Rehabilitation counselling is in need of a conceptual framework that will distinguish it from the medical notion of restoration and will provide a theoretical base from which rehabilitation counsellors can operate. The current paper presents a model of dishabilitation that highlights the processes that occur following acquired disability and that must be considered in designing a rehabilitation programme. The model suggests that the goal of rehabilitation should be the expansion of opportunities rather than the restoration of functions or previous position. By providing rehabilitation counsellors with a suitable “macro”level conceptualisation of rehabilitation, this approach will enable counsellors to implement “micro”level techniques in a manner that will empower individuals. Because intervention is aimed at opportunity expansion rather than the pursuit of specific goals, this approach allows individuals to retain control and to develop positive perceptions of themselves with their disability. The approach is also more sensitive to the impact of acquired disability on social networks and suggests that opportunities for families must also be expanded.

Key stakeholders' perceptions of the role of the treating doctor, including treating doctors themselves, in the management of workplace injury and in occupational rehabilitation of injured workers was assessed via in-depth semi-structured interviews of doctors and via interviews and surveys of other stakeholders (injured workers, employers, rehabilitation co-ordinators, rehabilitation providers and insurers) in the post-injury period. A number of difficulties were identified by both doctors themselves and by other stakeholders in the treating doctors' management of compensable work injury clients. It was argued that these problems were a function of the conflict of interest that arises for various service providers within the current workers' compensation system and the polarised and adversarial nature of relationships between providers. The discussion of the underlying structural and policy problems inherent in the current workers' compensation system at various levels of practice which this study has highlighted provides a first step in attempts to resolve these difficulties in individual practitioner-client relationships.

The main principles and practices of cognitive-behavioural therapies are briefly outlined and discussed in terms of their relevance to counselling individuals with physical disabilities. The cognitive-behavioural therapies of Beck, Ellis, and Nezu to counselling persons with physical disabilities are specifically presented. A case study involving the application of cognitive-behavioural therapies to counselling a person with severe facial and hand burn injuries is also presented. The view is advanced that although cognitive-behavioural therapies have considerable potential in counselling of persons with physical disabilities, lack of conceptual clarity of some central constructs in cognitive-behavioral therapy is a limitation to practice in rehabilitation settings. The paucity of controlled research studies in this area of study is noted, and suggestions are offered for further research.

This paper is an overview of the transition process for students with disability who are exiting from high school programs into adult life in the United States. Information about available adult services and the changing nature of the employment situation is highlighted. Further, practices that are currently considered to be the best by those actively involved in conducting research and articulating models for improving the future for persons with disability are briefly described. Finally issues and barriers that prevent persons with disability from establishing an adult presence through full participation within our communities are discussed and recommendations about service provision offered.

A series of studies has tested the hypothesis that individuals with chronic pain (especially low back pain) who are receiving compensation respond less satisfactorily to treatment and rehabilitation than those not receiving it, and that symptoms and disability are reinforced and maintained by financial reward. Some examples of evidence for such ‘compensation neurosis’ are reviewed. The impact of socio-economic status, employment and litigation need also to be taken into account. The best response to individuals with chronic pain who are receiving compensation may not be the obvious punitive one of lowering or ceasing benefits. Rather, a compensation system minimising litigation and emphasising co-ordinated rehabilitation is advocated. The author challenges a common clinical — and political — bias against the so-called ‘compensation patient’.