Vocational Rehabilitation Counseling at a Distance: Challenges, Strategies and Ethics to Consider

Abstract

Today's vocational rehabilitation counselors are faced with many challenges that have an impact on the services they provide (Leahy & Szymanski, 1995). One challenge involves providing vocational rehabilitation services to consumers residing in rural areas. This task is significant, as 15 million Americans with disabilities live in rural areas (Seekins, Jackson, & Offner, 1993). Counselors must undergo extensive, time-consuming travel to provide services for these consumers. However, for these consumers to travel to frequent appointments at centrally-located vocational rehabilitation agencies is also inconvenient and expensive. Furthermore, people with disabilities living in rural areas commonly receive disproportionately fewer resources than do people in metropolitan areas (Allen & Seekins, 1994). The government's tendency toward decreasing human service allocations will mean even fewer dollars available for rural rehabilitation programs. One remedy for these problems is to supplement traditional services with distance vocational rehabilitation counseling (telecounseling) for individuals unable to access vocational rehabilitation agencies. Telecounseling, a concept derived from telemedicine and distance education, involves counseling and support when distance or time separates the consumer from the counselor. Although distance technology has been discussed at length in the medical and educational fields, no other reports found in the literature relate distance technology to the profession of vocational rehabilitation counseling. This article is designed to provide a brief background on distance technology services. Furthermore, it will focus on the special challenges, advantages, and ethics associated with providing vocational rehabilitation counseling to individuals via telecounseling. Strategies recommended for effective telecounseling in the vocational rehabilitation profession are also addressed. Background The ability to provide services at a distance relies on a variety of technologies from simple systems (e.g., telephone, audio and videotapes) to more complex systems, (e.g., Internet, audio conferencing, facsimile machines and real time video). The use of the telephone as a component of health care has been discussed at length in the literature. Telephone communication systems have been key to suicide hot lines, 24-hour counseling services, and mental health consultation in inaccessible regions. Furthermore, counselors used telephones to assess obsessive-compulsive disorders (Baer, Brown-Beasley, Sorce & Henriques, 1993) and to test for the human immunodeficiency virus (HIV) (Frank et al., 1997). Telephones also effectively provided support to Alzheimer's care-providers who were isolated from other natural supports (Gallienne, Moore, & Brennan, 1993; Mahoney, Tarlow, & Sandaire, 1998; Smyth & Harris, 1993). Self-administered psychotherapy for depression (Osgood-Hynes et al., 1998) and hypertension monitoring (Friedman et al., 1996) were also successfully implemented via telephone. Similarly, many elders lived in their homes safely due to telephone reassurance programs (Guy, 1995). Finally, the telephone has proven extremely useful for people who can not receive traditional services because of physical impairments or psychiatric disabilities that make travel inconvenient or impossible (Mermelstein & Holland, 1991). Telephone communications are the most used, low-tech resource in distance education. The telephone was used for admission interviews, individual feedback sessions (McNamara, Nemec, & Farkas, 1995), and audio teleconferencing (Bitter, 1995). In particular, the telephone made distance learning possible for many students living in rural areas. The pervasiveness and low cost of telephone use in the United States makes telephone-based distance learning a sensible option for distance education programs (Threlkeld & Brzoska, 1994). Furthermore, outcome assessments verified that use of the telephone facilitated distance education effectively (Threlkeld & Brzoska, 1994). …