Vocational rehabilitation (VR) clients who leave the system prematurely experience worse employment outcomes than clients who stay in services. The authors conducted this study to learn about factors leading to premature exit by rural VR clients. Results will inform survey development for a large longitudinal study on this topic. The authors content coded 27 qualitative telephone interviews with former rural VR clients who exited the system prematurely. Reported reasons for premature exit included (a) discrepancies between services provided and services desired, (b) unmet counselor expectations, (c) counselor—client relationship problems, (d) health issues, (e) limited job opportunities, (f) work disincentives, and (g) slow service speed. VR might reduce premature exits by helping clients better understand the VR process, including the types of VR services offered and associated counselor expectations.
Anderson, C., & Vogel, L. ( 2002). Employment outcomes of adults who sustained spinal cord injuries as children or adolescents. Archives of Physical Medicine and Rehabilitation, 83, 791-801.
2.
Arnold, N., & Seekins, T. ( 1998). Rural and urban vocational rehabilitation: Counselors perceived strengths and problems. Journal of Rehabilitation , 64(1), 5-13.
3.
Arnold, N., Seekins, T., & Nelson, R. ( 1997). A comparison of vocational rehabilitation counselors: Rural and urban differences. Rehabilitation Counseling Bulletin , 41, 2-14.
4.
Balcazar, F., Suarez-Balcazar, Y., Taylor-Ritzler, T., & Keys, C. ( 2010). Race, culture, and disability: Rehabilitation science and practice. Sudbury, MA: Jones and Bartlett.
Cardoso, E., Romero, M.G., Chan, F., Dutto, A., & Rahimi, M. ( 2007). Disparities in vocational rehabilitation services and outcomes for Hispanic clients with traumatic brain injury: Do they exist? Journal of Head Trauma Rehabilitation, 22(2), 85-94.
7.
Chan, F., Cheing, G., Chan, J., Rosenthal, D., & Chronister, J. (2006). Predicting employment outcomes of rehabilitation clients with orthopedic disabilities: A CHAID analysis. Disability and Rehabilitation, 28, 257-270.
8.
Day-Vines, N.L., Wood, S.M., Grothaus, T., Craigen, L., Holman, A., Dotson-Blake, K., & Douglass, M.J. (2007). Broaching the subject of race, ethnicity, and culture during the counseling process: Report. Journal of Counseling and Development, 85(4), 401-409.
9.
DeVivo, M. ( 1998, September). Rehospitalization costs of individuals with SCI [Research update]. Birmingham: Medical Rehabilitation Research and Training Center at the University of Alabama at Birmingham.
10.
Donnell, C.M., Lustig, D.C., & Strauser, D.R. (2004). The working alliance: Rehabilitation outcomes for persons with severe mental illness. The Journal of Rehabilitation, 70(2), 12-18.
11.
Feist-Price, S. ( 1995). African Americans with disabilities and equity in vocational rehabilitation services: One state’s review. Rehabilitation Counseling Bulletin, 39(2), 119-130.
12.
Field, M., Jette, A., & Martin, L. (Eds.). (2006). Workshop on disability in America: A new look . Washington, DC: The National Academic Press.
13.
Hanson, S.L., & Kerkhoff, T.R. (2007). Ethical decision making in rehabilitation: Consideration of Latino cultural factors. Rehabilitation Psychology, 52(4), 409-420.
14.
Hayward, B., & Schmidt-Davis, H. (2003, May). Longitudinal study of the Vocational Rehabilitation Services Program: Final report 2: VR services and outcomes. Research Triangle Park, NC: Research Triangle Institute.
15.
Hein, S., Lustig, D., & Uruk, A. ( 2005). Consumers’ recommendations to improve satisfaction with rehabilitation services: A qualitative study. Rehabilitation Counseling Bulletin, 49(29), 29-39.
16.
Ipsen, C. ( 2006). Health, secondary conditions, and employment outcomes for adults with disabilities. Journal of Disability Policy Studies, 17, 77-87.
17.
Ipsen, C., Rigles, B., Arnold, N., & Seekins, T. ( 2010a). The use of telecommunications to deliver vocational rehabilitation services to rural and urban clients: Client report. Missoula: The University of Montana Rural Institute .
18.
Ipsen, C., Rigles, B., Arnold, N., & Seekins, T. ( 2010b). The use of telecommunications to deliver vocational rehabilitation services to rural and urban clients: National report. Missoula: The University of Montana Rural Institute .
19.
Ipsen, C., Seekins, T., & Arnold, N. ( 2011). A prospective study to examine the influence of secondary health conditions on VR client employment outcomes. Disability and Health Journal, 4(91), 28-38.
20.
Ipsen, C., Seekins, T., & Ravesloot, C. ( 2010). Building the case for delivering health promotion services within the vocational rehabilitation system. Rehabilitation Counseling Bulletin, 53(2), 67-77.
21.
Jiang, Y., & Hesser, J. ( 2006). Associations between health-related quality of life and demographics and health risks: Results from Rhode Island’s 2002 Behavioral Risk Factor Survey. Health and Quality of Life Outcomes, 4, 14-24.
22.
Johnstone, B., Price, T., Bounds, T., Schopp, L., Schootman, M., & Schumate, D. ( 2003). Rural/urban differences in vocational outcomes for state vocational rehabilitation clients with TBI. NeuroRehabilitation , 18, 197-203.
23.
Johnstone, B., Vessell, R., Bounds, T., Hoskins, S., & Sherman, A. ( 2003). Predictors of success for state vocational rehabilitation clients with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 84, 161-167.
24.
Kinne, S., Patrick, D., & Doyle, D. ( 2004). Prevalence of secondary conditions among people with disabilities. American Journal of Public Health, 94(3), 442-445.
25.
Lustig, D., Strauser, D., Rice, N., & Rucker, T. ( 2002). The relationship between working alliance and rehabilitation outcomes. Rehabilitation Counseling Bulletin, 46(1), 25-33.
26.
Lustig, D., Strauser, D., & Weems, G. ( 2004). Rehabilitation service patterns: A rural/urban comparison of success factors. Journal of Rehabilitation, 70(3), 13-19.
27.
Marge, M. ( 1988). Health promotion for persons with disabilities: Moving beyond rehabilitation. American Journal of Health Promotion , 2(4), 29-35.
28.
Marini, I., Lee, G., Chan, F., Chapin, M., & Romero, M. ( 2008). Vocational rehabilitation service patterns related to successful competitive employment outcomes of persons with spinal cord injury . Journal of Vocational Rehabilitation, 28, 1-13.
29.
Matrone, K., & Leahy, M. ( 2005). The relationship between vocational rehabilitation client outcomes and rehabilitation counselor multicultural counseling competencies . Rehabilitation Counseling Bulletin, 48(4), 233-244.
30.
McAweeney, M., Keferl, J., Moore, D., & Wagner, J. ( 2008). Predictors of successful closure in the state-federal vocational rehabilitation system: Findings from a sample of persons with disability and substance use disorders. Journal of Applied Rehabilitation Counseling, 39(2), 30-36.
31.
Park, H.C., Kim-Rupnow, W.S., Stodden, R., & Starbuck, D.E. (2005). Disparity of closure types in vocational rehabilitation services. Journal of Vocational Rehabilitation, 23, 33-38.
32.
Peterson, C., Semmel, A., von Baeyer, C., Abramson, L.Y., Metalsky, G.I., & Seligman, M.E.P. (1982). The Attributional Style Questionnaire. Cognitive Therapy and Research, 6(3), 287-300.
Rimmer, J. ( 1999). Health promotion for people with disabilities: The emerging paradigm shift from disability prevention to prevention of secondary conditions . Physical Therapy, 79, 495-502.
35.
Rojewski, J. ( 1992). Vocational rehabilitation in rural America: Challenges and opportunities. American Rehabilitation, 18, 39-44.
36.
Scheier, M.F., & Carver, C.S. ( 1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4(3), 219-247.
37.
Stodden, R.A., Stodden, N.J., Kim-Rupnow, W.S., Thai, N.D., & Galloway, L.M. (2003). Providing effective support services for culturally and linguistically diverse persons with disabilities: Challenges and recommendations. Journal of Vocational Rehabilitation , 18, 177-189.
38.
Strauss, A., & Corbin, J. ( 1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage.
39.
U.S. Department of Agriculture Economic Research Service. ( 2003). Measuring rurality: Rural-urban continuum codes. Retrieved from http://www.ers.usda.gov/briefing/rurality/ruralurbcon/
40.
U.S. Department of Commerce. (2010). Exploring the digital nation: Home broadband Internet adoption in the United States. Retrieved from http://www.esa.doc.gov/DN/
41.
Whitfield, H.W., Venable, R., & Broussard, S. ( 2009). Are client- counselor ethnic/racial matches associated with successful rehabilitation outcomes?Rehabilitation Counseling Bulletin, 53, 96-105.
