manage the disability
management program by specifying essential procedures
and training components consistent with pertinent
regulations and identifying appropriate services and
metrics in order to offer effective services for stakeholders.

4. Champion individual and organizational behavioral
change by assigning responsibility to stakeholders at all
levels of the organization in order to achieve strategic
outcomes.

5. Procure intemal and external services using commonly
accepted selection criteria to maximize consistency and
desired program outcomes.

6. Manage service providers using stakeholder-deﬁned
performance standards in order to maximize the quality
of services and the return on investments.

1 .88

1.94

1.73

1.74

1.97

2.27

2.19

.67
.97

.95

.90

.99

.92

1.07

 

87

Table 13- (cont’d)

Means and Standard Deviations

 

 

M SD
7. Facilitate the exchange of data and metrics by 1.81 1.01
integrating information systems for disability
management programs in order to achieve and
report desired program outcomes.
8. Conduct ongoing formative and summative program 2.14 .84
evaluations using qualitative and quantitative methods
to improve process and measure outcomes.
9. Create disability management performance reports 1.98 1.00

and other communication vehicles targeted to relevant
stakeholders using variety of media in order to
promote stakeholder awareness and collaboration.

 

88

Table 14 - Overall Scale Means for Combined 26 Items

Means and Standard Deviations

 

 

M SD
Importance 3.63 .67
Proﬁciency 3.38 .72
Preparedness 2.38 .52

 

Table 14 shows the overall means and standard deviations for the scales for
the combined 26 items. Consisteme ratings from educators listed importance
(M=3.63), proﬁciency (M=3.38) and preparedness (M=2.38) in that order. Based
on the Likert type scales used for this survey, importance and proﬁciency were
between the 3.00 and 3.99 range resulting in educators rating the tasks as
“important” and themselves as “proﬁcient” in teaching the disability management
tasks. Preparedness was rated between the 2.00 and 2.99range, “somewhat
prepared”, for the 26 tasks.

Cronbach’s index of intemal consistency (a), or the probability of Type I error,
was calculated for each scale overall (Table 15) and showed, importance (a
=.956), proﬁciency (a =.954), and preparedness (0:930). All three of these
scales were 2 .900 showing high internal consistency. Table 16 reports
Cronbach’s alpha for each scale by domain. Cronbach’s alpha ranged from .849

for the proﬁciency scale, disability case management domain (domain I), to .923

89

for both the importance scale and proﬁciency scale for, program development,
management and evaluation domain (domain III).

Corrected item-total correlation and the corresponding alpha if an item were
deleted were evaluated. Data showed there was minimal yield in terms of
improving interitem reliability if an item were deleted as there were no items less
than .3 in corrected item-total correlation, and no item greater than the item in
alpha, in item deleted category, which would have indicated the item was

measuring something different from the scale as a whole (Pallant, 2007).

90

Table-15 Reliability Importance, Proﬁciency and Preparedness Scales

 

 

Scale 0

Importance .956
Proﬁciency .954
Preparedness .930

 

Reliability Coefﬁcients 3 items. N=26

Table-16 Reliability Importance, Proﬁciency and Preparedness Scales by
Disability Management Domain

 

 

Scale (1
Importance
Disability Case Management* .860
Disability Prevention and Workplace lntenrention" .897
Program Development, Management and Evaluation*** .923
Proﬁciency
Disability Case Management* .849
Disability Prevention and Workplace Intervention“ .889
Program Development, Management and Evaluation*** .923
Preparedness
Disability Case Management* .864
Disability Prevention and Workplace Intervention” .898
Program Development, Management and Evaluation*** .903

 

*N=10, “N=7, ***N=9

91

Demographic Differences in lmportance, Proﬁciency and Preparedness

To address the research questions regarding whether demographic variables
inﬂuence educator’s perception of the importance of the three disability
management domains, independent samples t-test were conducted.
Demographic characteristics looked at below were educators: (a) gender, (b)
whether they engaged in paid disability management activities; (c) if they
authored or co-authored any articles related to disability management that were

published in peer reviewed journals, book chapters and/or books; and (d) if they

 

have written any grants or completed and requests for proposals related to
disability management. The demographic characteristics were compared on
each scale importance, proﬁciency and preparedness based on the three
disability management domains; domain I: disability case management, domain
ll: disability prevention and workplace intervention, and domain Ill: program
development, management and evaluation.

A series of multivariate analysis of variance (MANOVA) Were conducted using
the General Linear Model with Type IV sum of squares in SPSS. The three
overall scales (importance, proﬁciency, and preparedness) across the three
disability management domains were set as the dependent variables.
Independent variables included emphasis of disability management in participant
master’s curriculum and the number of credit hours for completion of the degree.
An alpha level of .05 was used for both the t-tests and MANOVA analysis.

Upon ﬁnding a signiﬁcant multivariate F (Wllks Iambda=.65, F(9,107) = 2.33,

p=.019), a univariate ANOVA was calculated for each dependent variable. In

92

order to reduce Type I error a Bonferroni adjustment was made. As
recommended by Tabachnick 8 Fidell (2007) the alpha was divided by the
number of dependent variables investigated (alpha=.05/3 = .017) (p. 270).
Demographic Variables and Importance
To address research question 1 b), independent-sample t-tests were
conducted. The independent t-test comparing gender and importance for domain I,
I, shows no signiﬁcant difference in scores for males (M=4.10, SD=.63) and

females (M=4.00, SD=.54); t (60) = .69, p=.49 (two-tailed). For domain II there

 

was no signiﬁcant difference in scores for males (M=3.66, SD=.79) and females i
(M=3.48, SD=.83); t (61) = .86, p=.39 (two-tailed). Domain Ill showed signiﬁcant

differences in scores for males (M=3.48, SD=.83) and females (M=3.08,

SD=.75); t (60) = 1.99, p= .05 (two-tailed).

The independent t-test comparing whether educators engaged in paid
disability management activities and importance of domain I, shows no signiﬁcant
difference in scores for those answering yes (M=4.16, SD=.52) and no (M=3.96,
SD=.63); t (59) = 1.33, p= .19 (two-tailed). For domain II there was no signiﬁcant
difference in scores for those anSwering yes (M=3.71, SD=.73) and no (M=3.39,
SD=.85); t (60) = 1.62, p=.11 (two-tailed). For domain Ill there was signiﬁcant
difference in scores for those answering yes (M=3.59, SD=.74) and no (M=3.00,
SD=.78); t (60) = 3.03, p=.004 (two-tailed).

The independent t-test comparing whether educators authored or co-authored
(and published) articles regarding disability management and perceived

importance for domain I, show no signiﬁcant difference in scores for those

93

answering yes (M=4.11, SD=.57) and no (M=4.00, SD=.60); t (58) = .62, p=.54
(two-tailed). For domain ll there was signiﬁcant difference in scores for those
answering yes (M=3.89, SD=.67) and no (M=3.41, SD=.85); t (59) = 2.23, p=.030
(two-tailed). Domain III also showed signiﬁcant difference in scores for those
answering yes (M=3.67, SD=.74) and no (M=3.09, SD=.80); t (58) = 2.65, p=
.010 (two-tailed).

The independent t-test comparing whether educators had written any grants
or requests for proposals related to disability management and perceived
importance for domain I, show signiﬁcant difference in scores for those
answering yes (M=4.41, SD=.39) and no (M=3.95, SD=.59); t (59) = 2.53, p=.014
(two-tailed). Domain II shows signiﬁcant difference in scores for those answering
yes (M=4.03, 80:65) and no (M=3.47, SD=.82); t (60) = 2.10, p= .04 (two-
tailed). Domain III also shows signiﬁcant difference in scores for those
answering yes (M=3.90, SD=.83) and no (M=3.15, SD=.76); t (59) = 2.81, p=.007
(two-tailed).

A series of four, one-way analysis of variance (ANOVA) were run to
determine whether educators perception of the importance of identiﬁed disability
management tasks, along the three disability management domains, differed due
to how much disability management was emphasized in educators overall
masters level rehabilitation counseling curriculum. For the tests of signiﬁcance,
the alpha of .017 was established using the Bonferroni adjustment. As reﬂected
in Tables 17 through 20 none of the four ANOVAs showed the effect of the

dependent variables were signiﬁcant.

94

 

Table 17 - One Way Analysis of Variance for Disability Management Emphasis
and Overall Importance

 

 

Source SS df MS F Sig
Between 1 .266 4 .317 .669 .616
Within 23.179 49 .473

Total 24.445 53

 

Table 18 — One Way Analysis of Variance for Disability Management Emphasis
and Domain l Importance

 

 

Source SS df MS F Sig
Between .600 4 .150 .436 .782
Within 18.946 55 .344

Total 19.546 59

 

Table 19 - One Way Analysis of Variance for Disability Management Emphasis
and Domain ll Importance

 

 

Source SS df MS F Sig
Between 2.074 4 .519 .766 .552
Within 37.920 56 .677

Total 39.995 60

 

95

 

Table 20 — One Way Analysis of Variance for Disability Management Emphasis
and Domain Ill Importance

 

 

Source SS df MS F Sig
Between 2.509 4 .627 .937 .449
Within 36.811 55 .669

Total 39.320 59

 

Demographic Variables and Proﬁciency

To address research question 2 a), independent-sample t-tests were
conducted. The independent t-test comparing gender and proﬁciency for domain
I, shows no signiﬁcant difference in scores for males (M=3.86, SD=.65) and
females (M=3.73, SD=.60); t (60) = .81, p= .42 (two-tailed). For domain Il there
was no signiﬁcant difference in scores for males (M=3.37, SD=.89) and females
(M=3.16, SD=.81); t (60) = .98, p= .33 (two-tailed). There was also no signiﬁcant
difference in scores in domain III for males (M=3.21, SD=.87) and females
(M=2.93, 30:92); t (60) = 1.20, p=.23 (two-tailed).

The independent t-test comparing whether educators engaged in paid
disability management activities and proﬁciency in all three domains. Domain I
shows signiﬁcant difference in scores for those answering yes (M=4.01, SD=.62)
and no (M=3.61, SD=.58); t (59) = 2.57, p=.013 (two-tailed). In domain ll there
were signiﬁcant difference in scores for those answering yes (M=3.56, SD=.80)

and no (M=2.98, SD=.81); t (59) = 2.80, p=.007 (two-tailed). There was also

96

signiﬁcant difference in scores in domain III for those answering yes (M=3.40,
SD=.87) and no (M=2.79, SD=.84); t (60) = 2.81, p=.007 (two-tailed).

The independent t-test comparing whether educators authored or co-authored
(and published) articles regarding disability management and proﬁciency in
domain I show no signiﬁcant difference in scores for those answering yes
(M=3.97, SD=.67) and no (M=3.70, SD=.60); t (58) = 1.49, p=.14 (two-tailed).
For domain ll there was no signiﬁcant difference in scores for those answering
yes (M=3.54, SD=.86) and no (M=3.12, SD=.82); t (58) = 1.83, p=.07 (two-tailed).
There were also no signiﬁcant difference in scores in domain III for those who
answered yes (M=3.39, SD=.88) and no (M=2.93, SD=.90); t (58) = 1.84, p=.07
(two-tailed).

The independent t-test comparing whether educators had written any grants
or requests for proposals related to disability management and proﬁciency in
domain I show signiﬁcant difference in scores for those answering yes (M=4.3,
SD=.50) and no (M=3.66, SD=.59); t(59) = 3.47, p=.001 (two-tailed). Domain II
shows signiﬁcant difference in scores for those answering yes (M=3.90, SD=.84)
and no (M=3.14, SD=.81); t (59) = 2.70, p=.009 (two-tailed). Domain III also
shows signiﬁcant difference in scores for those answering yes (M=3.96, SD=.89)
and no (M=2.90, SD=.81); t (59) = 3.72, p=000 (two-tailed).

A series of four, one-way analysis of variance (ANOVA) was run to determine
whether educators perceived proﬁciency in teaching identiﬁed disability
management tasks, along the three disability management domains, differed due

to how much disability management was emphasized in educators overall

97

masters level rehabilitation counseling curriculum. For the tests of signiﬁcance

an alpha of .017 was set. As reﬂected in Tables 21 through 24 none of the four

ANOVAs showed that effect of the dependent variables were signiﬁcant.

Table 21 — One Way Analysis of Variance for Disability Management Emphasis
and Overall Proﬁciency

 

 

Source SS df MS F Sig
Between 2.815 4 .704 1 .345 .267
Within 25.125 48 .523

Total 27.940 52

 

Table 22 — One Way Analysis of Variance for Disability Management Emphasis

and Domain I Proﬁciency

 

 

Source 88 df MS F Sig
Between 1 .774 4 .443 1 .148 .344
Within 21 .235 55 .386

Total 23.009 59

 

98

 

 

Table 23 - One Way Analysis of Variance for Disability Management Emphasis
and Domain Il Proﬁciency

 

 

Source SS df MS F Sig
Between 3.045 4 .761 1 .037 .396
Within 40.371 55 .734

Total ‘ 43.416 59

 

Table 24 - One Way Analysis of Variance for Disability Management Emphasis
and Domain lll Proﬁciency

 

 

Source SS df MS F Sig
Between 6.161 4 1.540 1.958 .114
Within 43.270 55 .787

Total 49.431 59

 

Demographic Variables and Preparedness
To address research question 3 a), independent-sample t-tests were
conducted. The independent t-test comparing gender and preparedness for
domain I, shows a signiﬁcant difference in scores for males (M=3.19, SD=.65)
and females (M=2.80, SD=.52); t (60) = 2.64, p=.01 (two-tailed). For domain II
there was no signiﬁcant difference in scores for males (M=2.51, SD=.73) and

females (M=2.24, so=.77); t (.59) = 1.41 ,-p=.17 (two-tailed). Domain III also

99

 

showed a signiﬁcant difference in scores for males (M=2.15, SD=.69) and
females (M=1.78, SD=.70); t (58) = 2.08, p=.04 (two-tailed).

The independent t-test comparing whether educators engaged in paid
disability management activities and student preparedness for domain I shows
no signiﬁcant difference in scores for those answering yes (M=2.98, SD=.66) and
no (M=3.02, SD=.59); t (59) = -.31, p=.76 (two-tailed). For domain II there was
no significant difference in scores for those answering yes (M=2.44, SD=.86) and
no (M=2.32, SD=.67); t (58) = .62, p=.54 (two-tailed). For domain Ill there was
no significant difference in scores for those answering yes-(M=1.88, SD=.71) and
no (M=2.00, SD=.73); t (58) = -.66, p=.51 (two-tailed).

The independent t-test comparing whether educators authored or co-authored
(and published) articles regarding disability management and perceived student
preparedness for domain I show no signiﬁcant difference in scores for those
answering yes (M=2.93, SD=.70) and no (M=2.99, SD=.59); t (58) = -.36, p=.72
(two-tailed). Domain ll showed no signiﬁcant difference for those answering yes
(M=2.48, SD=1.00) and no (M=2.29, SD=.65); t (57) = .86, p=.39 (two-tailed).
Domain III shows no signiﬁcant difference in scores for those answering yes
(M=1.94, SD=.80) and no (M=1.94, SD=.70); t (56) = .02, p=.99 (two-tailed).

The independent t-test comparing whether educators had written any grants
or requests for proposals related to disability management and preparedness for
domain I show no signiﬁcant difference in scores for those answering yes
(M=3.05, SD=.67) and no (M=2.97, SD=.61); t (59) = .43, p=.67 (two-tailed). For

domain II there was no signiﬁcant difference in scores for those answering yes

100

(M=2.36, SD=.83) and no (M=2.35, SD=.76); t (58) = .01, p=.99 (two-tailed).
Domain lll showed no signiﬁcant difference in scores for those answering yes
(M=1.93, SD=.92) and no (M=1.95, SD=.69); t (57) = -.09, p=.93 (two-tailed).

A series of four, one-way analysis of variance (ANOVA) was run to determine
whether educators perception of student preparedness in identiﬁed disability
management tasks, along the three disability management domains, differed due
to how much disability management was emphasized in educators overall
masters level rehabilitation counseling curriculum. For the tests of signiﬁcance
an alpha of .017 was established. As reﬂected in Tables 25 through 28 all four

ANOVAs showed that the effect of the dependent variables were signiﬁcant.

Table 25 - One Way Analysis of Variance for Disability Management Emphasis
and Overall Preparedness

 

 

Source 88 df MS F Sig
Between 4.525 3 1 .508 7.279 .000
Within 9.946 48 .207

Total 14.472 51

 

101

Table 26 — One Way Analysis of Variance for Disability Management Emphasis

and Domain l Preparedness .

 

 

Source SS df MS F Sig
Between 6.677 4 1 .669 5.786 .001
Within 15.866 55 .288

Total 22.543 59

 

Table 27 — One Way Analysis of Variance for Disability Management Emphasis

and Domain ll Preparedness

 

 

Source 88 at MS F Sig
Between 11.253 4 2.813 6.615 .000
Wlthin 22.965 54 .425

Total 34.219 58

 

Table 28 - One Way Analysis of Variance for Disability Management Emphasis

and Domain III Preparedness

 

 

Source SS df MS F Sig
Between 13.426 3 4.475 14.510 .000
Within , 16.654 54 .308

Total 30.080 57

 

102

Relationship Between Perceptions of Importance and Proﬁciency

To answer research question 2 c) regarding the relationship between
educators’ perceptions of the importance and their perceived instructional
proﬁciency to teach disability management tasks, a Pearson’s product moment
correlation was calculated for the data overall and by domain (Tables 2932).
Educators’ perception of the importance of disability management tasks (by
domain) was used as the constant and educators perceived proﬁciency in
teaching these tasks was used as the dependent variable.

Table 29 shows the correlation between the educators’ perceptions of overall
importance and their own proﬁciency in teaching these tasks, was high and
positively correlated between the two variables, r = .578, n= 56, p < .01 (Cohen,
1988). Table 30 shows the correlation between the educators’ perceptions of
domain I importance and their own proﬁciency in teaching, was high and
positively correlated, r= .641, n=63, p< .01. There was also a high and positive
correlation between educators’ perceptions of domain ll importance and their
own proﬁciency in teaching these tasks, F .508, n=63, p< .01 (Table 31). Table
32 shows again a high and positive correlation between educators’ perceptions

of domain lll importance and their proﬁciency in teaching, l=.607, n=63, p< .01).

103

Table 29 — Correlation Overall Importance and Proﬁciency

 

Overall Importance Overall Proﬁciency

 

Overall Importance Pearson Correlation 1 .578“

Sig. (2-tailed) .000

N 57 .56

Overall Proﬁciency Pearson Correlation .578“ 1
Sig. (2-tailed) .000

N 56 56

 

“Correlation is signiﬁcant at the .01 level (two-tailed).

Table 30 — Correlation Domain I Importance and Proﬁciency

 

Domain l Importance Domain l Proﬁciency

 

Domain I Importance Pearson Correlation 1 .641“
Sig. (2-tailed) .000

N 63 63

Domain I Proﬁciency Pearson Correlation .641“ 1

Sig. (2-tailed) .000
N 63 63

 

“Correlation is signiﬁcant at the .01 level (two-tailed).

104

Table 31 - Correlation Domain ll Importance and Proﬁciency

 

Domain II Importance Domain lI Proﬁciency

 

Domain ll Importance Pearson Correlation 1 .508“
Sig. (2-tailed) .000

N 64 63

Domain ll Proﬁciency Pearson Correlation 508* 1

Sig. (2-tailed) .000
N 63 63

 

“Correlation is signiﬁcant at the .01 level (two-tailed).

Table 32 - Correlation Domain Ill Importance and Proﬁciency

 

Domain Ill Importance Domain lll Proﬁciency

 

Domain lll Importance Pearson Correlation 1 .607“
Sig. (2-tailed) .000

N 63 63

Domain III Proﬁciency Pearson Correlation .607“ 1

Sig. (2-tailed) .000
N 63 63

 

“Correlation is signiﬁcant at the .01 level (two-tailed).

105

l W P’. n‘ -1.§‘hIL-nﬁ
,"
I

Chapter V
Discussion

The purpose of this study was to determine which disability management
tasks, associated with three speciﬁc domains, rehabilitation counselor educators
perceived as important for rehabilitation counseling practice, their perceived level
of proﬁciency in teaching these tasks, and overall student preparedness in these
tasks upon completion of a Master’s level rehabilitation counseling program. The
three disability management domains were disability case management (domain
I), disability prevention and workplace intervention (domain II), and program
development, management and evaluation (domain III). This study also focused
on whether educators’ perceptions of importance, proﬁciency and preparedness
differed according to demographic characteristics and whether there was a
relationship between educators’ perceptions of the importance and their own
perceived proﬁciency to teach tasks within these domains.

In order to address the research questions mentioned above, a
quantitative study was conducted utilizing a modiﬁed version of the Certiﬁcation
of Disability Management Specialists Commission (CDMSC) Role and Function
Analysis Survey for the Certiﬁed Disability Management Specialist (CDMS)
constructed for a 2004 study, as well as an 18 item demographic survey. An a
priori criterion of (23.0) was established for the importance, proﬁciency and
preparedness of disability management task, or domains of tasks, from this

survey.

106

An evaluation of the item mean scores shows 25 of the 26 importance
items met or exceeded the criterion set for importance. The one item that did not
meet the a priori criterion for importance was from domain III. A review of the
item mean scores shows 22 of the 26 proﬁciency items met or exceeded the
criterion set for proﬁciency. One item from domain ll did not meet the minimum
set, and 3 items from domain Ill did not meet the minimum criterion for
proﬁciency. Evaluating the item mean scores for the a priori criterion for
preparedness reveals only 6 of the 26 items met the criterion set for
preparedness. Reviewing by domain for preparedness shows that 4 items from
domain I, and all of the items from domain ll (7 items) and domain III (9 items)
did not meet the minimum criterion set for preparedness. For domain III, 3 of the
9 items were rated between 2.00-2.99 (somewhat prepared) and 6 of the 9 were
rated at 1.00-1.99 (not prepared). The item mean scores for the three domains

consisting of importance, proﬁciency and preparedness are reﬂected in Table 33.

Table 33 - Importance, Proﬁciency, and Preparedness Item Means by Domain

 

 

Domain Importance Proﬁciency Preparedness
Domain I 4.05 (SD=.58) 3.77 (SD=.62) 2.90 (SD=.61)
Domain II 3.52 (SD=.81) 3.26 (SD=.84) 2.25 (SD=.76)
Domain III 3.27 (SD=.80) 3.03 (SD=.90) 1.88 (SD=.71)

 

107

On average rehabilitation counselor educators reported they felt the tasks
within the three disability management domains were important or very
important. Educators’ reported being proﬁcient at teaching tasks within the three
disability management domains, with the exception of domain Ill where 3 of the 4
items did not meet minimum criterion. Regarding student preparedness, a
majority of the disability management tasks did not meet the minimum criterion
set, including all of the tasks in domain II and domain III. A high and positive
correlation was also revealed in this study, implying a relationship between
rehabilitation counselor educators’ perception of the importance of disability
management tasks and their self-reported instructional proﬁciency in teaching

these tasks (overall and across the three domains).

Perceived Importance

Rehabilitation counselor educators perceived 25 of the 26 disability
management tasks as important (23.00) and 7 tasks as very important (4.00-
4.99). The only task not to meet the minimum criterion was from domain III, and
included: facilitating the exchange of data and metrics by integrating information
systems for disability management programs in order to achieve and report
desired program outcomes (M=2.98).

The six tasks rated by educators as very important were all from domain I.
Rated highest by educators were: managing caseload using ethical strategies to
enhance effectiveness and efﬁciency (M=4.46), implementing interventions using

appropriate counseling and behavior change techniques in order to optimize

108

 

 

functioning and productivity (M=4.35), develop individualized retum-to-work plans
consistent with standards of practices and procedures by collaborating with
relevant stakeholders in order to facilitate employment (M=4.24), promoting
collaboration among stakeholders using communication strategies to optimize
functional recovery (M=4.19), perform comprehensive individual case analysis
and beneﬁts assessments using accepted practices in order to develop
appropriate interventions (M=4.12) and coordinate beneﬁts services and
community resources through strategic planning in order to facilitate optimal
functioning (M=4.02).

Educators’ rated domain I as the most important, as shown by overall item
mean, with all items rated as very important captured in this domain as well.
Since domain I, disability case management, primarily consists of tasks
associated with individual practice, it makes sense that rehabilitation counselor
educators would place more importance on this domain and associated disability
management tasks. Domain I focuses on the practitioner working one-on-one
with injured and ill employees to return them to productivity in the workplace (Lui
8 Rosenthal, 2008). Leahy (2004) further explains this focus of rehabilitation
counselors on individuals by stating, “regardless of variations in their employment
setting and client population, most rehabilitation counselors (a) assess needs, (b)
establish a working alliance with the individual to develop goals and
individualized plans to meet identiﬁed needs, and (0) provide or arrange for

therapeutic services and interventions (e.g., psychological, medical, social,

109

behavioral), including job placement and follow-up services” (p. 143). These
same goals are reﬂected in the disability management tasks of domain I.

Comparing importance item mean scores by domain, educators rated
domain I as most important (M=4.05), followed by domain ll (M=3.52) and ﬁnally
domain In (M=3.27). Domain l is the most important to educators when
compared to the other domains. This is consistent with the outcome of the 2004
Certiﬁcation of Disability Management Specialists Commission (CDMSC) Role
and Function Analysis Survey for the Certiﬁed Disability Management Specialist
(CDMS) study conducted by Rosenthal, et. al., (2007) which this current study is
based on. In the Rosenthal et al., (2004) study, domain I was seen as the most
important by survey respondents, consisting of 304 disability management
specialists, as shown by M=4.55 (SD=.67). It should be noted that the
importance scale was the only one shared by both this survey and the 2004
CDMS survey.

Educators’ rated all disability management tasks associated with domain II
(disability prevention and workplace intervention) as important. The top three
rated tasks in domain II by importance were: develop an interactive process for
job site modiﬁcation, accommodation, or job task assignment incorporating
appropriate resources in order to facilitate optimal functioning in the workplace
(M=3.98), support employment practices that align work abilities with essential
job functions by serving as a resource for employees and management in order
to prevent disabilities and optimize productivity (M=3.82), and implement

disability prevention practices through training, education and collaboration in

110

 

 

order to change organizational behavior and integrate prevention as an essential
component of organizational culture (M=3.64).

Comparing item means scores by domain II for importance, shows that
educators in this study rated domain II as second most important (M=3.52,
SD=.81) as did respondents in the Rosenthal, et al., (2007) study (M=3.89,
SD=.99). Domain II consists of more proactive approaches in reducing workers’
compensation claims and costs through early intervention and remediation.
Rosenthal et al, (2007) explain that previous surveys involving disability
management, (e.g., Chan, Currier, Taylor, Wood, 8 Lui, 1999: Chan et al., 2001)
describe disability management being practiced on two levels, Level I
(organizationally) and Level II (individually). What has been shown through by
the Rosenthal et al., (2007) study is that the two previous disability management
levels are now being “blended”, predominantly in domain II. Lui 8 Rosenthal
(2008) further explain the changing of the disability management ﬁeld in relation
to the previous Level I and Level II associated with disability management. They
explain that domain I is now most associated with what was previously
expressed as Level II, domain III is most associated with Level I, and domain II is
a blending of the two.

Within domain lll (program development, management and evaluation),

' eight of the nine tasks were ranked as important to educators’. The three highest
ranked tasks in domain lll included: conduct ongoing formative and summative
program evaluations using qualitative and quantitative methods to improve

process and measure outcomes (M=3.58), procure internal and external services

111

 

using commonly accepted selection criteria to maximize consistency and desired
program outcomes (M=3.31), and manage service providers using stakeholder-
deﬁned performance standards in order to maximize the quality of services and
the return on investments (M=3.31).

Comparing item means scores by domain III for importance, shows that
educators in this study rated domain III as third most important (M=3.27, SD=.83)
as did respondents in the Rosenthal, et al., (2007) study (M=3.35, SD=1.22).
Domain III consists of the design, implementation and evaluation of programs
and utilizing expertise in broader absence management and health and
productivity initiatives.

In relation to demographic characteristics and importance, no signiﬁcant
differences were found in relation to whether educators perception of the
importance of identiﬁed disability management tasks, along the three domains,
differed due to how much disability management was emphasized in educators
overall master’s level rehabilitation counseling curriculum, or the number of credit
hours required for completion of a master’s degree in their program. There were
signiﬁcant differences in other demographic characteristics of educators and their
perceived importance of disability management tasks along the three domains
when independent t-tests were conducted.

In relation to gender and importance of domain lll there was signiﬁcant
differences in scores for males and females. It is unclear why there is this
difference in relation to gender and importance of domain lll. There was no

demographic difference in relation to gender and importance for the Rosenthal et

112

 

al., (2007) study, thus the researchers felt conﬁdent in being able to generalize
the survey results. This researcher feels these results can still be generalized in
this current study.

Another signiﬁcant difference in scores occurred in domain III as well with
regards to whether educators engaged in paid disability management activities
and importance of that domain. There was a signiﬁcant difference in domain III
between those that had participated and those that had not. For those engaging
in paid disability management activities it is more likely that they have experience
involved with tasks in domain lll, program development, management and
evaluation. Although domain I" is a more recent addition to the ﬁeld of disability
management it has increasingly become part of disability management in
reaction to employer demands (Lui 8 Rosenthal, 2008).

Signiﬁcant differences in scores were also found in relation to perceived
importance and whether educators authored or co-authored (and published)
articles regarding disability management. There were signiﬁcant difference in
scores for domain II and domain III for those that had authored articles and those
that had not. There was also signiﬁcant difference in scores for perceived
importance for those educators that had written grants or requests for proposals
related to disability management on all three domains, versus those that had not.
It is not surprising that those educators that authored or co-authored articles and
those that have written grants or requests for proposals related to disability
management ﬁnd tasks associated with disability management more important.

Educators’ involved with writing or applying for grants/RFP’s are more in tune to

113

 

 

 

the literature and changing ﬁeld of disability management and thus have a better
understanding of how speciﬁc tasks relate and are important to the ﬁeld.
Educators’ acknowledging 25 of the 26 disability management tasks,
across all three domains, as important is signiﬁcant for the ﬁeld of rehabilitation
counseling, speciﬁcally for those students interested in moving into that area of
practice. Rosenthal et al., (2007) state that “employers now place greater
expectations on disability managers to demonstrate a broader range and more
specialized practice that includes an understanding of such advanced concepts
as absence management, presenteeism, integrated beneﬁt practice, productivity
enhancement, and health and wellness paradigms” (p. 82). However,
importance is the ﬁrst step. Canying the importance of tasks into the educational

realm and preparing students for practice is also required.

Perceived Proﬁciency

Rehabilitation counselor educators perceived themselves as proﬁcient
(23.00) in teaching 22 of the 26 disability management tasks and very proﬁcient
(4.00-4.99) in 4 tasks, all of which were located in domain I (disability case
management). The four items to not meet the minimum criterion set for
proﬁciency were from domain II and domain III. Domain ll included: recommend
strategies to identify ergonomic, safety, and risk factors using available resources
in order to mitigate exposure and improve employee health (M=2.98). Tasks
from domain III that did not meet the minimum criterion included: analyze

workplace practices using a needs assessment to establish baselines and design

114

effective interventions (M=2.95), collaboratively develop and manage the
disability management program by specifying essential procedures and training
components consistent with pertinent regulations and identifying appropriate
services and metrics in order to offer effective services for stakeholders (M=2.65)
and facilitate the exchange of data and metrics by integrating information
systems for disability management programs in order to achieve and report
desired program outcomes (M=2.60).

The four tasks educators rated themselves as very proﬁcient to teach
(4.00-4.99) were all from domain I and included: manage caseload using ethical
strategies in order to enhance effectiveness and efﬁciency (M=4.30), implement
interventions using appropriate counseling and behavior change techniques in
order to optimize functioning and productivity (M=4.24), promote collaboration
among stakeholders using communication strategies to optimize functional
recovery (M=4.16) and prepare case notes and reports using applicable forms
and systems in order to document case activities in compliance with standard
practices and regulations (M=4.01).

As with importance, educators rated domain I as the area where they feel
most proﬁcient to teach, as shown by the overall item mean (M=3.77). There
was also a high and positive correlation shown between educators perceived
importance of domain I and their proﬁciency to teach tasks associated with this
domain (r=.641, n=63, p<.01). As stated earlier domain I tasks consist of those

most associated with individual practice and reﬂect knowledge and skills most

115

'1 _~.
4.-

 

associated with rehabilitation counseling, so it makes sense that educators would
feel most proﬁcient in teaching in these areas.

Domain ll (disability prevention and workplace intervention) showed
educators reporting themselves as proﬁcient in teaching 6 of the 7 tasks. The
three tasks educators felt most proﬁcient to teach included: develop and
interactive process for job site modiﬁcation, accommodation, or job task
assignment incorporating appropriate resources in order to facilitate optimal
functioning in the workplace (M=3.72), support employment practices that align
work abilities with essential job functions by serving as a resource for employees
and management in order to prevent disabilities and optimize productivity
(M=3.72) and implement disability prevention practices through training,
education and collaboration in order to change organizational behavior and
integrate prevention as an essential component of organizational culture
(M=3.29).

As with importance, educators rated domain II as the second highest area
where they feel most proﬁcient to teach (M=3.26). There was also a high and
positive correlation between educators perceived importance and their
proﬁciency to teach in domain II (r=.508. n=63, p<.01). The same holds true for
domain III which was rated third in educators perceived proﬁciency to teach
(M=3.03). Again, a high and positive correlation was found between importance
and proﬁciency to teach in domain lll (F607, n=63, p<.01).

Within domain lll, educators rated themselves as proﬁcient to teach on 6

of the 9 tasks. The three tasks not to meet the minimum criterion set included:

116

 

facilitate the exchange of data and metrics by integrating information systems for
disability management programs in order to achieve and report desired program
outcomes (M=2.60). collaboratively develop and manage the disability
management program by specifying essential procedures and training
components consistent with pertinent regulations and identifying appropriate
services and metrics in order to offer effective services for stakeholders (M=2.65)
and analyze workplace practices using a needs assessment to establish
baselines and design effective interventions (M=2.95).

The three highest rated tasks in domain Ill regarding proﬁciency to teach
included: conduct ongoing formative and summative program evaluations using
qualitative and quantitative methods to improve process and measure outcomes
(M=3.77), champion individual and organizational behavior change by assigning
responsibility to stakeholders at all levels of the organization in order to achieve
strategic outcomes (M=3.23), and procure internal and external services using
commonly accepted selection criteria to maximize consistency and desired
program outcomes (M=3.16).

Regarding demographic characteristics of educators and their perceived
proﬁciency to teach disability management tasks within the three domains, no
signiﬁcant differences were found in relation to gender, how much disability
management was emphasized in educators overall master’s level rehabilitation
counseling curriculum, the number of credit hours required for completion of a
masters’ degree in their program, or whether educators authored or co-authored

(and published) articles regarding disability management.

117

 

Signiﬁcant differences in other demographic characteristics of educators
and their perceived proﬁciency to teach in the three domains was found when
independent t-tests were run. For all three domains, signiﬁcant differences in
scores for proﬁciency were found for educators who reported being engaged in
paid disability management activities versus those who were not. There was
also signiﬁcant difference in scores, along all three domains, for those educators
that had written grants or requests for proposals related to disability management
and their perceived proﬁciency to teach disability management tasks. Again, it is
not surprising that educators feel more proﬁcient in teaching tasks associated
with a disability management domain when they report being engaged in paid
disability management activities as well as writing grants and RFP’s. What is
interesting is that authoring or co-authoring articles regarding disability
management did not have a signiﬁcant effect on an educators’ perceived
proﬁciency to teach disability management tasks.

Educators rated a high majority of the 26 tasks asSociated with the three
disability management tasks as important (25 out of 26) as well as being
proﬁcient to teach (22 out of 26). It is interesting to note such a high level of
perceived proﬁciency of educators, speciﬁcally in domain III (reported proﬁciency
in 6 of 9 tasks), when Lui 8 Rosenthal (2008) state that the “major challenge
posed by domain III is that it is an area in which disability case managers oﬂen
have the least amount of experience, exposure and training” (p. 11). Perhaps we
need to explore further whether the same can be said for rehabilitation counselor

educators. It has been suggested that educators identify course material they

118

 

teach to be more valuable and important than course content they do not teach
(McGlothlin 8 Davis, 2004). As reﬂected in the next set of data (student
preparedness) it cannot be assumed that because tasks are rated as important
and educators feel proﬁcient to teach those tasks, that we can state that is

enough to prepare students in those areas.

Perceived Preparedness

Rehabilitation counselor educators rated student as prepared (23.00) in
only 6 of the 26 disability management tasks, all of which were found in domain I.
The six tasks to meet the minimum criterion set were: manage caseload using
ethical strategies in order to enhance effectiveness and efﬁciency (M=3.47),
implement interventions using appropriate counseling and behavior change
techniques in order to optimize functioning and productivity (M=3.43), prepare
case notes and reports using applicable forms and systems in order to document
case activities in compliance with standard practices and regulations (M=3.23),
perform worksite/job analyses using observation, interview, and records review in
order to determine the requirements of the job (M=3.18), promote collaboration
among stakeholders using communication strategies to optimize functional
recovery (M=3.03) and develop individualized retum-to-work plans consistent
with standards of practices and procedures by collaborating with relevant '
stakeholders in order to facilitate employment (M=3.02). Student preparedness
in the other 4 tasks in domain I fell within the somewhat prepared category (2.00-

2.99).

119

 

Educators rated student preparedness in the 7 tasks of domain II as being
somewhat prepared (2.00-2.99) and only 3 of the 9 tasks in domain Ill. The other
6 tasks of domain Ill rated student preparedness as not prepared (1 .00-1 .99).
Across the three domains students were rated as prepared (23.00) on 6 of the 26
tasks (23%), somewhat prepared (2.00-2.99) on 14 of the 26 tasks (54%) and not
prepared (1 00-199) on 6 of the 26 tasks (23%). Students were not seen as
meeting the minimum criterion of prepared (23.00) on 20 of the 26 items, or 77%
of the time.

Comparing item mean scores by domain, educators rated student
preparedness as: domain I (M=2.90), domain II (2.25), and domain Ill (1.88).
This order remains consistent with the importance and proﬁciency mean scores
by domain. However none of the overall mean scores by domain for student
preparedness meet the minimum criterion (23.00). Domain I and II reﬂect
student preparedness as somewhat prepared (2.00-2.99) while in domain III
students are rated as not prepared (1 .00-1 .88).

When asked how much disability management was emphasized in the
cuniculum, participants responded: not emphasized (25.4%), somewhat
emphasized (38.8%), emphasized (22.4%), very emphasized (6%) and extremely
emphasized (3%). Regarding how participants programs offered disability
management curriculum responses included: as part of another course (74.6%.),
both required course and an elective (11.9%), not applicable (7.5%), and
required interdepartmental course and currently developing a course (3.0%). If

64.2% of the responses reﬂect that disability management is somewhat or not

120

emphasized in the curriculum, it is not surprising then that educators do not feel
students are prepared in disability management tasks upon completion of a
master's level rehabilitation counseling program. Also if only 14.9% stated
participant programs offered disability management as some form of a required
course, we can’t expect students to be fully prepared when 74.6% report
disability management emphasis comes as part of another course.

This challenge is not unique only to teaching disability management within
a rehabilitation counseling master’s program. Due to CORE standards there is a
limited amount of course work that can be covered during the master’s degree
program. Since “rehabilitation counseling program curricula are generally
organized according to accreditation guidelines and core requirements”, other
avenues of educating students in the ﬁeld of disability management must be
addressed and researched (Zanskas 8 Leahy, 2007, p. 212).

Educators demographic characteristics and perceived student
preparedness in the disability management tasks and related domains, there was
no signiﬁcant difference found in relation to educators engaging in paid disability
management activities, whether educators authored or co-authored (and
published) articles regarding disability management, whether educators had
written any grants or requests for proposals related to disability management, or
the number of credit hours required for completion of a master’s degree in their
program.

Signiﬁcant differences in demographic characteristics and student

preparedness were found in relation to males (M=3.19) and females (M=2.80) for

121

 

domain I and males (M=2.15) and females (M=1.78) in domain lll. As stated
earlier it is difﬁcult to determine these demographic differences in relation to
educators perceived student preparedness.

Another signiﬁcant effect was found in relation to whether educators
perception of student preparedness in the disability management tasks, along the
three domains, differed due to how much disability management was
emphasized in educators overall master’s level rehabilitation counseling
curriculum. The ANOVA’s for this test were all signiﬁcant showing a signiﬁcant
effect on overall preparedness, and preparedness in domain I, domain II and
domain Ill. The more disability management was emphasized the more prepared
educators felt students were in the disability management tasks (and domains)
upon completion of a Master’s degree.

While students lack of preparedness in tasks associated with domain "I
may not seem as signiﬁcant, since this is a relatively new domain identiﬁed
through research, lack of preparedness in the ﬁrst two domains is somewhat
surprising. Tasks associated with domain I and domain II, as explained earlier in
this study, have been studied since the early 1980’s and can be correlated to
current CORE standards, which should be already incorporated in rehabilitation
counseling curriculum. The lack of student preparedness across all three
domains perhaps brings to light further issues in rehabilitation counselor

education that needs to be addressed.

122

 

Limitations

An obvious limitation of this study is the 12% overall response rate. The
response rate did not provide enough of a sample to carry out exploratory factor
analysis. Every attempt was made to get the most recent and up—to-date email
addresses for educators by using the 2005-2006 National Council on
Rehabilitation Education Membership Directory, which was the most recent at the
time this study occurred. Membership Institutions were looked up on the web,
comparing educators listed in the NCRE directory to educators listed on the
institutions website. Email addresses were conﬁrmed and updated, when
necessary, as well as new educators added who were not included in the NCRE
directory. Based on the above conﬁrmation of email addresses via institutional
websites, it is surprising that 101 (14%) of the email addresses still came back as
undeliverable.

The sample of educators is a sample of convenience. Even though
participants for this study were expanded beyond ten-year track faculty, to
include adjunct and instructors, the sample was still small. It is also feasible that
the low response rate was due in part to educators not being interested in
disability management and chose not to participate because of the nature of the
survey subject matter.

Another possible limitation was the timing of the survey distribution. Even
though the survey was sent to educators in April, hoping to catch educators

before they left for the summer, it is possible that this was still a bad time for

123

 

 

educators to respond as they may have been busy with end of the semester
classes and projects.

Self-reported methodology is also a potential limitation in this survey as it
is assumed educators will have the required skills, knowledge and background to
accurately answer the survey questions.

As explained previously through research conducted by Sheehan 8
McMillan (1999) issues of subject saliency and response rate have a high
correlation. Perhaps the low response rate, combined with the reported low
perceived preparedness of students (across all three domains) speaks to the lack
of disability management’s coverage in rehabilitation counselor education.
Refusal by educators to participate in this study may reﬂect further on the lack of
disability management incorporation into rehabilitation counselor education but
also educators not wanting to report their own proﬁciency (or lack thereof) in

disability management as well.

implications
Implications for the Profession
The results of this study were the ﬁrst to attempt to describe the perceived
importance, proﬁciency and student preparedness in empirically identiﬁed
disability management tasks, within speciﬁc domains. Rosenthal et al., (2007)
state in the original CDMSC survey, from which this survey is modiﬁed from,
“using an approach that incorporates subject expert agreement and practitioner-

based validation is the process of role and function identiﬁcation, a more

124

 

 

 

scientiﬁc and, one would hope, accurate approach to understanding current DM
practice is obtained” and that “for the CDMSC, the process increases the
likelihood that the certiﬁcation exam accurately reﬂects current practice in the
ﬁeld” (p. 82). Utilizing a survey based on role and function for ensuring accurate
certiﬁcation exams and surveying educators, who will be preparing future takers
of that exam, uncovers shortcomings in the educational process.

One of the challenges of the disability management ﬁeld has been getting
employers to see rehabilitation counseling as the most appropriate profession to
help manage workplace disability (Rosenthal, 1999). Using this study as a
platform to address the high educator perception of students not being prepared
in disability management tasks and related domains, will move disability
management education into the spotlight of rehabilitation education and better
prepare students thus making them more marketable, and recruited, by
employers.

An additional implication for practice is the identiﬁcation of a third disability
management domain, “program development, management and evaluation”. As
reported by Lui 8 Rosenthal (2008), domain III has “increasingly become part of
disability management in response to employer demands” (p. 10). Rehabilitation
counselors will need to have a thorough understanding, and skills in domain lll if

they are going to be successful in disability management.

125

 

Implications for Rehabilitation Education

Results from this study, speciﬁcally the reported lack of preparedness of
students in the identiﬁed disability management tasks and domains, should act
as a wake-up call to rehabilitation counselor educators, institutions and
certiﬁcation bodies. Back in 1999, Rosenthal and Olshesky stated that “the
emerging importance of disability management within vocational rehabilitation
and rehabilitation counseling has been recognized for over a decade” (p. 31).
We can now say two decades, however little has been done to prepare students
in the area of disability management.

From as far back as 1990, there have been recommendations that
rehabilitation counselor education curricula expand to include disability
management (Kilbury, Benshoff, 8 Rigger). In 1999 CORE accredited program
cunicula were urged by Rosenthal and Olshesky to consider addition courses
that would infuse disability management material into current courses as well as
offer internship sites in disability management. While some of the 26 disability
management tasks from this study can be found in the CORE standards,
speciﬁcally in section 04 Employment and Career Development, based on
educators’ response to student preparedness in this current study, it doesn’t
seem to be enough.

Also with the identiﬁcation of the new domain Ill, rehabilitation counselor
education is going to have to respond and attempt to infuse this additional
knowledge and training into their programs. Chan et al., (2003) recognize that

many of the “emerging knowledge areas (e.g., disability management) may not

126

 

 

even be emphasized in many current rehabilitation counselor education curricula
(p. 83). With the identiﬁcation of this new domain there will be even more
knowledge/skills that will need to be instilled into rehabilitation counselor
education programs. Lui 8 Rosenthal (2008) state that the “training and curricula
associated with CORE accredited programs may not be adequate at this time to
enable graduates from such programs to enter the labor market with the capacity
to provide the complex array of services associated with domain III of disability
management” (p. 12). Counselors in private rehabilitation settings have already
reported needing further training in job accommodations/ergonomics, disability
management, workers’ compensation laws, beneﬁt programs, and intemet
resources (Chan et al., 2003).

Zanskas and Leahy (2007) offer recommendations to incorporate private
sector training needs (including disability management) into current curricula for
master’s level rehabilitation counseling students. Their recommendations for
rehabilitation counselor educators include: (a) using collaborative Ieaming; (b)
using problem and case based learning methods; and (4) develop private
practice settings as practicum or internship sites. While these methods may not
solve all of the issues in preparing students for the ﬁeld of disability management,
it is a start.

Implications for Research

This study is the ﬁrst to empirically attempt to quantify the perceived

importance, educator proﬁciency and student preparedness in disability

management. Hopefully this will start a new line of research regarding the new

127

 

face of disability management and the education of rehabilitation counselors.
Research must be conducted to determine the most effective way of infusing
disability management into the current curricula as well as how to respond
quickly to the changing profession of disability management.

Additional research is also required speciﬁcally to domain III. This domain
requires a demand for evidence-based practice and disability management
practitioners will need to be “informed consumers of current and relevant
research, including justifying the retum on investment in what they do in terms of
reducing direct and indirect costs, decreasing beneﬁts consumption, and
improving workplace productivity (Rosenthal et al., 2007). Continual research
will need to be conducted to ensure that students are prepared in providing these
additional services to employers.

Continued research should also be conducted regarding employers views
of rehabilitation counseling as providers of disability management services.
Perhaps with increased educational focus of disability management speciﬁc
tasks in the rehabilitation counselor education programs, employers will identify

more with rehabilitation counselors as candidates to provide these services.

Conclusions

The purpose of this quantitative study was to determine how rehabilitation
counselor educators perceived identiﬁed disability management tasks in relation
to importance to the ﬁeld of rehabilitation counseling, their own proﬁciency to

teach as well as student preparedness. This study also looked at whether

128

importance, proﬁciency and preparedness differed across the three disability
management domains according to participant demographics.

Educators reported that 25 of the 26 tasks associated with disability
management (across three domains) were important to the ﬁeld of rehabilitation
counseling. They also reported being proﬁcient in teaching 22 of these 26 tasks.
A high positive correlation was found between educators’ perception of

importance of a task and their perceived proﬁciency to teach that task.

[tiff-m?"

Participants did perceive students as not prepared on all but 6 of the 26 tasks.
The six tasks educators felt students were prepared in all fell within domain I of
this study.

Comparison of demographic variables shows some differences across
variable and domain. For importance their were some signiﬁcant ﬁndings
regarding perceived importance and gender for domain III as well as gender and
perceived preparedness for domain I and domain II (in all cases of signiﬁcant
ﬁndings males had a higher mean for importance and preparedness). Whether
educators participated in paid disability management activities reﬂected higher
scores for perceived importance for domain III as well as perceived proﬁciency
across domains I, II and Ill. Authoring or co-authoring articles related to disability
management also related to higher perceived importance for domain II and III.
Educators that had reported writing grants or RFP’s pertaining. to disability
management also had higher scores for perceived importance of domain I, II and
III as well as perceived proﬁciency for domain II and Ill. How much disability

management was emphasized in educators’ rehabilitation counselor curriculum,

129

for their respective institutions, also had a higher score related to perceived
student preparedness for domain I, II and Ill.

The aging of the workforce will bring the ﬁeld of disability management to
the foreﬁont by keeping individuals employed, as well as keeping employers
competitive. As employees age, the likelihood of disability increases and due to
economic conditions facing many individuals, remaining in the workplace will

become a necessity. Employers will also be seeking ways to keep disability

I‘mm

costs down, as healthcare costs and costs associated with disability programs
continue to rise (i.e., workers’ compensation, short-term and Iong-tenn disability
insurance). Disability management programs can address both of these issues.
While this is the ﬁrst step in determining educators’ perception of
importance, proﬁciency and student preparedness in disability management for
the ﬁeld of rehabilitation counseling, it is clear from some of these results that this
subject is one that will need to be studied further. Speciﬁcally with the aging of
the workforce, and potential increase for the ﬁeld of rehabilitation counseling to
participate in this unprecedented phenomenon, leaders in rehabilitation
counselor education must not wait by for other professions to ﬁll the gaps we are
not ﬁlling. This will include recognizing the importance of disability management,
not only for our students but for people with disabilities as well as employers and
our nation as a whole. Educators, and the profession, must act svlriftly by
incorporating disability management into both the curriculum as well as the

profession of rehabilitation counseling.

130

Appendix A: Certiﬁcation of Disability Management Specialists Commission Role
and Function Analysis Survey

PLEASE READ THE ENTIRE PAGE CAREFULLY.

Please read the instructions and informed consent statement. If you decide to
participate, you can then proceed to completing the questionnaire.

Directions and Informed Consent

I am a PhD. student in rehabilitation counselor education at Michigan State
University. I am in the process of completing my dissertation under the
supervision and guidance of Dr. Michael Leahy. The purpose of this research is
to obtain your perceptions of the importance, proﬁciency and student
preparedness in identiﬁed disability management domains (through 26 speciﬁc
tasks). I hope you will decide to participate.

Participation will require 15-20 minutes of your time in order to read and
complete the questionnaires. If you decide to participate, you will be asked some
questions related to your education, experience and disability management .
expertise. If you decide not to participate, or stop after you begin, there will not
be any consequence.

Although no information can be guaranteed completely safe, we have attempted
to keep all information conﬁdential by having you provide responses via this
website provided by Survey Monkey. No identifying information is requested in
the questionnaires. If you decide to withdraw from this study before your survey
is completed, you can simply discontinue and there will not be any identifying
information connecting you to your responses, other than your responding email
address linked to your survey, which will be hidden from the researchers and
used for the sole purpose of sending email reminders to you to complete the
survey from Survey Monkey directly. During the survey, you will have the chance
to save your responses after each selection when you press the next button.
You can discontinue the survey and return to it at another time where you left off.
Since no identifying information is included in your responses it will not be
possible to withdraw or delete your responses after they are submitted, as we
would not be able to distinguish your responses from those of other participants.

The information in this study will be used for the secondary researcher’s,
dissertation requirement. Only the researchers will have access to the database.
All individual responses will be kept conﬁdential. Only group data will be included
in reports from the project, not individual data.

131

If you have any questions about this study, you may contact the researchers:

Wendy Coduti: coduti msu.edu
Michael Leahy, Ph.D., CRC: leahym@msu.edu

Ofﬁce of Rehabilitation 8 Disability Studies
Michigan State University

462 Erickson Hall

East Lansing, MI 48824

Please print a copy of this page for your records.

 

Click the “Complete Questionnaire” button below“

“By selecting/clicking this button, you acknowledge that you have agreed to
participate in this study, that you are at least 18 years of age, and have read the
information presented on this page. You understand that your responses will be
anonymous and are being provided for the purpose of research at Michigan State
University. Participation is voluntary and you can withdraw or refuse to answer
any particular question without penalty, by simply skipping that particular
question. Your privacy will be protected to the maximum extent allowable by law.

Thank you.

132

Certiﬁcation of Disability Management Specialists Commission
Role and Function Analysls Survey

Please complete the survey below regarding tasks identiﬁed with the three
disability management domains listed. There are three Likert-type scales for
each of the 26 tasks:

 

 

 

 

 

 

Importance Proficiency Preparedness
1=not important 1=not proﬁcient 1=not prepared
2=somewhat important 2=somewhat proﬁcient =somewhat prepared

=important 3=proﬁcient 3=prepared
4=very important 4=very proﬁcient 4=very prepared
5=extremelj important 5=extremely proﬁcient =extremely prepared
Importance: Importance of this skill for effective rehabilitation

counseling practice

Proﬁciency: Educators own perceived instructional proﬁciency in
teaching these tasks

Preparedness: Overall student preparedness in these tasks upon
completion of a Master’s level rehabilitation counseling

program

133

 

Domain l: Disability Case Management

Tasks associated with this domain consist of a practitioner working one-on-one
with ill/injured employees in returning them to productive work.

 

Domain l: Disability Case
Management

Importance

Proﬁciency

Preparedness

 

Task 1:

‘ Task 2:

Perform comprehensive
individual case analysis
and beneﬁts assessments
using accepted practices in
order to develop
appropriate interventions.

12345

12345

12345

 

Review disability case
management intervention
protocol using standards
of care in order to promote
quality care, recovery, and
cost effectiveness.

12345

12345

12345

 

Task 3:

Promote collaboration
among stakeholders
using communication
strategies to optimize
functional recovery.

12345

12345

12345

 

Task 4:

Perform worksite/job
analyses using
observation, interview, and
records review in order to
determine the requirements
of the job.

12345

12345

12345

 

Task 5:

Develop individualized
return-to-work plans
consistent with standards
of practices and

procedures by collaborating
with relevant stakeholders
in order to facilitate
employment.

12345

12345

12345

 

 

Task 6:

Implement interventions
using appropriate
counseling and behavior
change techniques in order
to optimize functioning and
productivity.

 

12345

 

12345

 

12345

 

134

 

 

Task 7: Coordinate beneﬁts,
services, and community
resources (e.g., orthotics, 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
prosthetics, FCE, IME,
durable medical, home
care, and vocational
rehabilitation) through
strategic planning in order
to facilitate optimal
functioning.

 

Task 8: Monitor progress for
achievement of targeted
milestones through ongoing 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
comparison with
established best-practice
guidelines in order to make
recommendations, optimize
functional recovery, and
provide needed follow-up.

 

Task 9: Manage caseload using
ethical strategies in order to 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
enhance effectiveness and
efﬁciency.

 

 

Task 10: Prepare case notes and
reports using applicable 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5
forms and systems in order
to document case activities
in compliance with
standard practices and
regulations.

 

 

 

 

135

 

Domain ll: Disability Prevention and Workplace Intervention

Consists of more proactive approaches in reducing workers’ compensation
claims and costs through early intervention and remediation.

 

Domain ll: Disability Prevention and
Workplace Intervention

Importance

Proﬁciency

Preparedness

 

Task 1: Implement disability
prevention practices
(risk mitigation procedures
such as job analysis, job
accommodation, ergonomic
evaluation, health and
wellness initiatives, etc)
through training, education,
and collaboration in order
to change organizational
behavior and integrate
prevention as an essential
component of

organizational culture.

12345

12345

12345

 

Task 2: Develop a comprehensive
transitional work program
through consultation with
all relevant stakeholders in
order to facilitate optimal
productivity and value in
the workplace.

12345

12345

12345

 

Task 3: Develop an interactive
process for job site
modiﬁcation,
accommodation, or job task
assignment incorporating
appropriate resources
(ergonomics and assistive
technologies) in order to
facilitate optimal functioning
in the workplace.

12345

12345

12345

 

Task 4: Support employment
practices that align work
abilities with essential job
functions by serving as a
resource for employees
and management in order
to prevent disabilities and
optimize productivity.

 

 

12345

 

12345

 

12345

 

136

 

 

Task 5:

Recommend strategies to
identify ergonomic, safety,
and risk factors using
available resources (data
and assessment tools) in
order to mitigate exposure
and improve employee
health.

12345

12345

12345

 

Task 6:

Recommend strategies
that integrate beneﬁt plan
designs and related
services (employee
assistance programs,
community resources, and
medical services) by
evaluating and coordinating
delivery in order to promote
prevention, optimal
productivity, quality care,
and cost containment.

12345

12345

12345

 

 

Task 7:

Recommend health and
wellness interventions by
targeting the speciﬁc needs
of employees and the
organization in order to
increase organizational
health and productivity
while demonstrating
measureable value.

 

12345

 

12345

 

12345

 

137

 

Domain III: Program Development, Management and Evaluation

Consists of the design, implementation and evaluation of programs and utilizing
expertise in broader absence management and health and productivity initiatives.

 

Domain III: Program Development,
Management, and Evaluation

Importance

Proﬁciency

Preparedness

 

Task 1: Analyze workplace
practices (beneﬁt design;
policies/procedures;
regulatory and compliance
requirements; employee
demographics; labor
relations) using a needs
assessment to establish
baselines 8 design
effective interventions.

12345

12345

12345

 

Task 2: Present the business
rationale for
comprehensive Disability
management program
using baseline data, best
practices, evidence-based
research, 8 benchmarks
incorporating cultural 8
environmental factors to
secure stakeholder
investment 8 commitment.

12345

12345

12345

 

Task 3: Collaboratively develop 8
manage the disability
management program by
specifying essential
procedures 8 training
components consistent with
pertinent regulations 8
identifying appropriate
services 8 metrics in order
to offer effective services
for stakeholders.

12345

12345

12345

 

 

 

Task 4: Champion individual 8
organizational behavioral
change by assigning
responsibility to
stakeholders at all levels of
organization to achieve
strategic outcomes.

 

12345

 

12345

 

12345

 

138

 

 

Task 5:

Procure internal 8 external
services using commonly

accepted selection criteria
to maximize consistency 8

desired program outcomes.

12345

12345

12345

 

Task 6:

Manage service providers
using stakeholder-deﬁned
performance standards in
order to maximize the
quality of services 8 the
return on investments.

12345

12345

12345

 

Task 7:

Facilitate the exchange of
data 8 metrics by
integrating information
systems for disability
management programs in
order to achieve 8 report

desired program outcomes.

12345

12345

12345

 

Task 8:

Conduct ongoing formative
8 summative program
evaluations using
qualitative 8 quantitative
methods to improve
process 8 measure
outcomes.

12345

12345

12345

 

 

Task 9:

Create disability
management performance
reports 8 other
communication vehicles
targeted to relevant
stakeholders using variety
of media in order to
promote stakeholder
awareness 8 collaboration.

 

12345

 

12345

 

12345

 

139

 

DEM GRAPHI ESTI NNAIRE
Please enter your current age:

Please select one to indicate your gender:
Male
Female

Please select current professional certiﬁcations (select all that apply):

Other (Please identify)

Please select your degree major.
Counselor Education
Psy.D.
Rehabilitation Counselor Education
Rehabilitation Psychology
Rh.D.
Other (Please identify)

 

Please enter the number of years you have been employed as a
Rehabilitation Counselor Educator:
Years ‘

Please identify the professional memberships you currently hold (please
list all that apply):

 

 

Have you engaged in paid disability management activities?
Yes
No

 

If yes, how many years:
less than one
15 years
6-10 years

1 1-15 years

16-20 years

20+ years

not applicable

 

 

 

140

 

 

10.

11.

12.

13.

14.

Please identify the following forms of disability management training you
have participated in (indicate all that apply)?

Workshops

Practicum/Intemship Experience

Speciﬁc Coursework

On-The—Job Training

Not Applicable

Have you authored or co-authored any articles regarding disability
management that have been published in peer reviewed journals, book
chapters, or books during the past?

Yes

No

 

Have you written any grants or completed requests for proposals related
to disability management?

Yes

No

 

Please select your current rank:
_ Assistant Professor

Associate Professor
Professor
Professor Emeritus
Adjunct Professor
Instructor
Other (please describe)

Considering the overall Master‘s level Rehabilitation Counseling
curriculum at your institution please select how much disability
management is emphasized:

Not emphasized

Somewhat emphasized

_Emphasized
Very emphasized
Extremely emphasized

How does your current Rehabilitation Counseling Education (RCE)
curriculum offer students disability management knowledge and skill
preparation (please select all that apply)?

A required course as part of the RCE curriculum

A required course as part of an interdepartmental curriculum

An elective course

Disability management knowledge is included as part of

other courses

Currently developing a course

141

15.

16.

17.

18.

Not applicable

Courses with disability management in your rehabilitation counselor
education program are taught by (please select all that apply)?
Full-time faculty in the Rehabilitation Counselor Education
program
Full-time faculty from an interdisciplinary counselor education
program
Adjunct or part-time faculty
Full-time faculty from another department
Faculty from the areas of labor relations, human resources or
organizational behavior
Not applicable 1

Please select the number of semester credit hours your institution requires
to complete the requirements for a master’s degree in Rehabilitation
Counseling:

48

60
48 or 60 credit hour option

Between 49 and 59

Other (please identify)

 

 

Is the college/university you are teaching in accredited through the
National Council of Rehabilitation Education (NCRE)?

Yes

No

 

Please select your college or university’s NCRE membership region:

Region I
Region II
Region III
Region IV
Region V

_Region VI
Region VII
Region VIII
Region IX

142

Appendix B: Survey Transmittal Letter

Subject Line: Dissertation Disability Management Survey
Dear Educator.

I am a Ph.D. student in rehabilitation counselor education at Michigan State
University. I am in the process of completing my dissertation under the
supervision and guidance of Dr. Michael Leahy.

I need your help and expertise as an educator to further understand disability
management as it pertains to the ﬁeld of rehabilitation counseling. The purpose
of this survey is to gather your perceptions of the importance, proﬁciency and
student preparedness in identiﬁed disability management knowledge domains. I
know your time is valuable and participation will require only 15-20 minutes. I
hope you agree to participate.

Here is the link to the survey:

(survey link here)

This link is uniquely tied to this survey and your email address, please do not
forward this message.

Please note: If you do not wish to receive further emails from us, please select
the link below and you will be automatically removed from our mailing list for this
survey.

(removal link here).

Thank you very much for your time and willingness to share your expertise to
further beneﬁt the ﬁeld of rehabilitation counseling.

”This research project has obtained permission to gain access to the NCRE
membership for purposes of furthering the mission of the association”.

Sincerely,

Wendy Coduti, ABD

143

Appendix C: Follow Up Survey Transmittal Letter
Subject Line: Reminder: Dissertation Disability Management Survey
Dear Educator.

Recently you were sent an email requesting your participation in my dissertation
survey pertaining to your perceptions of the importance, proﬁciency and student
preparedness in identiﬁed disability management knowledge domains. Thank
you to those that have completed the survey. For those that haven’t completed,
or haven’t yet started the survey, your participation would be greatly appreciated.
I understand your time is valuable but I hope you will participate in this survey,
which should only take 15-20 minutes of your time. This survey will close on
April 30"" at 5:00 pm.

Here is the link to the survey:

(survey link)

This link is uniquely tied to this survey and your email address, please do not
forward this message.

Please note: If you do not wish to receive further emails from us, please select
the link below and you will be automatically removed from our mailing list for this
survey.

(removal link).

Thank you very much for your time and willingness to share your expertise to
further beneﬁt the ﬁeld of rehabilitation counseling.

"This research project has obtained permission to gain access to the NCRE
membership for purposes of furthering the mission of the association”.

Sincerely,

Wendy Coduti, ABD

144

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