Certified Rehabilitation Counselor Examination Preparation PDF

Fong Chan Malachy Bishop Julie A. Chronister Eun-Jeong Lee Chungyi Chiu NOTICE ====== This accessible media has been made available to people with bona fide disabilities that affect reading. This notice tells you about restrictions on the use of this accessible media, which could be a book, a periodical, or other content. Copyright Notice ---------------- **Title:** Certified Rehabilitation Counselor Examination Preparation **Author:** Fong Chan, Malachy Bishop, Julie A. Chronister, Eun-Jeong Lee, Chungyi Chiu **Copyright** 2022 by © 2022 Springer Publishing Company LLC This notice is not part of the copyrighted work, which begins below after the phrase \"Begin Content\". Bookshare distributes this accessible media under restrictions set forth either in copyright law or in an agreement with the copyright owner. If you are not a person with a print disability, or an agency serving people with print disabilities, you should not use this accessible media and should destroy this content. 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Book Quality ------------ Bookshare is interested in improving book quality over time, if you can help us by providing any book quality feedback, we\'ll work hard to make those changes and republish the books. Begin Content Certified Rehabilitation Counselor Examination Preparation ========================================================== Certified Rehabilitation Counselor Examination Preparation ========================================================== **i** **Certified Rehabilitation Counselor Examination Preparation** **ii** **Fong Chan, PhD,** is the Norman L. and Barbara M. Berven Professor of Rehabilitation Psychology (Emeritus) in the Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison. He has more than 37 years of experience conducting applied rehabilitation research in the topical areas of psychosocial interventions, demand-side employment, transition and postsecondary education, evidence-based vocational rehabilitation practices, multicultural issues in rehabilitation, and research methodologies. Dr. Chan has published more than 400 refereed journal articles and 67 book chapters. He is a fellow of the American Psychological Association and National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR) Mary Switzer research fellow. For his research, Dr. Chan has received 12 American Rehabilitation Counseling Association Research (ARCA) Awards, the National Council on Rehabilitation Education (NCRE) Career in Rehabilitation Education Award, the ARCA James Garrett Distinguished Career in Rehabilitation Research Award, and the American Psychological Association, Division of Rehabilitation Psychology, Tamara Dembo and Beatrice Wright Lecture Award. Dr. Chan is the coeditor of the *Rehabilitation Counseling Bulletin,* an associate editor for the *Australian Journal of Rehabilitation Counseling,* and the editor of six rehabilitation counseling textbooks. **Malachy Bishop, PhD, CRC,** is the Norman L. and Barbara M. Berven Professor of Rehabilitation Psychology in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. He obtained his PhD in rehabilitation psychology from the University of Wisconsin-Madison. He has been a rehabilitation counselor educator for over 20 years and has served as the University of Kentucky Rehabilitation Counseling Doctoral Program coordinator and Director of Research for the Human Development Institute, the University of Kentucky\'s University Center for Excellence in Developmental Disability Research. He conducts research in the employment and psychosocial aspects of chronic neurological conditions, effective practice in vocational rehabilitation, and quality of life in chronic illness and disability. **Julie Chronister, PhD,** is a professor in the Department of Counseling at San Francisco State University. She received her PhD from the University of Wisconsin-Madison in 2004. Dr. Chronister has been a counselor educator and researcher for 20 years and has published numerous peer-reviewed articles, book chapters, and books. She is a committed disability advocate, educator, and researcher and has focused much of her research on understanding the lived experiences of those living with psychiatric disabilities. Dr. Chronister has been awarded several federal research and training grants and is committed to improving the lives of the most marginalized and stigmatized communities through her research, teaching, and community partnerships. **Eun-Jeong Lee, PhD, CRC, LCPC,** is an associate professor in the Counseling and Rehabilitation Science Division of the Department of Psychology at Illinois Institute of Technology. Her current duties include teaching graduate-level courses in psychosocial/multicultural issues in rehabilitation and mental health counseling, medical aspects of disability, group counseling, and rehabilitation engineering technology. She also supervises master\'s degree students during counseling practicum and internship experiences and doctoral student research including master\'s thesis and dissertation. Dr. Lee received her PhD in rehabilitation psychology from the University of Wisconsin-Madison in 2007. She has served in many leadership roles including Region 5 representative of the National Council on Rehabilitation Education and Treasurer of American Psychological Association Division 22 (Rehabilitation Psychology). Dr. Lee has been actively working and publishing in psychosocial issues facing family and caregivers of people with chronic illness and disabilities, multicultural issues related to help-seeking behaviors, and vocational rehabilitation. **iii** **Chungyi Chiu, PhD, CRC, LPC,** is an associate professor in the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign. Dr. Chiu received her PhD in rehabilitation psychology from the University of Wisconsin-Madison and her master\'s degree in occupational therapy from the National Taiwan University. She is the founder and director of the Health Promotion and Rehabilitation Laboratory. Her research interests are health promotion for people with disabilities and chronic illnesses, patient healthcare experience, psychosocial adjustment, and social participation. **iv** \[Blank page\] **v** Certified Rehabilitation Counselor Examination Preparation Third Edition ======================================================================== *Fong Chan, PhD* *Malachy Bishop, PhD, CRC* *Julie Chronister, PhD* *Eun-Jeong Lee, PhD, CRC, LCPC* *Chungyi Chiu, PhD, CRC, LPC* **SPRINGER PUBLISHING** **vi** CRC^®^ is a registered trademark of the Commission on Rehabilitation Counselor Certification. This book is not endorsed by or in any way supported by the Commission on Rehabilitation Counselor Certification. Copyright © 2022 Springer Publishing Company LLC All rights reserved. First Springer Publishing edition 2011; subsequent edition 2017. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, or at [www.copyright.com](http://www.copyright.com). Springer Publishing Company, LLC 11 West 42nd Street, New York, NY 10036 [www.springerpub.com](http://www.springerpub.com) connect.springerpub.com/ *Acquisitions Editor:* Rhonda Dearborn *Compositor:* S4Carlisle Publishing Services *ISBN:* 978-0-8261-5824-6 *ebook ISBN:* 978-0-8261-5825-3 *DOI:* 10.1891/9780826158253 21 22 23 24 25 / 5 4 3 2 1 The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. The author and publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers\' use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. **Library of Congress Cataloging-in-Publication Data** Names: Chan, Fong, editor. \| Bishop, Malachy, editor. \| Chronister, Julie A., editor. \| Lee, Eun-Jeong, editor. \| Chiu, Chungyi, editor. Title: Certified rehabilitation counselor examination preparation / \[edited by\] Fong Chan, Malachy Bishop, Julie Chronister, Eun-Jeong Lee, Chungyi Chiu. Other titles: CRC examination preparation. Description: Third edition. \| New York, NY: Springer Publishing, \[2022\]. \| Includes bibliographical references and index. \| Summary: \"We are pleased to present this third edition of Certified Rehabilitation Counselor Examination Preparation. In the first edition of this guide, we indicated that\"\... the purpose of the book is to provide a concise yet comprehensive preparation guide for the CRCC\'s Certified Rehabilitation Counselor (CRC) examination.\" In the development of this third edition this has remained our purpose and commitment\"--- Provided by publisher. Identifiers: LCCN 2021027877 (print) \| LCCN 2021027878 (ebook) \| ISBN 9780826158246 (cloth) \| ISBN 9780826158253 (ebook) Subjects: MESH: Rehabilitation-methods \| Counseling-ethics \| Disabled Persons---rehabilitation \| Examination Questions Classification: LCC HD7255.5 (print) \| LCC HD7255.5 (ebook) \| NLM WB 18.2 \| DDC 362.2/04256076---dc23 LC record available at LC ebook record available at Contact to receive discount rates on bulk purchases. *Publisher\'s Note:* New and used products purchased from third-party sellers are not guaranteed for quality, authenticity, or access to any included digital components. Printed in the United States of America. **vii** Contents -------- [Contributors](#ch002-contributors) [Preface](#ch002-preface) [1 Certified Rehabilitation Counselor Examination Information and Study and Test-Taking Strategies YUNZHEN HUANG AND STUART RUMRILL](#ch002-certified-rehabilitation-counselor-examination-information-and-study-and-test-taking-strategies-yunzhen-huang-and-stuart-rumrill) [2 Professional Orientation and Ethical Practice CONNIE SUNG, FONG CHAN, JESSICA M. BROOKS, JILL BEZYAK, EMRE UMUCU, AND XIANGLI CHEN](#ch002-professional-orientation-and-ethical-practice-connie-sung-fong-chan-jessica-m-brooks-jill-bezyak-emre-umucu-and-xiangli-chen) [3 Evidence-Based Practice, Counseling Theories, and Techniques SANDRA FITZGERALD AND JULIE CHRONISTER](#ch002-evidence-based-practice-counseling-theories-and-techniques-sandra-fitzgerald-and-julie-chronister) [4 Group Work and Family Dynamics EUN-JEONG LEE, JINHEE PARK, AND KRISTIN KOSYLUK](#ch002-group-work-and-family-dynamics-eun-jeong-lee-jinhee-park-and-kristin-kosyluk) [5 Crisis and Trauma Counseling and Intervention JULIE CHRONISTER, YAZMIN CASTRUITA RIOS, AND STUART RUMRILL](Certified_Rehabilitation_Cou00002.docx#ch002-crisis-and-trauma-counseling-and-intervention-julie-chronister-yazmin-castruita-rios-and-stuart-rumrill) [6 Psychosocial Aspects of Chronic Illness and Disability JULIE CHRONISTER AND SANDRA FITZGERALD](Certified_Rehabilitation_Cou00002.docx#ch002-psychosocial-aspects-of-chronic-illness-and-disability-julie-chronister-and-sandra-fitzgerald) [7 Assessment EUN-JEONG LEE, NICOLE DITCHMAN, AND YEN CHUN TSENG](Certified_Rehabilitation_Cou00002.docx#ch002-assessment-eun-jeong-lee-nicole-ditchman-and-yen-chun-tseng) 8 Career Development and Job Placement CONNIE SUNG, JESSICA Μ. BROOKS, JOSHUA TAYLOR, EMRE UMUCU, BEATRICE LEE, CAHIT KAYA, AND FONG CHAN [9 Demand-Side Employment FONG CHAN, JILL BEZYAK, TIMOTHY N. TANSEY, SHARON HSU, CAHIT KAYA, AND XIANGLI CHEN](Certified_Rehabilitation_Cou00003.docx#ch002-demand-side-employment-fong-chan-jill-bezyak-timothy-n-tansey-sharon-hsu-cahit-kaya-and-xiangli-chen) [10 Community Resources and Partnerships MALACHY BISHOP, MUNA BHATTARAI, STUART RUMRILL, MIRANG PARK, AND DEBORAH LEE](Certified_Rehabilitation_Cou00003.docx#ch002-community-resources-and-partnerships-malachy-bishop-muna-bhattarai-stuart-rumrill-mirang-park-and-deborah-lee) [11 Rehabilitation, Disability, and Healthcare Case Management MALACHY BISHOP, STUART RUMRILL, MIRANG PARK, MUNA BHATTARAI, KAIQI ZHOU, JAY KIM, AND MEGAN BAUMUNK](Certified_Rehabilitation_Cou00003.docx#ch002-rehabilitation-disability-and-healthcare-case-management-malachy-bishop-stuart-rumrill-mirang-park-muna-bhattarai-kaiqi-zhou-jay-kim-and-megan-baumunk) [12 Medical Aspects of Individuals With Chronic Diseases and Disabilities CHUNGYI CHIU, CONNIE SUNG, AND JESSICA M. BROOKS](Certified_Rehabilitation_Cou00004.docx#ch002-medical-aspects-of-individuals-with-chronic-diseases-and-disabilities-chungyi-chiu-connie-sung-and-jessica-m-brooks) [13 Research, Methodology, and Performance Management CHUNGYI CHIU AND PHILLIP RUMRILL](Certified_Rehabilitation_Cou00004.docx#ch002-research-methodology-and-performance-management-chungyi-chiu-and-phillip-rumrill) [14 Mock Examination](Certified_Rehabilitation_Cou00005.docx#ch002-mock-examination) [Index](Certified_Rehabilitation_Cou00005.docx#ch002-index) **ix** []{#ch002-contributors.anchor} Contributors ------------ **Megan Baumunk, BA,** is a graduate student in the Clinical Rehabilitation Counseling Program in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Jill Bezyak, PhD, CRC, Licensed Psychologist,** is a professor of rehabilitation counseling and sciences in the Department of Human Services at the University of Northern Colorado. **Muna Bhattarai, MA, MNS,** is a doctoral candidate in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Malachy Bishop, PhD, CRC,** is the Norman L. and Barbara M. Berven Professor of Rehabilitation Psychology in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Jessica M. Brooks, PhD, CRC,** is a clinical psychologist and faculty in the Department of Psychiatry at the School of Medicine and Public Health at the University of Wisconsin-Madison. **Fong Chan, PhD,** is the Norman L. and Barbara M. Berven Professor of Rehabilitation Psychology (Emeritus) in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Xiangli Chen, MS, CRC,** is a doctoral candidate in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Chungyi Chiu, PhD, CRC, LPC,** is an associate professor in the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign. **Julie Chronister, PhD,** is a professor in the Department of Counseling at San Francisco State University. **Nicole Ditchman, PhD, CRC, LCPC,** is an associate professor in the Department of Psychology at Illinois Institute of Technology, Chicago, Illinois. **Sandra Fitzgerald, PhD, CRC,** is an associate professor in the Department of Counseling at San Francisco State University. **Sharon Hsu, PhD, MPH,** is a researcher at Alliance Healthcare Services, Memphis, Tennessee. **x** **Yunzhen Huang, MS, CRC,** is a doctoral student in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Cahit Kaya, PhD,** is an associate professor and an assistant chair in the Department of Educational Sciences at Giresun University, Turkey. **Jay Kim, MA,** is a doctoral student in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Kristin Kosyluk, PhD, LCPC,** is an assistant professor in the Department of Mental Health Law & Policy at the University of South Florida, Tampa, Florida. **Beatrice Lee, PhD, CRC, LPC,** is an assistant professor in the Department of Rehabilitation Sciences at the University of Texas at El Paso. **Deborah Lee, MA, CRC,** is a doctoral candidate in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Eun-Jeong Lee, PhD, CRC, LCPC,** is an associate professor in the Department of Psychology at Illinois Institute of Technology, Chicago, Illinois. **Jinhee Park, PhD, CRC,** is an assistant professor in the Department of Special Education, Rehabilitation, and Counseling at Auburn University, Auburn, Alabama. **Mirang Park, MS,** is a doctoral candidate in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Yazmin Castruita Rios, MRC,** is a doctoral student in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Phillip Rumrill, PhD, CRC,** is the director of research and training at the University of Kentucky Human Development Institute. **Stuart Rumrill, MS, CRC,** is a doctoral student in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Connie Sung, PhD, CRC, LPC,** is an associate professor in the Department of Counseling, Educational Psychology, and Special Education at Michigan State University. **Timothy N. Tansey, PhD, CRC,** is a professor in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **Joshua Taylor, M.Ed., Doctoral Candidate,** is a research associate at Virginia Commonwealth University Rehabilitation Research & Training Center. **Yen Chun Tseng, MS, CRC,** is a doctoral student in the Division of Counseling and Rehabilitation Science in the Department of Psychology at Illinois Institute of Technology, Chicago, Illinois. **Emre Umucu, PhD, CRC,** is an assistant professor in the Department of Rehabilitation Sciences at the University of Texas at El Paso. **Kaiqi Zhou, MA,** is a doctoral student in rehabilitation counselor education in the Department of Rehabilitation Psychology and Special Education at the University of Wisconsin-Madison. **xi** []{#ch002-preface.anchor} Preface ------- We are pleased to present this third edition of *Certified Rehabilitation Counselor Examination Preparation.* In the first edition of this guide, we indicated that \"the purpose of the book is to provide a concise yet comprehensive preparation guide for the Commission on Rehabilitation Counselor Certification (CRCC) Certified Rehabilitation Counselor (CRC^®^) examination.\" In the development of this third edition, this has remained our purpose and commitment. Although our goal in preparing this text has remained consistent, much has changed in rehabilitation counseling education, practice, and policy since the publication of the previous edition. The number of people requiring rehabilitation counseling services has continued to increase, and this population is becoming increasingly diverse (Rumrill et al., 2019). Significant recent changes in rehabilitation and disability legislation, including the enactment of the 2014 Workforce Innovation and Opportunity Act (WIOA) and concurrent reauthorization of the Rehabilitation Act, with their increased focus on developing and implementing employment and education services for transition-aged youth with disabilities, have created the need for new approaches, skills, and knowledge. Rehabilitation counselor education programs are continuing to adapt and respond to the 2017 merger between the rehabilitation counselor education accreditation agencies and are striving to ensure that rehabilitation counselors are trained to meet accreditation and licensure standards while preserving vocational rehabilitation training and the profession\'s identity (Bishop, 2020; Chan et al., 2017). Social and environmental factors, including globalization, poverty, the aging population, and climate change, are increasingly being recognized for their uneven impacts on people with existing disabilities and their capacity to increase the prevalence of chronic health conditions and disability (Koch & Rumrill, 2017). Finally, emerging diseases, disabilities, and chronic conditions have fused with global and national events to create new and challenging questions for rehabilitation counseling, and all health professions, about practices and policies, access, advocacy, and new methods of delivering services. This rapidly evolving professional landscape requires new and adapted skills and knowledge sets. In light of these changes, we have revised and updated this book extensively, in both content and format, in order to ensure that it continues to provide a current, user-friendly, and comprehensive preparation for counselors and students preparing for the CRC examination. The contents of this book are based on the most recent empirically derived rehabilitation counselor roles and functions studies (Leahy et al., 2019) that inform the test specifications for the CRC examination. In addition, this book corresponds to accreditation standards for master\'s degree programs in rehabilitation counseling. We begin this edition with a new chapter on the CRC examination, including strategies for study and test-taking. The remaining content is addressed in the following chapters: Professional Orientation and Ethical Practice; Evidence-Based Practice, **xii** Counseling Theories, and Techniques; Group Work and Family Dynamics; Crisis and Trauma Counseling and Intervention; Psychosocial Aspects of Chronic Illness and Disability; Assessment; Career Development and Job Placement; Demand-Side Employment; Community Resources and Partnerships; Rehabilitation, Disability, and Healthcare Case Management; Medical Aspects of Individuals With Chronic Disease and Disabilities; and Research, Methodology, and Performance Management. As with prior versions, each chapter of this guide provides a concise overview of the key concepts, summary tables of the key concepts, practice questions (with annotated answers), and links to web-based materials for further study and review. We believe that this edition will prove highly valuable to rehabilitation counseling graduate students, working rehabilitation counselors seeking to obtain the CRC credential, and those in allied rehabilitation professions seeking to become a CRC through additional coursework. Rehabilitation counselor educators who use the CRC examination as an alternative to a comprehensive examination for graduation may find this book useful to offer and/or require of students. We encourage rehabilitation counselor educators to build a CRC preparation strategy into master\'s-level rehabilitation programs, beginning early in the program and positioning students to take the CRC examination prior to graduation. **References** Bishop, M. (2020). Editorial on the rehabilitation counseling curricular standards revision. *Rehabilitation Research, Policy, and Education, 34*(3)*,* 140-145. Chan, F., Tansey, T., Chronister, J., McMahon, B., Iwanaga, K., Wu, J.-R., Chen, X., Lee, B., Bengston, K., Umucu, E., Flowers, S., & Moser, E. (2017). Rehabilitation counseling practice in state vocational rehabilitation and the effect of the Workforce Innovation and Opportunity Act (WIOA). *Journal of Applied Rehabilitation Counseling,* 48, 20-28. [https://doi.org/10.1891/0047-2220.48.3.20](https://doi.org/10.1891/0047-2220.48-3.20) Koch, L., & Rumrill, P. (2017). *Rehabilitation counseling and emerging disabilities.* Springer Publishing Company. Leahy, M. J., Chan, F., Iwanaga, K., Umucu, E., Sung, C., Bishop, M., & Strauser, D. (2019). Empirically derived test specifications for the Certified Rehabilitation Counselor Examination: Revisiting the essential competencies of rehabilitation counselors. *Rehabilitation Counseling Bulletin,* 63(1) 35-49. https://doi.org/10.1177/0034355218800842 Rumrill, P., Koch, L., Bishop, M., & Huber, M. (2019). Introduction to the Special Issue: Emerging client populations in rehabilitation counseling. *Journal of Applied Rehabilitation Counseling,* 50(1), 3-6. https://doi.org/10.1891/0047-2220.50.1.3 **1** 1 Certified Rehabilitation Counselor Examination Information and Study and Test-Taking Strategies YUNZHEN HUANG AND STUART RUMRILL ---------------------------------------------------------------------------------------------------------------------------------- The rehabilitation counseling credentialing process is the oldest and most established certification mechanism among the counseling and rehabilitation professions (Leahy & Holt, 1993). Since the inception of the Commission on Rehabilitation Counselor Certification (CRCC) and the Certified Rehabilitation Counselor Examination (CRCE) in 1974, more than 23,000 qualified professionals have participated in the certification process (Leahy & Holt, 1993), and today there are over 15,000 certified rehabilitation counselors (CRCs^®^) practicing around the globe (CRCC, 2021a). This chapter provides a brief history of the CRC and the CRCE, a breakdown of eligibility criteria for the CRCE, an overview of the examination and its content, tips and strategies for preparing and studying for the examination, a description of what to expect on the examination day, and some test-taking strategies. **LEARNING OBJECTIVES** By the end of this chapter, you should be able to: 1\. Understand the history of the CRCC and the history and purpose of the CRCE. 2\. Describe the eligibility criteria and current requirements for each category of eligibility for the CRCE. 3\. Describe the CRCE structure and content, including the knowledge domains and subdomains and the percentage of examination questions representing each domain. 4\. Understand CRCE question type and scoring mechanism. 5\. Describe the available CRCE testing accommodations and process for requesting a testing accommodation. 6\. Develop an effective study plan and schedule. 7\. Have an informed understanding of the CRCE process and test center procedures. 8\. Utilize strategies for answering multiple-choice questions and reducing test anxiety during the examination. **2** **KEY CONCEPTS** **History of the CRCC and CRCE** The initial discussion of rehabilitation counselor certification took place in 1963 when a report generated by the National Rehabilitation Counseling Association (NRCA) included a proposal to develop a certification body for those who practice rehabilitation counseling. In 1969, the American Rehabilitation Counseling Association (ARCA) proposed forming a joint ARCA/NRCA committee to study the role and function of counselors and support personnel, which would serve as the blueprint for developing certification protocol and criteria. In 1971, the joint ARCA/NRCA committee officially held their first meeting and drafted a proposal calling for a single certification process for rehabilitation counseling. The CRCC was officially incorporated in 1974, based on the mutual efforts of the joint committee. It was also during this year that a field review examination, which would ultimately become the CRCE, was developed. In 1976, the first wave of certification examinations was administered to prospective CRCs across the nation. Between 1973 and 1976, the CRCC grew from a small organization to one with a valid examination and effective certification process serving 8,000 CRCs (Leahy & Holt, 1993). In 1980, the Commission was granted full accreditation as a certifying body by the National Commission for Health Certifying Agencies (NCHCA). Recognizing the ever-changing nature of technology, the field, and the way society interacts, in 1985, the commission decided to conduct a \"role and function\" study at 5-year intervals to ensure the relevance and validity of the examination content. The most recent study was conducted by Leahy et al. in 2019. Since its inception in 1974, the CRCE has grown and changed significantly. Today, the CRCC continues to regularly conduct job analyses and engage with consultants and subject matter experts to inform examination specifications and develop the items on the examination (Saunders et al., 2009). As the CRCC and the CRCE grew in recognition as an accreditation body and a licensure examination, the CRCC began to closely consider the way the CRCE had originally been designed. In 2003, the CRCC implemented a conjunctive scoring model for the CRCE, which required that individuals receive passing scores both on items related to counseling and on items related to rehabilitation and disability (Saunders et al., 2009). With this change, the CRCC concluded that a sharper definition of rehabilitation counseling was now apparent, one that includes counseling, rehabilitation, and disability as equally important (Saunders et al., 2009). Further combining the separate yet related realms of counseling and disability studies was the 2017 merging of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) and the Council on Rehabilitation Education (CORE). Prior to the merger, both councils offered accreditation to counseling programs, with CORE accrediting rehabilitation counseling programs and CACREP accrediting other counseling programs. In 2015, the boards of CACREP and CORE began the process of merging the two organizations. The merger was finalized in 2017, with CACREP carrying out the mission of CORE and taking on responsibility for accrediting all graduate-level rehabilitation counselor education programs (CACREP, 2017). **CRCE Eligibility** The CRCC offers a certification guide that helps applicants determine their eligibility for the CRCE, and the guide also clearly outlines how the certification process works. Full details on the CRC eligibility requirements are provided on the CRCC website at.com/get-certified/. **3** **CRCE Overview** **EXAMINATION STRUCTURE AND CONTENT** The CRCE is administered three times a year, typically in March, July, and October. The CRCE is a computer-based examination completed within 3.5 hours. It consists of 175 multiple-choice questions drawn from the CRCC\'s item pool, including 150 scored items and 25 unscored field test questions (i.e., items that are posed in the current examination to determine whether they would be good test questions for future examinations). Examination questions cover 12 knowledge domains underlying rehabilitation counseling, which are then further divided into subdomains (CRCC, 2021b; Leahy et al., 2019). Table 1.1 summarizes the 12 current knowledge domains, identifies the percentage of examination questions representing each domain, and provides subdomain examples. A complete description of the subdomains can be found in the CRCC Certification Guide from the CRCC website (CRCC, 2021b). (Note that as the CRCC completes new Job Task Analyses/Role & Function Studies, the examination structure and knowledge domains may change.) **EXAMINATION SCORING AND RESULTS** The CRCE uses a pass/fail grading scale. The examination score is divided into two parts, one for knowledge about counseling and the other for knowledge about rehabilitation and disability issues. Examinees must achieve a passing score on both parts in a single examination to pass the CRCE. Upon completion of the examination, examinees receive a preliminary score report informing them of their pass/fail status. Examinees who fail the examination will receive a score report including diagnostic information that can be used for further study. Official examination results packets will be mailed to the examinees approximately 4 weeks after the close of the CRCE window (CRCC, 2021c). Pass rates for recent examinations are also available on the CRCC website (CRCC, 2021c). **TEST ACCOMMODATIONS** The CRCC provides a variety of test accommodations to individuals with documented disabilities. Accommodations may include, for example, adjustable height tables, braille examinations, extra time, scribe, and sign language interpreters. A complete list of available accommodations is provided in the CRCC certification guide (CRCC, 2021b). Requests for accommodations are reviewed by the CRCC on a case-by-case basis. Alternative versions of the examination can only be provided in the multiple-choice format. **Preparing for the Examination** **STUDY TIPS** The CRCE requires test takers to be equipped with relevant knowledge in counseling and disability issues. Preparation is crucial for passing the CRCE, and strategic studying can help you prepare for the examination more efficiently. In this section, we summarize study tips based on the literature, the authors\' own experience, and interviews with students who have recently passed the CRCE. **4** **Develop Study Plans** **Plan Ahead.** It is always important to start preparing for an examination ahead of time. How far in advance to begin studying depends on the individual and the level and recency of their educational and experiential background. It is certainly better to start sooner than later and ensure that you provide yourself sufficient time to master the comprehensive examination topics. **TABLE 1.1 CRCE KNOWLEDGE DOMAINS AND SUBDOMAINS** **CRCE Knowledge Domains** **Percentage of Questions** ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------- 1\. Professional Orientation and Ethical Practice 9 *Example subdomains:* Laws and public policy affecting individuals with disabilities; Diversity and multicultural counseling issues 2\. Counseling Theories, Techniques, and Evidence-Based Practice 16 *Example subdomains:* Clinical problem-solving and critical-thinking skills; Rehabilitation techniques for individuals with psychological disabilities 3\. Group and Family Counseling 3 *Example subdomains:* Family and group counseling practices and interventions; Family and group counseling theories 4\. Crisis and Trauma Counseling and Interventions 4 *Example subdomains:* Assessment of client risk and development of a safety plan; The emergency management system within rehabilitation agencies and in the community 5\. Medical and Psychosocial Aspects of Chronic Illness and Disability 11 *Example subdomains:* Medical aspects and implications of various disabilities; Environmental and attitudinal barriers for individuals with disabilities 6\. Assessment, Occupational Analysis, and Service Implementation 15 *Example subdomains:* Vocational implications of functional limitations associated with disabilities; Occupational and labor market information 7\. Career Development and Job Placement 9 *Example subdomains:* Career development and job placement strategies; Job readiness including seeking and retention skills development 8\. Demand-Side Employer Engagement 6 *Example subdomains:* Assisting employers with job accommodation issues for their employees with disabilities (e.g., assistive technology, workspace modifications); Demand-side employment issues related to hiring, return to work, and retention 9\. Community Resources and Partnerships 9 *Example subdomains:* Social Security programs, benefits, work incentives, and disincentives; Life-care planning and life-care planning services **5** +-----------------------------------+-----------------------------------+ | 10\. Case Management | 7 | +===================================+===================================+ | **CRCE Knowledge Domains** | **Percentage of Questions** | +-----------------------------------+-----------------------------------+ | *Example subdomains* : The case | | | management process, including | | | case finding, planning, service | | | coordination, referral to and | | | utilization of other disciplines, | | | and client advocacy; Negotiation, | | | mediation, and conflict | | | resolution strategies | | +-----------------------------------+-----------------------------------+ | 11\. Healthcare and Disability | 5 | | Management | | +-----------------------------------+-----------------------------------+ | *Example subdomains:* Appropriate | | | medical intervention resources; | | | Healthcare benefits and delivery | | | systems | | +-----------------------------------+-----------------------------------+ | 12\. Research, Methodology, and | 6 | | Performance Management | | +-----------------------------------+-----------------------------------+ | *Example subdomains:* Program | | | evaluation procedures for | | | assessing the effectiveness of | | | rehabilitation services and | | | outcomes; Research methods and | | | statistics | | +-----------------------------------+-----------------------------------+ | CRCE, Certified Rehabilitation | | | Counselor Examination | | | | | | *Source:* Adapted with permission | | | from the Commission on | | | Rehabilitation Counselor | | | Certification. | | | wp- | | | content/uploads/2021/01/CRCCertif | | | icationGuide-2021.pdf | | +-----------------------------------+-----------------------------------+ **Create** a **Consistent Study Routine.** It is recommended that those preparing for the CRCE set aside several hours each day to study for the examination (Agarwal & Argalious, 2019). People differ, however, in the study routines that are effective for them. For instance, some students we interviewed set aside 2 or 3.5 days each week to study, while other students spend the whole week prior to the examination studying. Despite the individual variance, the important theme is to develop a consistent study routine and stick to it. **Set SMART goals.** Develop a study plan that is \"SMART\" (Lawlor & Hornyark, 2012): \* Specific: What exactly do you want to achieve? \* Measurable: How will you know when you have achieved it? \* Achievable: Is achieving this goal realistic with effort and commitment? Do you have the resources to achieve this goal? If not, how can you acquire them? \* Relevant: Will achieving this goal make you more prepared for the CRCE? \* Time Bound: When will this goal be achieved? **Consider Your Learning Style(s)** The term *learning style* describes an individual\'s learning characteristics and preferred ways of gathering, organizing, and processing information (Fleming, 2001). The following are the four main types of learning styles (Fleming, 2001) and some study tips for each specific learning style. People can fall into one or more types of learning styles, and they can often overlap with each other. **Visual.** Visual learners learn best with seeing and observing and may prefer to do the following: \* Create charts, diagrams, and tables to organize information \* Use highlighters and different colors to organize materials \* Use flashcards or note cards **Auditory.** Auditory learners learn best with listening and speaking and may prefer to do the following: \* Join a study group \* Record study materials and listen to these recordings **6** \* Teach the examination content to a friend **Verbal (Reading/Writing).** Verbal learners learn best with reading and writing and may prefer to do the following: \* Read study materials \* Take notes and make annotations \* Create flashcards or note cards manually **Kinesthetic.** Kinesthetic learners learn best with hands-on experience and may prefer to do the following: \* Use practice questions and simulation tests \* Copy and paraphrase study materials \* Quiz themselves or work with a partner and quiz each other **Create a Learning Environment** Creating and maintaining a healthy learning environment enable you to stay focused and study more efficiently. Find a quiet place in your home and make it your study comer. Organize your study comer and be sure to remove all distractions. When studying, mute or turn off your phone and place it out of reach. **Take Breaks** Research has shown that taking breaks can improve study efficiency (Ariga & Lleras, 2011). Depending on your preference, you might, for example, study for 25 minutes and take a 5-minute break or study for 50 minutes before taking a 10-minute break. In addition, some people find switching between tasks helpful for them to stay focused, while others prefer completing one task before starting another. **Manage Stress and Anxiety** It can be stressful and anxiety provoking to take an examination that is important to your career development. Successfully managing stress and anxiety is integral to the examination preparation process (Agarwal & Argalious, 2019). The following are some tips that can help you reduce stress and anxiety: \* Set clear and realistic expectations and develop a study plan. \* Remind yourself that you do not have to get a \"perfect\" score on the examination. A \"passing\" score is sufficient. \* Remind yourself about your past success on examinations and tell yourself that you will do fine on this examination as well. \* Reassure yourself that even if you fail, you can retake the examination in the future. \* Make sure you get enough sleep. \* Engage in self-care practices (e.g., exercise, mindfulness meditation, deep breathing, listening to relaxing music). **7** **Examination Day** Once you have scheduled your appointment with the test center, you should receive an email or another form of communication outlining what to expect the day of the examination, what to bring, and when to arrive. Each test center has different check-in and setup protocols, but you can probably expect a scenario similar to the following upon arriving at the test center. An employee at a desk will ask for your name and which examination you are taking. Upon telling them your name and that you are here to take the CRCE, they will then ensure that you have brought all the documentation and information needed (e.g., your ID), and they will then ask you to take a seat until they call your name. When your name is called, you will be asked to provide your identification (e.g., a driver\'s license or passport). They will scan your ID and briefly explain the test-taking process. Most test centers have designated lockers or cubbies, where you will be asked to store your belongings such as your cell phone, car keys, and wallet---none of which are allowed in the testing area. You may be provided a key with which to lock your locker. Some test centers may allow you to bring some personal items into the testing area such as a wristwatch or certain foods or drinks, but this will depend on the test center and any accommodations you may have requested. After that, they may complete a security check (in which you may be asked to turn yourself around and empty your pockets, roll up your sleeves, etc.). They may also do a scan with a metal detector to ensure that you have not brought any electronic devices. Upon being checked in and having stored your personal belongings in your locker, you will be escorted to the testing area. The size of the room and the number of computers/stations will vary depending on the testing site. Your examination station will likely contain a computer, a mouse, and a keyboard, and two plain sheets of paper and several pencils in case you wish to write any notes. Stations also typically include a pair of noise-canceling headphones in case the typing of other test takers or other noises may become distracting. You will have 3.5 hours to complete the examination unless you have requested and received a testing accommodation of extended test time. You are allowed to get up and leave the testing center as you wish for restroom breaks and short breathers, but keep in mind that breaks do count in your test time. You do not need to ask permission to leave the room, but you will likely be asked to sign out, record your exit time, and sign back in when you are ready to resume taking the test. There is generally a window/one-way mirror between the test-taking area and the lobby and cameras. If you need assistance, such as an additional pencil or if you are having technical problems, proctors should be available to assist you. Upon completion of the examination, you will receive your preliminary pass/fail results immediately on your computer screen. If you did not pass on your first time, do not be discouraged. Now you are familiar with the test process and format, you can study areas of weakness and be more prepared for the next time. **TIPS FOR THE EXAMINATION DAY** A few additional tips for the day of the examination: **The Day Before the Examination** \* Do a brief review of your study materials the day/hours before the test. Do not cram! \* Get a good night\'s sleep. **8** **The Examination Day** \* Eat a healthy meal the night before and the morning of the examination day. \* Carefully review instructions from the testing center and make sure you bring all the materials you will need (including your ID and any other paperwork/documentation). \* Plan to arrive at the test center a few moments earlier than the center suggests, just to be safe. \* Use the available paper and pencil(s) the test center provides as you take the examination. \* Consider using the noise-canceling headphones to reduce excess noise. The test-taking atmosphere is usually quiet, but the headphones may be helpful. \* If time permits, it may be helpful to take advantage of the breaks that are allowed to step away and clear your head. \* Be sure to carefully review all of your answers once you have finished until you feel confident you have answered everything to the best of your knowledge. \* Relax! Remember that you worked hard to get to this point. Your studying, your courses, and your clinical experiences have prepared you well. **Test-Taking Strategies** To pass the CRCE, it is important not only to have the knowledge and understanding of counseling and disability issues but also to know how to respond to examination questions and choose the correct answer. The following are some test-taking tips to help reduce test anxiety. Again, these tips are gathered from the literature, the authors\' experience, and interviews with students who have recently passed the CRCE. **TIPS FOR ANSWERING MULTIPLE-CHOICE QUESTIONS** **Manage Your Time** The CRCE consists of 175 multiple-choice questions to be completed within 3.5 hours. This allows 1.2 minutes on average to answer each question. Keep in mind that some questions are straightforward and take less time to answer, while others require more thought and take more time. Keep track of your time and progress. It is also helpful to check your remaining time half way through the examination. If you are at Question 88 and have approximately 1 hour 45 minutes remaining, you would be right on track. **Eliminate Wrong Answers** When you are uncertain about a question, eliminating wrong answers can increase your chances of choosing the correct answer. Answer choices in the CRCE can often be narrowed down to two, in which case you would have a 50% chance of selecting the correct answer. **Skip Difficult Questions and Revisit Them Later** If you do not know the answer to a question, or a question is taking you too much time, mark it, skip it, and go back to it after you complete the rest of the questions. If you skip a question **9** without answering, the question will be automatically noted, and you will receive an alert at the end that you have unanswered questions left. **Trust Your Instincts** If you find yourself at a total loss for what the right answer to a question may be, trust your instincts and select the one that you feel is correct. Be very cautious of changing an answer. Unless you misread a question, it is usually advisable to stick with your first answer (Keller, 2006). **Take a Guess** The CRCE does not penalize for wrong answers, meaning that you will not have points taken off for incorrect answers. Therefore, if you do not know the answer to a question, taking a guess is always better than leaving it blank. **TIPS FOR REDUCING TEST ANXIETY DURING THE EXAMINATION** **Positive Thinking** It is helpful to think positively as you practice and study during the examination preparation phase. For example, remind yourself that you do not have to get a \"perfect\" score to pass the examination. Remind yourself that others are taking the examination with you, and many of them likely have the same feelings toward the examination as you do. **Accept Moderate Stress** Although uncomfortable, moderate stress can be desirable because it enhances memory performance (Parfitt et al., 2012) and keeps your mind alert throughout the examination. Moreover, accepting moderate stress can help reduce test anxiety and lead to better performance in examination situations (Jamieson et al., 2016). **Focus on the Examination Questions** During the examination, it is vital to avoid distractions and stay focused on the examination. However, some unhelpful, off-task thinking may occur and distract you from the examination. Off-task thinking usually involves negative mental comments, such as \"Will my colleagues assume I\'m an idiot if I fail?\" or \"Does the proctor think I\'m taking too long?\" (Keller, 2006). When you notice yourself engaging in these off-task thoughts, redirect yourself back to the examination questions. Focus on analyzing the examination question and the time remaining for the examination. **Deep Breathing** Deep breathing is a handy and effective technique to reduce your test anxiety during the examination. To do this, slowly inhale through your nose, hold your breath for a few seconds, and **10** then slowly exhale through your mouth. To improve relaxation, say, \"Relax,\" to yourself as you exhale. **Conclusion** This chapter has provided a history of the CRC and the CRCE, outlined the eligibility criteria for prospective test takers, provided an overview of the examination and tips and strategies on how to best prepare, offered a scenario as to what taking the actual examination may look like regarding the test center, and provided several tips and techniques for the test-taking process. We hope that this chapter has provided you with some useful information and tools as you prepare to take the CRCE and begin your career as a CRC. **INTERNET RESOURCES** **Internet Resources for CRC Examination Information** CRC Examination Overview: [www.crccertification.com/crc-exam-overview](http://www.crccertification.com/crc-exam-overview) CRC Certification Guide: tificationGuide-2021.pdf **Internet Resources for Professional Rehabilitation Counseling Associations** American Rehabilitation Counselor Association (ARCA): [www.arcaweb.org](http://www.arcaweb.org) National Rehabilitation Counseling Association:.wildapricot.org/ National Council on Rehabilitation Education: **REFERENCES** Agarwal, D., & Argalious, M. (2019). Learning theories and exam taking strategies. In A. Abd-Elsayed (Ed.), *Pain: A review guide (pp. 1293-1297).* Springer International Publishing. Ariga, A., & Lleras, A. (2011). Brief and rare mental \"breaks\" keep you focused: Deactivation and reactivation of task goals preempt vigilance decrements. *Cognition, 118(3),* 439-443. [https://doi.org/10.1016/j](https://doi.Org/10.1016/j).cognition.2010.12.007 Commission on Rehabilitation Counselor Certification. (2021a). *About CRCC.* https://[www.crccertification](http://www.crccertification).com/about-crcc Commission on Rehabilitation Counselor Certification. (2021b). *CRC certification guide.* http://crccertifica-tion.com/wp-ontent/uploads/2021/01/CRCCertificationGuide-2021.pdf Commission on Rehabilitation Counselor Certification. (2021c). *CRC exam overview.*.crccertification.com/crc-exam-overview Council for Accreditation of Counseling and Related Educational Programs. (2017). *CACREP/CORE merger information.* https://[www.cacrep](http://www.cacrep).org/home/cacrepcore-updates/ Fleming, N. D. (2001). *Teaching and learning styles: VARK strategies.* N.D. Fleming. Jamieson, J. P., Peters, B. J., Greenwood, E. J., & Altose, A. J. (2016). Reappraising stress arousal improves performance and reduces evaluation anxiety in classroom exam situations. *Social Psychological and Personality Science, 7(6),* 579-587. Keller, T. (2006). ICEA certification examination-taking: Strategies for test phobics. *International Journal of Childbirth Education, 21(1),* 14-16. 9983c447/l Lawlor, K. B., & Homyark, M. J. (2012). Smart goals: How the application of smart goals can contribute to achievement of student learning outcomes. *Developments in Business Simulation and Experiential Learning, 39,* 259-267. Leahy, M. J., Chan, F., Iwanaga, K., Umucu, E., Sung, C., Bishop, M., & Strauser, D. (2019). Empirically derived test specifications for the certified rehabilitation counselor examination: Revisiting the essential **11** competencies of rehabilitation counselors. *Rehabilitation Counseling Bulletin,* 63(1), 35---49..org/10.1177/0034355218800842 Leahy, M. J., & Holt, E. (1993). Certification in rehabilitation counseling: History and process. *Rehabilitation Counseling Bulletin,* 37(2), 71-80. Parfitt, G. M., Barbosa, A. K., Campos, R. C., Koth, A. P., & Barros, D. M. (2012). Moderate stress enhances memory persistence: Are adrenergic mechanisms involved? *Behavioral Neuroscience,* 126(5), 729-734. Saunders, J. L., Barros-Bailey, M., Chapman, C., & Nunez, P. (2009). Rehabilitation counselor certification: Moving forward. *Rehabilitation Counseling Bulletin,* 52(2), 77-84..org/10.1177/0034355208325077 **12** \[Blank page\] **13** 2 Professional Orientation and Ethical Practice CONNIE SUNG, FONG CHAN, JESSICA M. BROOKS, JILL BEZYAK, EMRE UMUCU, AND XIANGLI CHEN ------------------------------------------------------------------------------------------------------------------------------------ Rehabilitation counselors have long played a central role in helping persons with disabilities achieve their independent living and employment goals (Ditchman et al., 2013; Rubin et al., 2016; Tarvydas & Hartley, 2017). Although the profession of rehabilitation counseling evolved from the state-federal vocational rehabilitation (VR) program, the professional practice of rehabilitation counseling is no longer restricted to state VR agencies. Today, rehabilitation counselors work in diverse settings and are required to meet the varied and often complex needs of a range of disability groups (Leahy et al., 2003, 2013, 2019). This chapter reviews the history and background regarding rehabilitation and related legislation, professional identity of rehabilitation counseling, certification and licensure, and professional ethics and risk management for rehabilitation counselors. **LEARNING OBJECTIVES** By the end of this chapter, you should be able to: 1\. Understand rehabilitation and the impact of related legislation on rehabilitation counseling practices and the inclusion and participation of people with disabilities. 2\. Understand the evolution of rehabilitation counseling and professional issues related to the profession, including certification and licensure. 3\. Understand the basic principles of ethics, ethical behavior, and risk management related to the professional practice of rehabilitation counseling. **KEY CONCEPTS** **Laws and Public Policy Affecting Individuals With Disabilities** The state-federal VR program is the oldest and most successful public program supporting the employment and independence of individuals with disabilities (Ditchman et al., 2013). It is also one of the major practice settings for rehabilitation counselors. The Smith-Hughes Act of 1917 is the impetus for the VR movement. With the beginning of the American Industrial Revolution in the 19th century, many people lost their jobs when technology made them obsolete (Rubin et al., 2016). Vocational training was needed for people who lost their obsolete jobs, unskilled workers, **14** and rural youths who were converging on cities on find employment during the early part of the 20th century. Recognizing these needs, the federal government enacted the Smith-Hughes Act of 1917, making federal money available to each state on a matching basis for vocational education programs. It also created the Federal Board for Vocational Education, which later administered both the veteran and the civilian VR programs (Rubin et al., 2016). The beginning of the veteran VR program can be traced back to World War I (WWI). Advances in trauma care allowed more injured soldiers to survive during WWI and return with significant disabilities than ever before. The Soldiers Rehabilitation Act of 1918 was introduced as a new concept in disability support to provide state VR services to injured veterans. After that, the Smith-Fess Act of 1920, also known as the Civilian Vocational Rehabilitation Act, was passed and subsequently expanded state VR services to include any civilians with a physical disability, not just veterans. This is considered the beginning of the public VR program. State VR services were further expanded to include people with mental disabilities after the enactment of the Barden-LaFollette Act of 1943. To be qualified for state VR services, people with disabilities must meet two eligibility criteria. Specifically, the individual must demonstrate (a) the presence of a physical or mental impairment that constitutes or results in a substantial impediment to employment and (b) the potential to benefit from employment secured through the assistance of VR services. With the passage of the 1973 Rehabilitation Act Amendments emphasizing services to people with severe disabilities, the philosophy of rehabilitation has evolved from an \"economic-return\" philosophy to a \"disability rights\" philosophy (Rubin et al., 2016). The goals of VR have been identified as (a) inclusion, (b) opportunity, (c) independence, (d) empowerment, (e) rehabilitation, and (f) quality life. Table 2.1 provides a description of the purpose and implications of key rehabilitation legislation. Figure 2.1 depicts the evolution of major rehabilitation and related legislation. **TABLE 2.1 REHABILITATION LEGISLATION** **Rehabilitation Legislation** **Purpose** ------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- The Smith-Hughes Act of 1917 \* Provided federal funding to states on a matching basis for vocational education programs The Soldier's Rehabilitation Act of 1918 \* Authorized VR services for World War I veterans The Smith-Fess Act of 1920 \* Expanded rehabilitation services to civilians with physical disabilities The Social Security Act of 1935 \* Made the state-federal VR program permanent The Randolph-Sheppard Act of 1936 \* Authorized people with blindness to operate vending stands in federal buildings (this is an example of specific legislation for individuals with blindness) The Wagner-O'Day Act of 1938 \* Required federal government agencies to purchase certain products manufactured by people who are blind The Barden-LaFollette Act of 1943\* \* Expanded services to include people with mental disabilities. It also established the state-federal program for individuals with blindness The Vocational Rehabilitation Act Amendments of 1954 \* Provided funding to universities to train master's-level rehabilitation counselors resulted in the professionalization of the rehabilitation counseling profession **15** +-----------------------------------+-----------------------------------+ | The Vocational Rehabilitation Act | \* Added extended evaluation to | | Amendment of 1965 | the VR process. State VR | | | counselors have been permitted to | | | extend the evaluation of the | | | employment potential of an | | | applicant with a disability for | | | up to 18 months. | +===================================+===================================+ | | \* | | | | | | Mandated an increase to \$3 of | | | federal funds for each state | | | dollar. This 75:25 ratio was | | | further increased by legislation | | | in 1968 to 80:20. Today, the | | | federal share is 78.7%, with the | | | state providing the remaining | | | 21.3%. | +-----------------------------------+-----------------------------------+ | The Rehabilitation Act of 1973 | \* | | | | | | Mandated services for people with | | | the most severe disabilities | +-----------------------------------+-----------------------------------+ | | \* | | | | | | Established the IWRP to ensure | | | joint client-counselor | | | involvement throughout the | | | rehabilitation process | +-----------------------------------+-----------------------------------+ | | \* | | | | | | Implemented CAPs to provide | | | assistance with application and | | | advocacy services | +-----------------------------------+-----------------------------------+ | | \* | | | | | | Established demonstration | | | projects in independent living | | | rehabilitation services | +-----------------------------------+-----------------------------------+ | | \* | | | | | | Increased funding for | | | rehabilitation and disability | | | research and established the | | | National Institute of Handicapped | | | Research | +-----------------------------------+-----------------------------------+ | | \* | | | | | | Mandated program evaluation and | | | guaranteed employment rights of | | | people with disabilities through | | | Title V, which included sections | | | covering the following: | | | | | | \- Section 501 (Affirmative | | | Action in Federal Hiring) | | | | | | \- Section 502 (Enforcement of | | | Accessibility Standards for | | | Federal Buildings) | | | | | | \- Section 503 (Affirmative | | | Action by Federal Contract | | | Recipient) | | | | | | \- Section 504 (Equal | | | Opportunities) | +-----------------------------------+-----------------------------------+ | The Rehabilitation Act Amendments | \* Mandated the provision of | | of 1978 | independent living rehabilitation | | | services | +-----------------------------------+-----------------------------------+ | The Rehabilitation Act Amendments | \* Mandated each state to have a | | of 1984 | CAP | +-----------------------------------+-----------------------------------+ | The Rehabilitation Act Amendments | \* Added the provision of | | of 1986 | rehabilitation engineering | | | services (the current term is | | | assistive technology) and | | | established supported employment | | | as an acceptable goal for | | | rehabilitation services | +-----------------------------------+-----------------------------------+ | The Individuals with Disabilities | \* Provided free, appropriate | | Education Act of 1990 | public education to students with | | | disabilities. Schools are | | | required to find and evaluate | | | students suspected of having | | | disabilities, at no cost to | | | families; provide special | | | education and related services to | | | qualified students with | | | disabilities to meet their unique | | | needs; and prepare them for | | | further education, employment, | | | and independent living | +-----------------------------------+-----------------------------------+ | The Americans with Disabilities | \* Provided the most | | Act of 1990 (fully implemented in | comprehensive civil rights | | 1992) | protections for people with | | | disabilities to date. It was the | | | most sweeping disability rights | | | legislation in history. See the | | | Americans With Disabilities Act | | | section for more details | +-----------------------------------+-----------------------------------+ | The Rehabilitation Act Amendments | \* Advanced the concepts of | | of 1992 | empowerment, self-determination, | | | and informed choice at both | | | individual and agency levels | +-----------------------------------+-----------------------------------+ | | \* Required state VR agencies to | | | establish "qualified personnel\" | | | standards for rehabilitation | | | counselors as mandated by the | | | development of the CSPD within | | | state VR agencies | +-----------------------------------+-----------------------------------+ | | \* CSPD established qualified | | | personnel standards to ensure the | | | quality of state-federal VR | | | leading to an emphasis on | | | master's degree and counselor | | | certification in the delivery of | | | VR services | +-----------------------------------+-----------------------------------+ **16** +-----------------------------------+-----------------------------------+ | | \* Other highlights include the | | | following: | +===================================+===================================+ | | \* Presumption of (employ)ability | | | | | | \* Career-based job placement | | | | | | \* Improving services to minority | | | groups | | | | | | \* Increased client involvement | | | in the IWRP | | | | | | \* Establishment of | | | Rehabilitation Advisory Councils | | | | | | \* Determining eligibility within | | | 60 days of application | | | | | | \* Order of selection | | | | | | \* Use of existing data | +-----------------------------------+-----------------------------------+ | | \* Established federal share of | | | the state-federal funding match | | | at 78.7% (80.0% in the 1968 | | | Rehabilitation Act) | +-----------------------------------+-----------------------------------+ | | \* Provided rehabilitation | | | engineering services | +-----------------------------------+-----------------------------------+ | | \* Training of rehabilitation | | | counselors from minority | | | backgrounds | +-----------------------------------+-----------------------------------+ | The School to Work Opportunities | \* Provided federal venture | | Act of 1994 | capital grants to state and local | | | agencies to help restructure | | | educational systems and to | | | establish school-to-work systems | +-----------------------------------+-----------------------------------+ | | \* Provided specific funding for | | | technical assistance, capacity | | | building, outreach, and research | | | and evaluation | +-----------------------------------+-----------------------------------+ | The Workforce Investment Act of | \* Linked the state-federal VR | | 1998 | program to the state's workforce | | | investment system; consolidated | | | several employment and training | | | programs into a unified statewide | | | workforce investment system | | | through which customers can | | | easily access employment | | | information and services through | | | a "one-stop" center. VR became a | | | mandated partner | +-----------------------------------+-----------------------------------+ | The Rehabilitation Act Amendments | \* Replaced the IWRP with the IPE | | of 1998 | to emphasize the employment focus | | | and to support the exercise of | | | informed choice of the individual | | | with a significant disability in | | | the selection of employment | | | outcomes, specific VR services, | | | service providers, and the | | | methods to procure the services | +-----------------------------------+-----------------------------------+ | | \* Established automatic | | | eligibility for people already | | | receiving SSI or SSDI benefits to | | | streamline VR administrative | | | procedures | +-----------------------------------+-----------------------------------+ | | \* Introduced a new category of | | | service, that is, the provision | | | of technical assistance and | | | consultation to individuals to | | | pursue self-employment, | | | telecommuting, or a small | | | business operation | +-----------------------------------+-----------------------------------+ | | \* Emphasized outreach to | | | minorities and encouraged | | | school-to-work transition service | | | provision to students with | | | disabilities, including | | | employment | +-----------------------------------+-----------------------------------+ | | \* Required the establishment of | | | mediation policies and procedures | | | to improve due process provisions | +-----------------------------------+-----------------------------------+ | The Ticket to Work and Work | \* Expanded Medicare and Medicaid | | Incentives Improvement Act | coverage for individuals with | | (TWWIIA) of 1999 | disabilities; established TWWIIA | | | to offer those with a disability | | | a "ticket" with which they could | | | obtain VR services and support | | | services from an employment | | | network of their choice | +-----------------------------------+-----------------------------------+ | The Individuals With Disabilities | \* Required states to establish | | Education Improvement Act of 2004 | performance goals for students | | | with disabilities that aligned | | | with the goals of their peers | | | without disabilities | +-----------------------------------+-----------------------------------+ | | \* Required schools to report the | | | progress of students with | | | disabilities on standardized | | | testing and incorporated | | | provisions for improving | | | graduation rates and dropout | | | rates | +-----------------------------------+-----------------------------------+ **17** The Americans With Disabilities Act Amendments of 2008 \* Revised definition of disability and broadened the scope of coverage for those who have a disability -------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- The Workforce Innovation and Opportunity Act and the Rehabilitation Act Amendments of 2014 \* Introduced significant changes to Title I of the Rehabilitation Act, affecting the state-federal VR program, including replacing the Workforce Investment Act of 1998, amending the Rehabilitation Act of 1973, and establishing an Advisory Committee on Increasing Competitive Integrated Employment for Individuals With Disabilities \* Requiring state VR agencies to set aside at least 15% of their federal funds to provide "pre-employment transition services\" to "students with disabilities who are eligible or potentially eligible for VR services" \* Emphasizing local labor market analysis, employer engagement, and customized training (e.g., apprenticeship, paid internships, and skills certification program) \* Identifying primary performance indicators to measure employment outcomes across programs. Introducing significant changes to Title IV of the Rehabilitation Act governing the supported employment program, including allotment of significant funds (not less than 10% of youth funds) to support youth with the most significant disabilities to obtain competitive, integrated employment \* Transferring several programs including the National institute on Disability and Rehabilitation Research from the Department of Education to the Department of Health and Human Services. The name National Institute on Disability and Rehabilitation Research has been changed to the National Institute on Disability, Independent Living, and Rehabilitation Research. CAPs, Client Assistance Programs; CSPD, Comprehensive System of Personnel Development; I PE, Individualized Plan for Employment; IWRP, Individualized Written Rehabilitation Program; SSDI, Social Security Disability Insurance; SSI, Supplemental Security Income; VR, vocational rehabilitation. \* Prior to 1943, VR services were provided to people with physical disabilities only **THE AMERICANS WITH DISABILITIES ACT** The Americans with Disabilities Act (ADA) of 1990 is a federal *civil rights* law designed to prevent discrimination and enable individuals with disabilities to participate fully in all aspects of society. The ADA guarantees equal opportunity for individuals with disabilities in employment (Title I), public services (Title II), public accommodations (Title III), telecommunications (Title IV), and other miscellaneous provisions (Title V). The employment provisions of Title I of the ADA are particularly relevant to rehabilitation counselors as the primary goal of VR is employment. The ADA definition of disability is commonly referred to as a \"three-prong\" definition. The first prong defines an individual with a disability as a person with a physical or mental impairment now that substantially limits a major life activity (e.g., caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working). The impairment must be severe, not temporary, and must have a permanent or long-term impact on the individual. The second prong defines disability as a person with a disability that does not affect them currently (e.g., cancer in remission). The third prong is about situations that do not meet either of the first two definitions but in which disability-related discrimination is still taking place. For example, a person is discriminated against based on untrue rumors about someone\'s mental **18** health or about whether they have a disease, such as an HIV infection or cancer. The \"regarded as\" standard (the third prong) applies to a person who is excluded from any basic life activity, including employment, or is otherwise discriminated against because of a covered entity\'s (e.g., an employer) negative attitudes toward the person regarded as having an impairment. The ADA Amendments Act (ADAAA) of 2008 overturns the controversial Supreme Court decisions in *Sutton v. United Airlines* and *Toyota v. Williams.* The Supreme Court stated that courts should interpret the definition of *disability* strictly in order to create a demanding standard for qualifying as having a disability, denying individuals with epilepsy, diabetes, cancer, HIV, and mental illness protection from disability discrimination, the very people whom Congress intended to protect. The ADAAA asserts that the definition of disability is intended to be a less demanding standard than that applied by the court. Specifically, the ADAAA clarifies and expands the meaning and application of the definition of disability in the following ways: \* It provides that the definition of disability shall be construed in favor of *broad coverage* of individuals under this act, to the maximum extent permitted by the terms of this act. \* It specifies that \"disability\" includes any impairment that is episodic or in remission if it would substantially limit a major life activity when active. \[FIGURE\] **2.1** Timeline of rehabilitation legislation. **19** \* It prohibits consideration of *mitigating* measures such as medication, assistive technology, accommodations, or modifications when determining whether an impairment substantially limits a major life activity. \* It redefines and expands the scope of coverage under the \"regarded as\" prong of the definition of *disability.* To satisfy the \"regarded as\" standard, an individual need only show that they have been subjected to an action prohibited under the statute (e.g., termination, failure to hire) because of an actual or \"perceived\" impairment. However, under the ADAAA, an employer does not need to provide a reasonable accommodation to an individual who meets only the \"regarded as\" prong of the definition of *disability.* Although the ADAAA is important, it addresses mostly Title I (Employment Provisions) of the act, suggesting that the remaining four titles (mostly public access provisions) were working rather well (McMahon, 2010). Table 2.2 provides a description of key ADA concepts. **TABLE 2.2 KEY ADA CONCEPTS** +-----------------------------------+-----------------------------------+ | **Key ADA Concepts** | **Definition** | +===================================+===================================+ | Major life activities | An impairment must substantially | | | limit one or more major life | | | activities in order to be a | | | disability covered by the ADA. | | | These are activities that an | | | average person can perform with | | | little or no difficulty. Major | | | life activities include, but are | | | not limited to, caring for | | | oneself, performing manual tasks, | | | seeing, hearing, eating, | | | sleeping, walking, sitting, | | | standing, lifting, bending, | | | speaking, breathing, learning, | | | reading, concentrating, thinking, | | | communicating, and working. These | | | are examples only. | +-----------------------------------+-----------------------------------+ | Substantially limiting | An impairment is only a | | | \"disability" under the ADA if it | | | substantially limits one or more | | | major life activities. An | | | individual must be unable to | | | perform, or be significantly | | | limited in the ability to | | | perform, an activity compared to | | | an average person in the general | | | population. The regulations | | | provide three factors to consider | | | in determining whether a person's | | | impairment substantially limits a | | | major life activity: | | | | | | \* Nature and severity | | | | | | \* Expected duration | | | | | | \* Expected impact | +-----------------------------------+-----------------------------------+ | Qualified individual with a | A person with a disability who | | disability | satisfies the requisite skill, | | | experience, education, and other | | | job-related requirements of the | | | desired or held employment | | | position and who, with or without | | | reasonable accommodation, can | | | perform the essential functions | | | of such position. | +-----------------------------------+-----------------------------------+ | Essential function | 1\. The position exists to | | | perform the function. | | | | | | 2\. There are a limited number | | | of other employees available to | | | perform the function, or among | | | whom the function can be | | | distributed. | | | | | | 3\. A function is highly | | | specialized, and the person in | | | the position is hired for | | | special expertise or ability to | | | perform it. | +-----------------------------------+-----------------------------------+ | Reasonable accommodation | A reasonable accommodation is a | | | modification or adjustment to a | | | job, the work environment, or | | | routine that enables a qualified | | | individual with a disability to | | | benefit from an equal employment | |

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