EdFix Episode 20: Rehabilitation Counseling - Fostering a Better Quality of Life for People with Disabilities

TRANSCRIPT

MAUREEN MCGUIRE-KULETZ:
Disability does not discriminate based on your age or your gender or national origin or anything. It cuts across everything.

MICHAEL FEUER:
This is EdFix, your source for insights about the practice and promise of education. I'm Michael Feuer, and I am so happy this episode to be speaking with two wonderful colleagues, Dr. Maureen McGuire-Kuletz and Dr. Ken Hergenrather, both of them faculty members in our rehabilitation counseling program here in the Graduate School of Education and Human Development.

MICHAEL FEUER:
Maureen is associate professor of counseling. She brings three-and-a-half decades of experience as an educator at the university level and as a manager in public vocational rehabilitation. Her research interests cover effective transition to higher education for transitioning youth, ethics for counselors, and employment barriers experienced by persons with disabilities.

MICHAEL FEUER:
Professor Hergenrather is a professor of counseling. Ken is a past president of the National Council on Rehabilitation Education and an executive board member for the National Working Positive Coalition. He's also on the editorial boards for AIDS Education and Prevention, the Journal of Applied Rehab Counseling, Rehabilitation Research, Education, and Policy.

MICHAEL FEUER:
Welcome to both of you to EdFix. Let me start by saying that Maureen and Ken, in your spare time, you are directors of one of our flagship programs in the school called the Rehabilitation Counseling Research and Education Center, which was recently, thanks to your amazing work, the recipient of yet another very significant research grant from the United States Department of Education.

MICHAEL FEUER:
Who wants to tell us what exactly is rehabilitation counseling, now that I've used that phrase 50 times in introducing you. One or both of you can unpack what that phrase means.

MAUREEN MCGUIRE-KULETZ:
Well, thank you first of all, so much for having us on your podcast, we really appreciate the opportunity to talk a little bit about our work and what we're doing. Rehabilitation counseling looks at working with the whole individual, but specifically folks with disabilities, and help them to live life to their fullest potential through independent living, through employment outcomes, and full integration into the community. The center is focused on education and research, and strives to provide opportunities for growth and development to diverse populations, obviously including people with disabilities, and has a long and rich history of collaboration valuing the role of partnerships and promoting positive change in our society. Ken, do you want to piggyback on that?

KEN HERGENRATHER:
Rehabilitation counseling and working with individuals that have disabilities as stated in the 1990s Americans with Disabilities Act, would meet the qualifications for eligibility to apply for vocational rehabilitation services through state agencies, also through federal agencies, that would include the Veterans Administration and also state departments of vocational rehabilitation.

KEN HERGENRATHER:
Once they're determined eligible, then they're working with counselors to assess their job-seeking skills, job readiness needs, their employment areas in which to pursue active employment or to contribute more likely in society in a more fulfilled role, or to pursue independent living. In order to work in those fields, the participants will usually engage in training programs in vocational rehabilitation services at the undergraduate level or the master's level. Through the master's level, they will receive training through graduate programs like ours, and they'll become eligible to sit to become certified rehabilitation counselors, which is a preferred credential to work in state vocational rehabilitation service-providing agencies, including Veterans Administration.

MAUREEN MCGUIRE-KULETZ:
Our counselors are found obviously in state vocation rehabilitation agencies, found in special ed programs, but we're also found at GW's Office of Disability Support Services and other disability support services, they're found in employee assistance programs. Disneyworld and Disneyland hire their own rehabilitation counselors to work with folks who get injured in the Magic Kingdoms and need to return to work; Ford and Chevrolet hire their own rehabilitation counselors who work with folks that are returning back to work, maybe after a stroke or some sort of an injury, and they want to bring them back into the workforce, so a wide range of places where you'll find rehabilitation counselors.

MICHAEL FEUER:
The word, disabilities, give us some examples. What kinds of disabilities are we mostly talking about?

KEN HERGENRATHER:
Well, I think I would start by referring to the Americans with Disabilities Act of 1990, that states what a disability criteria is. Then also looking at the ability to perform activities of daily living. Activities of daily living would be the abilities to function, so am I able to take care of oneself? Am I mobile? Am I able to demonstrate those daily skills: get up, dress ourselves, eat. Do we go to work? Are we mobile? Looking at our cognitive processes, looking at our executive functioning skills, looking at our hearing, looking at our vision.

MICHAEL FEUER:
The passage of the Americans with Disabilities Act, so that's 1990. I think that was hailed as quite a significant landmark accomplishment. In what way did things change? And what were we doing before then? Let's put it that way.

MAUREEN MCGUIRE-KULETZ:
Vocational rehabilitation first started after World War I with returning soldiers, and it was the Soldiers' Act, and they dealt with soldiers. And then they realized that they needed to expand out to the community at large, and they started looking at people with physical disabilities. So it has evolved over the years. And certainly with legislation, legislative changes, IDEA, the Americans with Disabilities Act, 504, it certainly has evolved and moved along in terms of that. But what the ADA provided was protection for people with disabilities against various forms of discrimination.

MICHAEL FEUER:
Compared to the situation in other countries, do either of you have a sense of whether we are behind the curve, ahead of the curve, in terms of what I view at least as a pretty enlightened effort on behalf of people with disabilities. What's the situation in other places?

KEN HERGENRATHER:
We're advanced in this area. The reason I would say that is because mainly of the rehabilitation legislation that's passed. Mainly if we look at the Rehab Act 1973, and we look at the amendments, and we look at the IDEA, looking at persons with disabilities in schools. So we've started this in the schools and heightened the awareness, and then we look at the transition-aged youth, and we look at adults. I would say we have this through the like young adult through adult lifespan. And I think that we have the legislation that was passed through the ADA, which includes employment, which includes facilities, which includes transportation. So the ADA kind of threaded the accommodations not only in the workplace, but also by services being used and services provided to individuals with disabilities in the United States and territories.

MICHAEL FEUER:
We have students from overseas who come and get this kind of professional development through our programs, and it's because they are then able to apply some of that knowledge and skill back in their home countries.

MAUREEN MCGUIRE-KULETZ:
I had a student from Pakistan, and she had gotten her master's here at GW in special ed. And she went to work in a school in Pakistan and was working with special ed students and realized they were graduating to nothing. There were no programs. So came back to, got her master's in rehabilitation counseling, had took advantage of some internship opportunities here in the United States and went back to Pakistan to look at developing programs for youth once they finished high school, that they could move on and do something else. We've had students from Saudi Arabia. We've had students from Japan, we've had students from all over the world that their government sent pay for them to come here and learn this and export it back to their country.

MICHAEL FEUER:
I want to go back to another aspect of this, which is there must be some, shall we say, correlation or overlap between disability and other individual characteristics including economic status, poverty, employment, and unemployment.

MAUREEN MCGUIRE-KULETZ:
Yeah, it's interesting, and I'm going to let Ken take this, because he's done a lot of work in this area, but Ken and I just finished up, literally just finished up a grant on looking at, it's called targeted communities, and was looking at the intersection of disability and poverty, high incidents of poverty among people with disabilities. And it's often, you're right, confounded by having the disability access to services. We're not at all surprised that there is a high rate of COVID found in poor communities, because they just don't have the resources that more affluent communities have. Ken, do you want to talk a little bit more?

KEN HERGENRATHER:
Sure. In regard to, we're looking at poverty, so we're looking at the access to resources, and access to resources, transportation, healthcare, also education, mental health services. If we're looking at the issues of employment and looking at unemployment and poverty, and looking at resources and not being available, then looking at rates of assault, rates of violence, issues of substance use, and I would like to say the research suggests that these may be hard to adapt to poverty and the stresses of living in poverty.

KEN HERGENRATHER:
When we look at rural poverty versus urban poverty, we can see some of the same factors coming into play. In rural areas, transportation becomes a problem. Then also there may be the necessity for housing. And do I live in environments in which housing is a priority for me, for my children. Looking at poverty, could it be generational poverty, or could it be situational poverty? I'm thinking those are some of the factors also. And if there's generational poverty, does that demonstrate- Research suggests that, that this generational poverty is likely that the next generation is going to be in that also. So I think what we could do is providing resources to persons in poverty, looking at services, and if the services aren't immediately available, how can we bring the services in to those communities?

MICHAEL FEUER:
It seems to me as though, but you can correct me if I'm wrong, it's not that we're saying that poverty- Well, I guess it does, increase one's odds of getting exposed to the virus, but it also reduces people's opportunities to get the right kind of treatment.

MAUREEN MCGUIRE-KULETZ:
Correct.

MICHAEL FEUER:
So it's a double whammy on that one. Discrimination or inequality as it affects people with disabilities can be made even worse, because many of the people with disabilities are also experiencing poverty, and those things intersect in a way that make this an even more challenging kind of situation. Let's talk a little bit about the program. In preparing future counselors to work in rehabilitation settings, they're going to need both clinical knowledge and diagnostic knowledge, but also a pretty good grip on all of the regulatory, institutional, legal, ADA-related things. So how do you guys do that?

MAUREEN MCGUIRE-KULETZ:
I did want to put in a plug for our rehabilitation counseling program, and I know we all have mixed feelings about rankings, but US News & World Report, we're ranked third in the country.

MICHAEL FEUER:
I think one of the reasons that it is probably ranked so highly is that there is this very interesting blend of formal, shall we say, book knowledge that you are endowing them with, but there's a big experiential component to this, because you learn by doing it. How do you choreograph all of that?

KEN HERGENRATHER:
We have two programs at GW. We have an online program, and we have the on-campus program. Our students, when they are in our program, what we do is we have created the curriculum for our programs so our rehabilitation counseling students can sit for the certified rehabilitation counselor credential exam, for the national certified counselor exam, and then graduate with a CACREP accredited program they can pursue licensure as a counselor, and they could also work in public vocational rehabilitation counseling, or they can work in private vocational rehabilitation counseling.

MAUREEN MCGUIRE-KULETZ:
We've been very successful in getting long-term training grants from the US Department of Education to fund students to go through these programs, which has been very, very helpful. And the US Department of Veterans Affairs also will fund folks they have to go through the program, as well, so that helps. And some companies, private insurance companies, that hire VR counselors will pay for their folks to take classes with us.

MICHAEL FEUER:
Some people would say that the reason we have more of this rehab counseling going on is because we have redefined certain conditions in a diagnostic way that makes it necessary to have trained professionals engaged.

KEN HERGENRATHER:
If I can just provide some information thinking about the number of people. So in 2019, the US Census Bureau reported 40.7 million people. That's 12.7% of the US non-institutionalized civilian population, as having a disability. Centers for Disease Control in 2018 estimates at 26% of the adults in the US have a disability. For example, they report one in four women, two in five adults over the age of 65. Of the more than 40 million individuals living with a disability, only 7.5 million were employed, making up about 13% of the US unemployment. If we look at the median income for individuals with disabilities 16 years of age and older, it's only $23,006. And that's from the US Census Bureau of 2019, compared to the people without disabilities in the same age group, $47,062.

MICHAEL FEUER:
But has there been a real increase in, again, I'm not sure if this is the right word, but in the prevalence of disabilities? Or has there been an increase in our awareness of existing disabilities and in our measurement of them and in our gathering of these statistics about them?

KEN HERGENRATHER:
Well, I think there are two issues that present here. One is what is a disability, and how is that assessed, and the other, that when we're looking at vocational rehabilitation services, it'd be the individuals that meet the criteria of the Americans with Disabilities Act. So we're looking at that population and providing services to them. In regard to the number of people receiving VR services, do we think that there's an increase in the number receiving VR services, the number of applying for services? Maureen, what would you say?

MAUREEN MCGUIRE-KULETZ:
I think the need for rehabilitation counselors is not so much that there's been a huge increase in the number of people with reported disabilities, although I think stigma around disability, at least in the United States, there's much less stigma. Other cultures will tell you that if they have a family member who has a significant intellectual impairment that keeps them at home, they don't expect them to do anything. They expect them to be cared for by the family. But I think that the bigger issue that we're seeing the need for more counselors, is actually the 60s and the 70s were kind of the golden age of rehabilitation. The field really grew. They brought in a lot of counselors, and those counselors are retiring now. There's a gray tsunami. They're just retiring. One state, Pennsylvania, told me that 50% of their counselors are eligible to retire if they wanted to. That is a lot. How can you prepare enough counselors to come in and take their place?

KEN HERGENRATHER:
Michael, I will share with you, in regard to increases in diagnoses, I will say the CDC reported during a period of 2009 through 2017, they looked at some diagnoses and developmental disabilities among children in the United States. So this is through age 3 and 17, and they did find that there was an increase in the number of children being diagnosed. And this is for attention deficit, autism spectrum disorder, intellectual disabilities. And so these will be the people who are pursuing transition services through vocational rehabilitation services and adults, so there are increases.

MAUREEN MCGUIRE-KULETZ:
Disability does not discriminate based on your age or your gender or national origin or anything. It cuts across everything.

MICHAEL FEUER:
Let me ask you this. A little bit about yourselves, how'd you guys get into this line of work?

MAUREEN MCGUIRE-KULETZ:
My background is in education, and then I got interested in working with individuals with disabilities, and certainly had family members and neighbors and friends with disabilities. So I kind of fell into it, if you will, and developed an interest in that, and it went along with my interest in human services and working with diverse populations. And it was a question of equity too, because at the time I was first started working in the field in the eighties, there was still a lot of discrimination against people with disabilities, some of it fairly blatant. Also a little social justice, to be honest with you. I think we were interested in the field of vocational rehabilitation and social justice before other people were talking about social justice and equity. Ken, yourself?

KEN HERGENRATHER:
That's a wonderful segue into mine. My background is also in public health. I was working in the field of HIV and AIDS, working with testing and counseling, and I also monitored support groups. These support groups would consist of people who were positive: grandmothers, people who are straight, people who were bisexual, people who were gay. Age, race, ethnicity didn't matter. But what I was hearing time after time for about three months are these types of comments: My position just got reduced from permanent to temporary; my hours just got cut from 40 to 20; I've been told my job's been terminated.

KEN HERGENRATHER:
So constantly throughout this, I'd heard this, and with the Americans with Disabilities Act coming in, persons with HIV and AIDS being protected under the Americans with Disabilities Act, I then pursued my degree in rehabilitation counseling. So it was more of an advocacy, because hearing, it must have been hundreds of people that were losing their positions, and it just logically didn't make sense. Then in talking with human resource directors and so forth, you understood what could happen.

KEN HERGENRATHER:
They would share some of the reasons and understandings. There were some laws such as hire at will, fire at will. So positions weren't necessarily guaranteed, and because of the discrimination that could happen during that time. The discrimination was to the point that the American Red Cross created training programs throughout the United States, regarded as businesses respond to AIDS. And these were trainings. I was a national trainer, trained trainers throughout the country. People would attend six-hour trainings on this, how not to discriminate in the workplace.

MICHAEL FEUER:
In so much of our world, our life in the Academy, one needs a real sense of delayed gratification about whether we're making a difference. We do very interesting and rigorous research, and then it takes a year to get it published. I don't want to be too facetious about this, because I'm obviously a great believer in the importance of scientific research, but in terms of getting that gratification that you've really made a difference to someone's life, that, you need a little bit of a stretch sometimes, but in this case, I can imagine that your students who are working with people who come in for counseling, can feel rather more almost immediately that they're really helping somebody get past an obstacle, deal with a recalcitrant employer, overcome an emotional hurdle. That must be wonderfully gratifying to the students when they see that they're having that kind of an effect.

MAUREEN MCGUIRE-KULETZ:
I would think so. The other thing I was thinking when you made that comment, I often talk with my staff about let's move the needle. Let's get things, and the movement in a positive direction. One of our grants is on innovative training and vocational rehabilitation. Obviously, when COVID hit, we had to move from in-person to online. One of the topics that had come up as of interest is looking at people with disabilities in the LGBTQ+ community. We did a series of webinars using one of our doc students, and one of our wonderful staff, and did several webinars. And we have state agencies who've told us they are now taking those webinars and using it to onboard new counselors to their programs. I think that's taking something very positive and having an immediate answer, and you get immediate gratification that you've moved that needle a little bit and made a positive change.

KEN HERGENRATHER:
I think also there are measures within the rehabilitation counseling programs. So these students are creating individualized plans for employment, and those actually have benchmarks. So when you're working with your client, and rehabilitation counselors working with their clients, they do see these benchmarks that are met, and they are looking at how has the client developed job-seeking skills, further job readiness skills, looking at some of those interviewing skills, looking at their own skills and abilities and accommodations that are needed in adapting. And so there are these benchmarks that are achieved throughout the individualized plan for employment. That's one way of seeing success.

MICHAEL FEUER:
We have really just scratched the surface on a whole set of issues. I want listeners to know where to look on our G[inaudible 00:25:46] website for more of the information about my guests, Ken and Maureen, and the program and some of the references. And we have some terrific resources for our listeners to know that they can go to.

MAUREEN MCGUIRE-KULETZ:
Our web address is GWCRCRE.org. O-R-G.

MICHAEL FEUER:
So this has been both wonderfully pleasant for me, and also a big eye-opener in terms of so many of the issues that we are confronting as a society trying to bring some calibration to all of the examples of inequality, to the examples of people in very difficult circumstances, to issues related to how we go about empathically trying to make the world at least a little bit better than the way we found it. You guys are both doing that, and your program is an exemplar of that. So I just want to thank you for letting me in on some of this at a level of detail, which I confess I didn't know much about or not enough about. It's very gratifying. It's very reassuring.

MICHAEL FEUER:
I just want to say again, a big thank you to Maureen McGuire-Kuletz and Ken Hergenrather for joining me in this episode of EdFix. If you've enjoyed this episode, you can subscribe to EdFix, and thanks to our superb executive producer engineer, Touran Waters. You can hear this on iTunes, Spotify, iHeart Radio, Player FM, or wherever else you listen to your podcasts. We have a website, too. It's called edfixpodcast.com, but in the meantime, a big, big thank you again to Maureen and Ken, and best wishes for continuation of success and good health.

MAUREEN MCGUIRE-KULETZ:
Thank you.

KEN HERGENRATHER:
Thank you, Michael.

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