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Identification of the characteristics of work environments and employers open to hiring and accommodating people with disabilities.
Dennis Gilbride; Robert Stensrud; David Vandergoot; Kristie Golden.
Rehabilitation Counseling Bulletin,
Spring 2003 v46 i3 p130(8)
Full Text: COPYRIGHT 2003 Pro-Ed

This study determined the characteristics of employers who are open to hiring and supporting people with disabilities. The purpose was to help rehabilitation professionals better target their placement and educational activities. Using a grounded theory qualitative approach, the researchers conducted focus groups and interviews with employers, employed persons with disabilities, and experienced rehabilitation placement professionals. The results indicated that 13 specific characteristics, organized into three major categories, are found among employers who are open to hiring and accommodating persons with disabilities. The three major categories were work cultural issues, job match, and employer experience and support.

It has been more than a decade since the Americans with Disabilities Act of 1990 (ADA) was signed into law, yet the unemployment rate for people with significant  disabilities has remained virtually  unchanged, http://www.census.gov/hhes/www/disable/emperndis.pdf.  Public policy makers recognized the persistent problem of unemployment among people with significant disabilities and responded by strengthening the employment outcome focus of the Rehabilitation Act of 1973 and initiating new programs such as the Ticket to Work andWork Incentives Improvement Act (TWWIIA, Pub. L. 106-170)

Although these initiatives are important, it is clear that by themselves they cannot solve the employment challenges of many people with disabilities. To effectively meet the employment goals desired by many consumers, rehabilitation providers also need to increase the effectiveness of placement services. One way to accomplish this is to increase our understanding of employers. Many employers do hire and effectively accommodate and include people with disabilities. Identification of the specific characteristics of those employers who are open to and successful in hiring and accommodating people with disabilities can help us focus our placement services and improve the targeting of our consulting, education, and advocacy activities.

Prior researchers have recognized the importance of understanding employers and how they perceive disability issues (Millington, Asner, Linkowski, & Der-Stepanian, 1996). Research has been conducted on employer attitudes toward people with various disabilities (Gilbride, Stensrud, Ehlers, Evans, & Peterson, 2000), employer's perceptions of the ADA (Hernanadez, Keys, & Balcazar, 2000), how to develop relationships with employers (Fry, 1997), and the types of consulting services that rehabilitation professionals might provide to employers (Gilbride & Stensrud, 1992, 1999; Jenkins & Strauser, 1999).

Stone and Colella (1996) developed a comprehensive model of factors that they believed affected the treatment of people with disabilities in organizations. They identified three clusters of variables: attributes of the people with disabilities, environmental factors (public policy issues), and organizational characteristics. The organizational variables that they hypothesized to have the most effect on people with disabilities included organizational norms and values, human resource policies, and the nature of the reward systems.

A number of other researchers have concurred with Stone and Colella, and they have attempted to identify the specific characteristics of the workplace that improve an organization's capacity to effectively hire and include people with disabilities (Akabas, 1994; Butterworth, Hagner, Helm, & Whelley, 2000; Kirsh, 2000a). Akabas asserted that placement professionals need to identify and reach out to employers who celebrate diversity and provide an individualized and supportive workplace.

Butterworth, Whitney-Thomas, and Shaw (1997) found that supported employment consumers had higher success rates in organizations that had a "culture of inclusiveness." In a qualitative study of eight young adults with developmental disabilities, Butterworth et al. (2000) identified four organizational characteristics that were related to successful integration of the consumers they studied. They found that successful employers allowed opportunities for multiple context relationships among employees, provided specific opportunities for social interactions, used a personal and team-building management style, and had an interdependent job design. Similarly, Kirsh (2000b) found that consumers with psychiatric disabilities were more successful in workplaces whose norms included acceptance of diversity and an atmosphere of respect and caring.

This initial research on workplace culture suggests that employers do vary in their openness to hiring and including people with disabilities and that there are specific organizational characteristics that enhance this inclusiveness. The present study was  designed to extend this research. In this study, focus groups and interviews were conducted with successfully employed people with disabilities, employers who have successfully hired and included employees with disabilities, and successful placement providers. This facilitated the identification of specific workplace factors that characterize employers open to inclusion of people with disabilities.

METHOD

A grounded theory qualitative design (Straus & Corbin, 1998) was chosen for this study. Although some research has been conducted on employer openness, it is in a formative stage and lacks specificity and broad empirical validation. Grounded theory is an effective method for developing a theory from the bottom up; that is, rather than beginning with a theory about employer openness and testing it, this strategy allows the theory to emerge from the data. In grounded theory, qualitative data are carefully obtained, and through a systematic procedure of data analysis and coding, categories and concepts are developed and then integrated into larger components. These larger components become the conceptual building blocks of hypotheses and theory, which can then be tested explicitly. A major advantage of qualitative research is the emphasis on data that identify the meaning people give to events in context (Hagner & Helm, 1994). A central component of employer openness to hiring persons with disabilities is the perception of consumers about the inclusiveness of the worksite. The importance of consumers' experiences of acceptance and inclusion make grounded theory appropriate for use in addressing this research area at its current stage of development.

Procedures

Focus groups and interviews were conducted with three groups: successfully employed people with disabilities, employers who have successfully hired and integrated people with disabilities into their workforces, and placement providers who have worked closely with employers and have successfully placed many people with disabilities. Only successful participants were included in this study because our purpose was identification of employer characteristics that enhanced hiring and inclusion of persons with disabilities. 

Two groups of successfully employed consumers were recruited for this study (n = 6 and n = 10). One group was conducted in a large city, the other in a midsize regional city. These two locations were chosen because they represented very different labor markets and consumer populations. Local rehabilitation providers and the state vocational rehabilitation (VR) agency in each area nominated consumers. The consumer groups consisted of people with a wide range of disabilities, including mobility limitations, cognitive disabilities, psychiatric disabilities, substance abuse, and AIDS. The consumer groups contained 11 women and 6 men, of which 9 individuals were African American and 1 person was Hispanic. The average age was 47.4 years. Four participants were married, 3 were divorced, 5 had never been married, and 4 provided no information on their marital status. Consumers were paid $100 plus expenses and lunch for their participation. The focus groups lasted approximately 4 hours, with a lunch break in the middle, and were tape-recorded and transcribed. The first consumer group met a second time toward the end of the stud to review findings and serve as a member check of the emerging theory. Consumers were asked to describe their employment experiences and discuss employer behaviors, policies, and procedures and other characteristics of the workplace that increased or decreased their feelings of acceptance and their ability to be a successful employee.

Five focus groups and nine individual interviews were conducted with employers. Employers included human resource directors from hospitals, manufacturing, and service industries; owners of small businesses; and mid-level supervisors of retail stores. The number of participants in each group varied from 6 to 10. Employers were identified by local rehabilitation providers as organizations that had hired consumers, and they were viewed in the community as open to hiring people with disabilities. Initial employer groups were asked to discuss their experiences with employees with disabilities. As potential issues for the consumers and placement providers were identified, employers were asked more specific questions that arose out of certain emerging topics. This process of feeding initial results back into the data collection process is viewed as essential to theory building from the grounded theory perspective (Straus & Corbin, 1998).

A focus group was also conducted with providers of placement services (n = 5), and individual interviews with placement providers (n = 3) were conducted. The focus group consisted of agencies that provided services to members of the second consumer group. Consumers indicated which service providers they believed had the strongest relationships with employers and which agencies were the most helpful to them in transitioning to work. The placement providers identified by the consumers were invited to participate in the focus group and agreed to participate. Placement providers were asked (a) how they identified which employers to contact for potential employment opportunities and (b) their perceptions of the characteristics of employers open to hiring people with disabilities.

Coding and Data Analysis

Independent open coding (Straus & Corbin, 1998) of the initial transcripts was conducted by each of the three primary investigators. After each focus group, investigators identified statements that they viewed as related to employer openness. Statements were collected and patterns and themes identified.  Those themes were then compared to the literature and refined into categories. As indicated in the grounded theory methodology, further questions were developed that related to those categories, and the next focus group was asked to answer these questions. The employer focus groups were conducted both before and after the second consumer group and the service provider group.

Differences among the three primary researchers in the coding of statements were discussed and negotiated as a group. During the final coding, a fourth, independent researcher was asked to review the categories, and items were discussed until consensus was reached. Categories were continually refined and reexamined after each focus group. The resulting model consisted of three major categories and 13 specific characteristics of employers open to hiring individuals with disabilities.

Credibility of Findings

In qualitative research, issues of reliability and validity are often discussed in terms of the credibility of the findings (Bogdan & Bicklen, 1998; Hagner & Helm, 1994; Straus & Corbin, 1998). The credibility of findings in a qualitative study is based upon the quality of the data obtained (often called thick description) and other specific techniques designed to limit potential bias and enhance the usefulness and generalizability of results. To enhance the credibility of this study, a number of techniques were utilized. First, as indicated previously, careful attention was paid to transcript coding and analysis, with an extensive audit trail and field notes from the three primary researchers. Thick description was ensured by examination and coding of more than 600 transcript pages. Second, triangulation of data was accomplished by obtaining information from multiple sources with different perspectives (consumers, employers, and service providers). Third, all the transcripts were reexamined after categories were developed to identify potential discrepant data and adjust the model to address those inconsistencies. Fourth, a participant check was conducted toward the conclusion of the data collection phase of the study. The participant check was conducted by reconvening the initial consumer group and presenting the emerging categories and model to the group members. They reviewed the categories and model and provided feedback that resulted in a number of the categories being extended and refined. At the conclusion of the participant check, the consumer focus group members confirmed that the revised model reflected their experiences in workplaces that were open to them as people with significant disabilities.

RESULTS

As indicated previously, the extensive data collection and analysis process resulted in identification of 13 specific employer characteristics organized into three major categories: Work Cultural Issues, Job Match, and Employer Experience and Support. Each of these categories will be discussed, along with the specific employer characteristics within each category. Direct quotations from all three data sources (people with disabilities, employers, and providers) will be provided to illustrate the employer characteristics. A complete list of categories and employer characteristics can be found in Table 1.

Work Cultural Issues

Work Cultural Issues was the largest category and included values and norms concerning diversity, work performance, organizational practices, and policies. The central issue for consumers was feeling included and respected. Consumers indicated that a good employer was one who included them with all employees and listened to their concerns and needs. The importance of feeling integrated into the organization was best expressed by one consumer, who used some version of the word "include" five times in one statement:

They include us in everything that they do. I mean we are included. We were having a Christmas party a couple of weeks ago, and they are including us in it. Everything they do we are included. We have staff meetings for, like, company meetings every month because how our production was the past month, how much scrap was there for the whole place, what new contracts were in, what old contracts were going out. They include us in everything.

Employers also indicated that diversity and inclusion of people who are different have become increasingly important to their organization's success. Reflecting on this, one employer stated, "Diversity is important to us as a company. Our customer base is getting more diverse. Our employees are getting more diverse. If we can't handle differences and handle them really well, it will cost us money."

A second cultural value expressed by both consumers and employers was a focus on job performance rather than disability. One consumer said,


I don't think they see the disabilities. They treat us like we're--like you want to be treated, like a regular human being, and that's the way they treat us there. You know they don't see disabilities. They see our performance. As long as we perform to the best of our abilities, that's all they ask.


Employers also indicated that they focus exclusively on job performance. One employer noted, "I hire for attitude and train for skills. After that, the cost of accommodations is nothing. I want employees who will stay and do good work."

Participants identified a number of other cultural issues that were related to the manner in which employers managed, supervised, and accommodated employees with disabilities. A key consideration was the employer's ability to be flexible regarding and  sensitive to the employee's specific situation. These employers frequently did not single out people with disabilities for special treatment, but rather understood, as one employer stated, that "everybody needs some kind of accommodation sometime." Another employer indicated, "We have the approach that, hey, if we can do anything to make your life easier at home or work, we try to work with the employee to do it."

Employers also recognized that values and norms concerning inclusion and flexibility should come from senior management. One employer said, "But I think it starts at the top; you have to hold people accountable and our managers have objectives that their bonuses depend upon in terms of working with diversity."

Consumers also indicated how important it was for employers to be flexible and accommodating. One consumer stated,

My disability is obvious; you can see it, but I get somewhat treated different, not in a bad way. They accommodate. Like we just moved from one area to another, so they make sure everything was accessible for me like the bathroom, the area.

TABLE 1. Key Characteristics of Employers Who Are Open to People with Disabilities
 
Work cultural issues

1. Employers include people with disabilities with all workers and treat them equally.

2. Employers welcome diversity; they are egalitarian and inclusive.

3. Employers' management style is more personal and flexible.

4. Employers focus on a worker's performance, not his or her disability.

5. Senior management expects and rewards diversity.

6. Employers are comfortable providing accommodations to all their
employees.

7. The organization provides "cafeteria style" benefits.
Job match

1. The employer focuses on the consumer's capabilities and effectively matches the worker with the job requirements.

2. The employer obtains input from people with disabilities on their ability to perform job duties, and he or she includes people with disabilities in all accommodation discussions.

3. The employer focuses on essential, rather than marginal, functions.

4. The employer offers internships, and they often lead to jobs.
 
Employer experience and support issues

1. The employer has the ability to supervise a diverse workforce.

2. The employer views the community rehabilitation program (or other rehabilitation agency) as a partner and as an on-going employment support resource.


Medical benefits were also frequently discussed by both consumers and employers. Participants recognized that people with disabilities may have unique medical needs that aren't effectively covered by traditional plans. One consumer stated, "The employer is hiring people with disabilities, so they need to look at that [benefits options], and it was looked at and it was changed." An employer said, "We've got five health plans and three vision plans and so on, but to go beyond this to accommodate a disability, we would look at that on a case-by-case basis."

A great deal of agreement existed among consumers, employers, and providers regarding the type of work culture that is welcoming of and supportive to people with disabilities. Seven specific employer characteristics that were identified in this category can be found listed in Table 1.

Job Match

The second major category was Job Match. All three groups discussed the importance of a specific match between the consumer and the job. The actual ability of the applicant to perform the essential functions of the job was emphasized, whereas disability issues were de-emphasized.

One consumer stated, "I was having trouble because I had to fit it [a particular part] a certain way into the gauge, and I couldn't do it. They said, `Okay, we'll put somebody else on this,' and they put me on a job I knew how to do." Another consumer said, "They're focusing on what it is you can do and trying to encourage you to look at yourself as an employee and not as a person with a special situation."

Employers were also concerned about focusing on the ability of the person to be a good employee. One employer said, "I can pick out the people that are nervous versus an attitude--you ask them why they want the job, and if they can explain that to you, that means a lot to me, that means the person is going to show up."

A placement provider emphasized focusing on job skills when working with employers. The provider stated, "You must make sure the person with a disability can do the job. I tell them I am here to help with your employment needs, I won't send you someone who can't do the job." Another provider indicated that focusing on just the essential functions of the job was key: "A closed employer stands by the job description to the letter; an open employer is more flexible and will try and make it work."

Many of the providers had consumers who developed their job skills by participating in internships. Although the use of internships is not a widely employed rehabilitation technique, it was very successful for many of these consumers and placement providers. Said one provider,

I mean, an internship, it's a no cost collaboration between [the agency] and the employer, so they basically get to see without any risk what this person is like, so it just--it's really a very casual way of working with employers ... I would say very small percentage of students [providers call consumers students] don't get placed right from internships.

All of the participants consistently emphasized the importance of a good match between the consumer and the specific job. Consumers wanted employers to recognize and allow them to use their skills and talents, whereas employers wanted good, reliable employees. The four specific employer characteristics from this category are listed in Table 1.

Employer Experience and Support

The key components of the third category were the extent to which an employer was skilled at managing differences and the level of support the employer believed he or she had to include and accommodate workers with disabilities. Employers who were comfortable and had experience with an ethnically diverse workforce found it easier to accommodate a person with a disability. For these employers, disability was just another form of diversity. As one employer said, "So you are so used to that [accommodating existing employees] that then hiring a person with a disability is not really an issue, and it gives you insight into how you can be creative, to make the choice work." Another employer said, "I think we can kind of stretch ourselves when we're making an accommodation, and we have done that, we haven't had anybody ask for anything unreasonable yet."

A consumer also recognized that at his organization, disability was just another type of diversity. He said,


It is the same thing with the ethnic part of it, and in the plant that I'm in there are a lot of people who are from different countries ... you know everybody helps each other out. Being disabled out there where I am, it doesn't really make any difference.

The second factor was the availability of human resources support. Having the necessary support, either from the disability community or an in-house human resource department was viewed as essential. One employer said,

I think what I could use the most is a point of contact, someone that I know I can pick up the phone and call and ask questions ... about reasonable accommodations ... the ADA, especially that, what it is we're expected to do, what's reasonable.

When responding to this type of expressed employer need, a vocational rehabilitation provider indicated that she had placed seven consumers with one employer. She said, "I became their HR staff, I did the paperwork and the interviewing; I did the hiring for them sight unseen."

Developing strong, effective relationships between community rehabilitation programs (CRPs) and employers was identified by both groups as a key support strategy. The need for support, and the willingness to rely on a CRP for that support, was underscored by an employer who said, "So perhaps that could go back to the education of us and supervision about disability in general, and you know, going beyond the obvious [disability issue] and you know, help us to understand and not, say, be afraid." A provider indicated that the profession's commitment to assisting employers and maintaining a strong relationship increased employer openness to hiring people with disabilities: "There are mutual benefits [between the agency and employers], and we try to make sure they see, [we want to] help them with their general employee who might have problems ... we get a lot of positive feedback on that." The two specific employer characteristics from this category are listed in Table 1.

DISCUSSION

The results of this study support and extend prior research concerning the characteristics of employers who are open to hiring and supporting workers with disabilities. The three categories identified in this study--Work Cultural Issues, Job Match, and Employer Experience and Support--are consistent with the factors discussed in the theoretical literature. Furthermore, during the member check, all of the consumers agreed that the employer characteristics identified in this study were on target. As one consumer concluded, "These are good things!"

The importance of Work Cultural issues concerning diversity, egalitarianism, and flexibility found in the work of Stone and Colella (1996), Akabas (1994), and Butterworth et al. (1997) was strongly supported by the results of this study, which indicate that organizations that authentically embrace those values and have strong senior management support create a culture in which people with disabilities can work and succeed. Employer values and culture vary. In this study, seven specific characteristics were identified that can be used to differentiate employers who may be more open to hiring and accommodating people with disabilities.

The second category, Job Match, has always been a key component of quality vocational rehabilitation (Gilbride, Stensrud, & Johnson, 1994; Spirito-Dalgin & Gilbride, in press). The current study underscores the importance of this match for both the consumer and employer. These results are consistent with the findings of Colella, DeNisi, and Varma (1997), who found more negative bias directed at a worker with a disability in a poor fit situation. Successful placement professionals understand the importance of job match and work closely with consumers and employers to ensure that the position is appropriate before a placement is made.

The results of this study concerning the category of Employer Experience and Support also confirm and extend the current literature. Employers with successful diversity experience find inclusion and accommodation of people with disabilities much easier. These results indicate that employment outcomes for people with disabilities can be enhanced if the rehabilitation community plays an active role in providing support for employers with less experience and limited internal personnel resources. Employers are likely to utilize members of the disability community to help them with personnel issues
if those services are provided consistently and are focused on job performance.

From the perspective of consumers, three issues seemed to emerge: inclusion and respect, an employer who listens to them, and a good job match that utilizes their capabilities. Although the importance of these factors is not surprising, it does suggest that along with a thoughtful analysis of the match between the consumer and the job, rehabilitation professionals need to attend much more to the culture of the specific employer. The employment success of the consumers in this study was significantly affected by these environmental factors, indicating that employment outcomes can be improved if consideration is given to the extent of these factors in the employer's environment prior to placement.

The results of this study suggest that even employers who are open to hiring and accommodating workers with disabilities are very concerned about maintaining explicit and rigorous hiring guidelines. Their first objective is to hire the person who most effectively demonstrates that he or she can perform the essential functions of the job, with or without accommodations. Their second objective is to hire people with the soft skills (i.e. positive attitude) to be reliable workers. In order to hire a person with a disability, employers consistently emphasized that applicants had to meet these criteria before they would be considered for a position. If the applicant was referred by an agency, employers wanted assurance that the worker could do the job. If the applicant posed a challenge to the existing system by needing accommodations with which the employer was unfamiliar or needing occasional rehabilitation counseling interventions, employers wanted ongoing support in understanding these needs. Employers without strong human resource departments would look toward the disability community for personnel support; however, they wanted that support to be job related, effective, and timely.

Limitations

The limitations of this study are those common to most qualitative research--the small sample size and the limited representativeness of the sample, both of which reduce generalizability. As indicated in the Method section, a number of procedures were employed to mitigate the inherent limitations of a qualitative design. Nonetheless, these results must be understood as preliminary, and they need further validation through other qualitative and quantitative research.

Implications for Rehabilitation Counselors

These results have a number of implications for rehabilitation counselors and other placement providers. First, placement should always be done in a thoughtful manner that matches employee ability with the essential functions of the job. The results of this study underscore the importance of rehabilitation and placement professionals' having a comprehensive understanding of the essential functions of positions in their local labor markets and using that knowledge to find appropriate fits for their consumers. Labor market knowledge and accurate consumer assessment have long been considered essential functions within rehabilitation counseling. The results of this study emphasize the importance of these skills in assisting consumers in finding meaningful and successful employment.

Second, rehabilitation professionals should go beyond traditional labor market research that emphasizes job openings and salary by also evaluating the organizational culture of  the target employer. Rehabilitation professionals can use the characteristics of open employers found in this study to help direct their analysis to identify employers most willing and capable of hiring people with disabilities. For example, rehabilitation providers can ask (or determine) some of the following key questions:

*How much diversity does the employer have in the workforce?

* Is the organization's management style personal and flexible?

* Does the organization provide ongoing training for frontline supervisors and see it as a critical factor in managing employees?

* Does the employer have experience working with people with disabilities?

* Does the employer have a source of support? If not, can my agency provide that support?

Rehabilitation professionals can use the answer from these types of questions to focus placement efforts on those employers most likely to provide quality employment opportunities.

Third, the rehabilitation community can use the characteristics outlined in this study to provide a direction and focus for employer education and consulting. In large part, the characteristics that make an employer open to a person with a disability are factors that would benefit all employees, particularly in the our increasingly diverse society. Not all employers (even very progressive ones) will embody all of these characteristics. Rehabilitation counselors can use these factors to help employers conduct a self-assessment from which they can identify areas in need of improvement. Rehabilitation professionals can also be involved in advocacy and educational initiatives that challenge other employers to authentically evaluate and change their organizational culture to enhance their openness.

Finally, the results of this study suggest that many employers require, and would welcome, thoughtful support in meeting their personnel needs. These results support prior suggestions in the literature that rehabilitation counselors should "horizontally expand" their role to include services to support employers (Gilbride & Stensrud, 1999; Jenkins & Strauser, 1999). Most of the employers in this study had received ongoing support and assistance from rehabilitation professionals. They were consistent in their appreciation for that support and the role that it played in their ability to successfully hire and accommodate people with disabilities. These results suggest that more opportunities for people with disabilities could be generated if rehabilitation professionals expanded their support to more employers. Although many rehabilitation agencies support the concept of providing services directly to an employer (Gilbride, 2000) few have committed the necessary organizational resources. Providing services directly to employers requires significant conceptual and systemic change. These results challenge rehabilitation professionals to consider those changes and find ways to reach
out and support employers. 

CONCLUSIONS

These results suggest that employment outcomes for people with disabilities can be enhanced if rehabilitation providers pay more attention to the specific characteristics of the organization in which they want to place their consumer. Specifically, this study provides preliminary empirical data on some of the characteristics of work environments that are related to increased employer openness to hiring and accommodating employees with disabilities. A number of issues suggested by this study require additional research. First, future research needs to confirm, revise, and expand these employer characteristics in order to deepen our understanding of the types of work environments that are conducive to success for workers with disabilities. Second, we need to develop a simple but valid method to measure these factors. In order to be helpful to rehabilitation counselors, placement professionals, consumers, and others interested in employment of people with disabilities, we need to find an easy, reliable method for accessing the type of employer information suggested by this study. Third, we need to determine it providing services and support directly to employers does increase the number and quality of placements. If rehabilitation agencies redirect resources toward employer support, we need to be sure that those resources result in increased numbers of quality placements.

Successful employment of people with disabilities is complex and challenging, but it is vitally significant. We must continue to build our understanding of employers and work environments so that we can reduce the barriers to employment that many people with disabilities confront.

AUTHORS' NOTE

This study was supported by Grant No. H133G000028 from the National Institute on Disability and Rehabilitation Research.

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Dennis Gilbride, PhD, is an associate professor and a coordinator of the rehabilitation counseling program at Syracuse University. Robert Stensrud, EdD, is an associate professor in rehabilitation and counseling at Drake University. David Vandergoot, PhD, is president of the Center for Essential Management Services, and Kristie Golden, MS, is a research associate at the Center. Address: Dennis Gilbride, Syracuse University, 257 Huntington Hall, Syracuse, NY 13244-2340; e-mail: ddgilbri@syr.edu

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