Disability and Vocational Rehabilitation in Rural Settings : Challenges to Service Delivery

This first-of-its-kind textbook surveys rehabilitation and vocational programs aiding persons with disabilities in remote and developing areas in the U.S. and abroad. Contributors discuss longstanding challenges to these communities, most notably economic and environmental obstacles and ongoing barriers to service delivery, as well as their resilience and strengths. Intersections of health, social, structural, and access disparities are shown affecting rural disabled populations such as women, racial and sexual minorities, youth, and elders. In terms of responses, a comprehensive array of healthcare and health policy solutions and recommendations is critiqued with regard to health, employment, and service effectiveness outcomes. Included among the topics: Healthcare initiatives, strategies, and challenges for people with disabilities in rural, frontier, and territory settings. Challenges faced by veterans residing in rural communities. The Asia and Pacific region: rural-urban impact on disability. Challenges after natural disaster for rural residents with disabilities. Meeting the needs of rural adults with mental illness and dual diagnoses. Capacity building in rural communities through community-based collaborative partnerships. Disability and Vocational Rehabilitation in Rural Settings makes a worthy textbook for graduate students and upper-level undergraduates in the fields of social work, community and environmental psychology, public health, sociology, education, and geography. Its professional audience also includes vocational rehabilitation counselors serving these dynamic populations. Foreword......Page 5 Preface......Page 8 Contents......Page 10 Editors and Contributors......Page 14 Part I: Community Characteristics and Issues in Rural, Frontier, and Territory Communities......Page 26 Introduction......Page 27 Differences of Living in Urban and Rural America......Page 28 Entrepreneurial Types......Page 30 Finances for Rural Entrepreneurs......Page 31 Opportunities for Rural Entrepreneurship......Page 32 Opportunities for Rural Entrepreneurs and People with Disabilities......Page 33 The Viability of Entrepreneurship for Those Who Have Disabilities......Page 35 Enhancing Rural Entrepreneurship Among People with Disabilities at the Local Level......Page 36 Summary......Page 37 References......Page 38 2: Disability, Income, and Rural Poverty......Page 41 Theories of Rural Poverty......Page 42 Ways That Poverty Has Been Defined in US Public Policy......Page 43 National Approaches to Poverty Alleviation......Page 44 State and County/Local Government Approaches......Page 45 Rural Poverty and Disability......Page 46 Defining Disability......Page 48 Defining Rural Areas......Page 49 Disability Prevalence......Page 50 Employment, Income Disparities, and Poverty Rate by Disability Status......Page 52 Implications for Rehabilitation Counselors and Human Service Providers......Page 54 Summary......Page 56 Discussion Boxes......Page 58 Illustrative Case Study or Vignette or Profile of a Person with a Disability in a Rural Area......Page 60 Multiple-Choice Questions......Page 61 Key......Page 62 References......Page 63 3: Transportation, Accessibility, and Accommodation in Rural Communities......Page 66 Introduction......Page 67 Barriers to Rural Transportation......Page 68 Transportation Funding......Page 69 Federal Transportation Policy and Programs for Persons with Disabilities......Page 70 Models of Rural Transportation for People with Disabilities......Page 73 Summary......Page 75 Multiple Choice Questions......Page 77 References......Page 78 Introduction......Page 81 Accessibility of Technology......Page 83 Legal and Ethical Issues......Page 86 Recommendations and Suggestions......Page 87 Service Providers......Page 88 Standards for Services......Page 89 Consumer......Page 90 Future Implications and Summary......Page 92 Self-Check Questions......Page 95 Multiple Choice Questions......Page 96 References......Page 97 5: Health-Care Initiatives, Strategies, and Challenges for People with Disabilities in Rural, Frontier, and Territory Settings......Page 99 Introduction......Page 101 Health System Reform......Page 102 Rural Communities......Page 104 ACA Implications for Rural People with Disabilities......Page 107 Limitations of the ACA to Rural Communities......Page 108 Improving Service Delivery to Rural Residents with Disabilities......Page 111 Summary......Page 112 References......Page 113 Introduction......Page 117 Limited Availability of Services......Page 118 Dual Relationships......Page 119 Dual Relationships: Intimate and Nonprofessional Relationships......Page 120 Can Dual Relationships Be Beneficial?......Page 122 Confidentiality and Privacy......Page 123 Implications of Technology to Manage Dual Relationships and Safeguard Confidentiality......Page 125 Recommendations to Manage Dual Relationships, Confidentiality, and Privacy......Page 126 Instructional Features......Page 128 Herlihy and Corey’s Decision-Making Model......Page 130 Future Implications that Potentially Will Influence Service Delivery and Approaches......Page 131 Summary......Page 132 Self-Check Questions......Page 134 Multiple-Choice Questions......Page 135 References......Page 136 7: Resilience and Strengths of Rural Communities......Page 138 Introduction......Page 139 Defining Community Capacity......Page 140 Assessing Community Strengths......Page 142 Community Pride......Page 144 Residents......Page 145 Coping with Adversity......Page 146 Getting Along and Creating Networks......Page 147 Collaborative Service Models......Page 148 Building Social Capital and Social Networks......Page 149 Community Advocacy to Address Needs......Page 150 Future Implications......Page 151 Summary......Page 152 Experiential Activities......Page 153 Key......Page 154 References......Page 155 Part II: Select Populations with Disabilities in Rural Settings......Page 158 8: Challenges Faced by Veterans Residing in Rural Communities......Page 159 History of Veteran Legislation......Page 160 Rural-Urban Classification System and Veteran Demographics......Page 161 Mental Health......Page 163 Medical Conditions......Page 165 Veteran Benefits......Page 166 Barriers Toward Receiving Educational Benefits......Page 167 Discussion Scenario 2......Page 168 References......Page 169 9: Marginalized Racial and Ethnic Adults with Disabilities in Rural Communities: The Role of Cultural Competence and Social Justice......Page 171 Attitudes Toward Disability......Page 173 Marginalized Client Access to VR Services and Quality of Services......Page 177 Counselor-Client Working Alliance with Marginalized Clients......Page 178 Counselor Cultural Competence......Page 180 Implications and Recommendations for Rural Rehabilitation Service Delivery......Page 182 Self-Check Questions......Page 183 Multiple-Choice Questions......Page 184 References......Page 185 10: Adolescents and Transition Students with Disabilities in Rural Areas......Page 189 Introduction......Page 190 Characteristics of Rural Students with Disabilities......Page 192 Recruitment of Qualified Teachers......Page 193 Low Expectations......Page 194 Parents’ Involvement......Page 195 Student Diversity......Page 196 Rural Families’ Participation in Transition Planning......Page 198 Transition to Adulthood and Postsecondary Life for Rural Students......Page 199 Recommendations for Best Practice in Rural Areas......Page 200 Parent Participation and Education......Page 201 Experiential Exercise......Page 202 Multiple-Choice Questions......Page 203 References......Page 204 11: Women, Older Adult, and LGBTQ Populations with Disabilities in Rural, Frontier, and Territory Communities......Page 208 Introduction......Page 209 Ethnicity......Page 211 Mental Health Risk and Protective Factors......Page 212 Susceptibility to Violence......Page 214 A Profile of Elders with Disabilities in Rural Regions......Page 215 A Profile of LGBTQ Persons with Disabilities in Rural Regions......Page 219 Service Delivery Implications for the Vocational Rehabilitation Counselor......Page 221 Service Needs of Women......Page 222 Service Needs of Older Adults......Page 223 Service Needs of LGBTQ Persons......Page 225 Summary......Page 226 Multiple-Choice Questions......Page 227 References......Page 228 12: Offender Populations with Disabilities in Rural Settings......Page 234 Introduction......Page 235 Characteristics of Offender Populations......Page 236 Disability Among Ex-offender Populations......Page 238 Substance Abuse Treatment......Page 239 Employment Barriers......Page 240 Employers’ Attitudes and Hiring Practices......Page 244 Community Reintegration into Rural Settings......Page 245 Post-incarceration and Transition to Rural Communities......Page 247 Ex-offender Reentry Risk to Rural Communities......Page 249 Summary......Page 250 Multiple-Choice Questions......Page 251 References......Page 252 13: American Indians and Alaska Natives with Disabilities in Rural, Tribal Lands, Frontier Regions, and Plain States......Page 258 Traditional Cultural Values and Strengths......Page 259 Tribal Government and Rehabilitation Services......Page 263 Rate of Disability......Page 264 Health Behaviors......Page 271 Service Utilization and Barriers......Page 273 Recommendations for Effective Vocational Rehabilitation Intervention......Page 275 Policy and Future Implications......Page 279 Summary......Page 280 Multiple-Choice Questions......Page 281 References......Page 282 Introduction......Page 288 Physical Disabilities......Page 289 Major Issues of Agricultural and Relevant Policies for Agricultural, Farm, and Immigrant Farm Workers......Page 290 The Role of Vocational Rehabilitation Counselors and AgrAbility When Providing Service Delivery to Agricultural, Farm, and Immigrant Workers......Page 291 Recommendations to Service Delivery to Agricultural, Farm, and Immigrant Workers with Disabilities......Page 292 Future Implications Impacting Service Delivery......Page 294 Summary......Page 295 Multiple Choice Questions......Page 296 Answer Key......Page 297 References......Page 298 15: Sensory Impairments Among Rural Populations in America......Page 299 Sensory Impairments......Page 300 Barriers in Rural Communities......Page 303 Rural Outreach......Page 306 Multiple Choice Questions......Page 309 References......Page 310 Part III: International Vocational Rehabilitation Practice, Employment, and Policy for Rural Development for People with Disabilities......Page 313 Introduction......Page 314 Disability and Service Delivery in West Africa......Page 315 Impacts of Nongovernmental Organizations (NGOs) on Service Delivery......Page 321 Government and Government Policies......Page 322 Employment and People with Disabilities in West Africa......Page 323 Belief System and Attitude Toward Disability......Page 324 Chronic Poverty......Page 325 Awareness Creation on Disability......Page 326 Community-Based Rehabilitation......Page 327 Collaboration in Research......Page 328 Rehabilitation Exchange Programs......Page 329 References......Page 330 Introduction: Overview of the Asia and Pacific Region......Page 333 Disability Statistics in Asia and Pacific Region......Page 336 An International Perspective of the Etiology of Disability......Page 337 Cultural Implications of Disability and Rehabilitation Practice......Page 339 Rehabilitation Service Practice......Page 340 Community-Based Rehabilitation and Other Related Services for People with Disabilities......Page 342 Barriers to Service Delivery for Persons with Disabilities in Rural Areas......Page 344 The United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the Asia and Pacific Region......Page 345 Challenges and Opportunities: Attitudinal, Social, Government, Familial......Page 346 Summary......Page 347 References......Page 348 18: Disability and Vocational Rehabilitation in Rural and Remote Australasia......Page 351 Vocational Rehabilitation Services in Australasia......Page 352 Significance of Work and Employment to Healthy Rural Living......Page 355 Disability in Rural and Remote Settings......Page 357 Work and Disability in Rural and Remote Australasia......Page 358 Improving Vocational Rehabilitation Counsellor Skills and Interventions in Australasia......Page 360 Strengthening Social and Technological Networks......Page 361 Improving Motivation and Optimism/Hope in People with Disabilities......Page 362 Reliable and Valid Vocational Rehabilitation Service Protocols......Page 363 Summary......Page 364 References......Page 365 19: Rural Development, Employment, Chronic Health, and Economic Conditions in Canada......Page 369 Description of Rural Canadian Population......Page 370 Canadian Rural Economy......Page 373 Health Conditions of Rural Canadians......Page 375 Determinants of Chronic Health Conditions and Disability......Page 376 Implications for Rehabilitation Counselors......Page 377 Case Study One......Page 378 Multiple-Choice Questions......Page 379 References......Page 380 20: People with Disabilities and Mental Health Disorders in Mexico: Rights and Practices......Page 383 Introduction......Page 384 Cultural Beliefs About Wellness/Illness and Mental Health......Page 385 Prevalence of Disabilities and Mental Health Disorders......Page 386 Ethnic and Ethnopharmacology......Page 388 Barriers to Service Delivery and Treatment......Page 389 Status of People with Disability and Mental Illness......Page 390 Mental Health Legislation and Policy......Page 392 Recommendation to Improve Services......Page 393 Summary......Page 394 References......Page 395 21: System of Service Delivery for People with Disabilities in India and Impact in Rural Areas......Page 398 Traditional Cultural Values and Strengths......Page 399 Rate of Disability......Page 400 System of Service Delivery......Page 401 Barriers to Service Delivery......Page 403 Strategies to Enhance Services......Page 405 Summary......Page 409 Multiple-Choice Questions......Page 410 References......Page 411 Introduction......Page 413 A Brief Overview of Republic of Turkey......Page 414 Disability Facts and Figures......Page 415 Stakeholders of Service Delivery......Page 417 Health-Care System......Page 418 Disability Benefits and Care Services......Page 419 Education and Vocational Rehabilitation of People with Disabilities......Page 421 Employment of People with Disabilities......Page 424 Role of Transportation......Page 425 Role of Intersecting Identities......Page 426 Future Implications......Page 427 Summary......Page 429 Multiple-Choice Questions......Page 430 References......Page 431 Introduction......Page 434 Community-Based Rehabilitation in Colombia......Page 436 The Community-Based Rehabilitation Matrix......Page 438 Disability Related to War......Page 441 Recommendations to Service Delivery......Page 443 Summary......Page 444 Multiple-Choice Questions......Page 445 References......Page 446 24: Disability Policies and Practices in the Rural United Kingdom......Page 449 Introduction......Page 450 Legislative Framework......Page 452 Status of People with Disabilities in the UK......Page 453 Social Attitudes Toward People with Disabilities......Page 455 Barriers for People with Disabilities......Page 456 Government Initiatives to Enhance Opportunities for PWDs......Page 458 Vocational Rehabilitation Service Delivery System......Page 460 Self-Check Questions......Page 463 References......Page 464 Part IV: Rural Vocational Rehabilitation Practice and Service Delivery......Page 467 25: Challenges After Natural Disaster for Rural Residents with Disabilities......Page 468 Introduction......Page 469 National Disaster Recovery......Page 471 Rural Aspects of Social Vulnerability and Challenges of PWDs in RFT Communities......Page 473 Understanding Disability in the Context of Disaster Response and Recovery......Page 475 Role of the Rehabilitation Counselor......Page 476 Standards for Disaster Crisis Counselors and Credentialing and Competence......Page 478 Counselor Self-care Issues......Page 479 Rehabilitation Agency Strategies to Minimize Service Disruption During and After Disaster......Page 481 Multiple-Choice Questions......Page 482 References......Page 484 26: Meeting the Needs of Rural Adults with Mental Illness and Dual Diagnoses......Page 487 Introduction......Page 489 Barriers to Mental Health Treatment in Rural Areas......Page 490 Risk Factors for Mental Illness in Rural Areas......Page 494 Dual Diagnosis......Page 499 Rethinking Approaches to Service Delivery in Rural Areas......Page 500 Recovery and Employment......Page 505 Summary......Page 506 Multiple-Choice Questions......Page 507 References......Page 508 Introduction......Page 514 Psychosocial Aspects......Page 515 Social Involvement......Page 516 Medical......Page 517 Self-Management......Page 518 Treatment Adherence......Page 519 Knowledge of MS......Page 520 Health Maintenance Behavior......Page 521 MS Health and Symptom Awareness......Page 522 Multiple Choice Questions......Page 523 References......Page 524 28: Substance-Related and Addictive Disorder Treatment in Rural, Frontier, and Territory Settings......Page 527 Characteristics of Persons with Substance-Related and Addictive Disorders in Rural Areas......Page 528 Barriers to Treatment......Page 533 Considerations for Counselors Working in Rural Areas with Addiction Population......Page 536 Approaches to Service Delivery......Page 540 Strategies to Address Substance Abuse in Rural Areas......Page 543 Experiential Exercises......Page 546 Key......Page 547 References......Page 548 29: Marketing Vocational Rehabilitation Services in Rural Communities......Page 552 Introduction......Page 553 Brand Marketing......Page 554 Internal Marketing......Page 555 Content Marketing......Page 556 Marketing Outreach to Consumers......Page 557 Discussion Questions......Page 558 References......Page 559 Introduction......Page 560 History of the Workforce Innovation Act and Current Reauthorization of WIOA......Page 561 Workforce Innovation and Opportunity Act of 2014......Page 562 Unified and Combined State Plans......Page 564 Increased Role of VR Agencies in Transition......Page 565 Formal Cooperative Agreements: VR-Medicaid-IDD Agencies......Page 566 Changed Performance Measures......Page 567 State VRC Educational Requirements......Page 568 Implications for Transition-Aged Youth......Page 569 Implications for Veterans......Page 571 Broader Potential Impact and Additional Policies......Page 572 Summary and Conclusions......Page 573 Multiple Choice Questions......Page 574 References......Page 575 31: Americans with Disabilities Act in Rural America: A Case Study......Page 577 Americans with Disabilities Act......Page 578 Titles and Provisions of the 1990 Americans with Disabilities Act......Page 579 Americans with Disabilities Act Amendments Act of 2008......Page 581 Health of Kentucky......Page 583 Physical Accessibility......Page 584 Barriers to Compliance with Provisions Related to Title I: Equal Employment......Page 585 Barriers to ADA Compliance in Kentucky......Page 586 Aging Populations in Rural Areas......Page 588 Rural Kentucky: Impact of Ongoing Factors that Influence ADA Compliance......Page 589 Financial Incentives......Page 590 Development of Technical Assistance Resources......Page 591 Outreach to the Rural Disability Community......Page 592 The Curious Case of Kentucky: What Is Next?......Page 594 Field-Based Experiential Assignments......Page 595 Multiple-Choice Questions......Page 596 References......Page 597 32: Rural Forensic Vocational Rehabilitation Practice: Challenges and Opportunities for Rehabilitation Professionals......Page 599 Introduction......Page 600 Social Security Disability......Page 601 Worker Compensation......Page 603 Personal Injury, Wrongful Death, and Childhood Claims......Page 606 Labor Market Changes Affecting Rural Residents of the United States......Page 607 Barriers to a Rural to Urban Transition......Page 610 Transportation......Page 611 The Impact of Substance Abuse, Dependence, and Drug Culture......Page 612 Access to Education......Page 613 Summary......Page 615 Glossary of Terms......Page 616 Multiple-Choice Questions......Page 617 References......Page 618 33: Climate and Weather in the United States and Its Impact on People with Disabilities in Rural Communities......Page 620 Northeast......Page 621 Southeast......Page 622 Great Plains......Page 623 Northwest......Page 624 Weather and Climate Conditions and Their Impact Toward Disability and Health......Page 625 Extreme Heat......Page 626 Summary......Page 629 Case Scenario I......Page 630 References......Page 631 Part V: Education, Training, Networking, and Research on Vocational Rehabilitation in Rural, Frontier, and Territory Communities......Page 634 34: Developing the Personnel to Meet the Needs of Persons with Disabilities in Rural Settings Through Online Learning......Page 635 Introduction......Page 636 Increase in Adult Learners......Page 639 Case Study of a Distance-Learning Program......Page 642 Summary......Page 647 Self-Check Questions......Page 648 Multiple Choice Questions......Page 649 References......Page 650 35: Human Resources Issues: Recruiting and Retaining Rehabilitation Counselors and Human Service Professionals in Rural, Frontier, and Territory Communities......Page 652 Introduction......Page 653 Challenges in Recruitment and Retention of Rural Counselors......Page 654 Partnerships with Counselor Training Programs......Page 655 Preparing Staff to Supervise and Mentor......Page 656 Promoting from Within......Page 657 Factors that Promote Rural Counselor Retention......Page 658 Consistency with Organizational Culture......Page 659 Worker Factors......Page 660 Work Environment Factors......Page 661 Role of Supervisors and Managers......Page 662 Future Implications......Page 663 Field-Based Experiential Assignments......Page 664 Key......Page 665 References......Page 666 Rural Communities......Page 668 Community Partnerships......Page 669 Barriers to Collaboration......Page 670 The National AgrAbility Project......Page 671 Kentucky AgrAbility Case Study......Page 673 Inside Home......Page 674 Kentucky Appalachian Rural Rehabilitation Network (KARRN)......Page 675 The Role of Rehabilitation Professionals......Page 677 Summary......Page 678 References......Page 679 37: Utilizing Indigenous Volunteers and Paraprofessionals for Disability Advocacy and Service in Rural America......Page 680 Introduction......Page 681 Who Are Paraprofessionals and Indigenous Volunteers?......Page 682 Rural Challenge that Supports Use of Indigenous Paraprofessionals......Page 684 Linking......Page 685 Service Provision......Page 686 Advantages and Benefits of Utilizing Volunteers and Paraprofessionals......Page 687 Paraprofessional Training......Page 688 Paraprofessional Duties......Page 689 Harm to Client......Page 691 Legal Challenges......Page 692 Paraprofessional Attrition......Page 693 Limitations and Implications for Future Service Delivery......Page 694 Experiential Exercises......Page 695 Key......Page 696 References......Page 697 38: Research and Evidence-Based Practices of Vocational Rehabilitation in Rural, Frontier, and Territory Communities......Page 699 Defining Evidence-Based Practice......Page 700 Brief History of EBP and the Rehabilitation Counseling Response......Page 703 Knowledge Translation......Page 705 How EBP Impacts Policy......Page 706 What Works in Rural Areas?......Page 707 Community Navigators......Page 709 Future Directions in EBP for Rural Practitioners......Page 710 Increasing Availability and Use of EBP in Rural Communities......Page 711 Field-Based Experiential Assignments......Page 713 Multiple Choice Questions......Page 714 References......Page 715 Erratum to: Disability and Vocational Rehabilitation in Rural Settings......Page 718 Index......Page 719 This first-of-its-kind textbook surveys rehabilitation and vocational programs aiding persons with disabilities in remote and developing areas in the U.S. and abroad. Contributors discuss longstanding challenges to these communities, most notably economic and environmental obstacles and ongoing barriers to service delivery, as well as their resilience and strengths. Intersections of health, social, structural, and access disparities are shown affecting rural disabled populations such as women, racial and sexual minorities, youth, and elders. In terms of responses, a comprehensive array of healthcare and health policy solutions and recommendations is critiqued with regard to health, employment, and service effectiveness outcomes.Included among the topics:Healthcare initiatives, strategies, and challenges for people with disabilities in rural, frontier, and territory settings.Challenges faced by veterans residing in rural communities.The Asia and Pacific region: rural-urban impact on disability.Challenges after natural disaster for rural residents with disabilities.Meeting the needs of rural adults with mental illness and dual diagnoses.Capacity building in rural communities through community-based collaborative partnerships.__Disability and Vocational Rehabilitation in Rural Settings__