Moral Distress Within Rehabilitation Counseling

Abstract

PurposeThis study surveyed sources of moral distress within rehabilitation counseling practice.MethodA mixed-methods approach, the study used both quantitative and qualitative analyses.ResultsOf the 83 participants who completed the survey, the average rating of moral distress was 4.32 (uncomfortable), with 43% reporting a distress rating of 5 (uncomfortable/distressing) or higher. Based on the descriptions, common sources of moral distress involved (a) compromised service delivery, client welfare, and resources, (b) conflicts between client, treatment team, and family, (c) leadership and climate, and (d) organizational policy and practice.ConclusionsImplications address areas for ongoing discussion, including considerations for how to address moral distress to potentially reduce professional burnout and compassion fatigue with in rehabilitation counseling.

The Underutilization of Mental Health Care Services in the Lives of People with Blindness or Visual Impairment: A Literature Review on Rehabilitation Factors Toward Provision

“…One participant (#29), as cited in Bourgeois et al stated, I am concerned that my clients are not getting the good quality care that they need to recover from mental health or substance abuse problems. 85 …”

“…n = 30. Purposive sampling FG; consistent with CBPR protocol Themes relative to disability, racial, and economic stressors/trauma, and poorly targeted VR-related mental health interventions Bourgeois et al 85 VR rehabilitation counselors. n = 83. random sampling OS with instrument Forty-three percent of participants reported high moral distress when providing VR-related services and poor connection to necessary external providers Crudden & Steverson 60 People with BVI and employment history.…”

“…Therefore, it is difficult to conclude that the relative findings can be generalized to this population; findings should be interpreted within the broader context of VR solely and with caution. Bourgeois et al 85 deployed a survey to which 83 rehabilitation counselors were asked to describe both rates and sources of moral distress, taking a conceptual approach to understanding patterns and the prevalence of ethical dilemmas involving people with disabilities engaged in health rehabilitation and/or VR-related services. Like Anderson et al’s 84 study, people with BVI are not explicitly mentioned as a constituent demographic in Bourgeois et al’s 85 study, and as such findings should be interpreted with caution.…”

“…Bourgeois et al 85 deployed a survey to which 83 rehabilitation counselors were asked to describe both rates and sources of moral distress, taking a conceptual approach to understanding patterns and the prevalence of ethical dilemmas involving people with disabilities engaged in health rehabilitation and/or VR-related services. Like Anderson et al’s 84 study, people with BVI are not explicitly mentioned as a constituent demographic in Bourgeois et al’s 85 study, and as such findings should be interpreted with caution. Crudden and Steverson 60 described their methodology as an iterative process, whereby data collected through semi-structured interviews with people with BVI was repeatedly reviewed, recorded, and summarized.…”

Ethics of Technology Practice: Beliefs and Behaviors of Certified Rehabilitation Counselors During the COVID-19 Pandemic

“…Rather, CRCs must have the clinical competence to deliver distance services ethically and effectively, including emergency and safety planning for client welfare (Lin et al, 2021; Maier et al, 2021). Clinical guidance on how to provide distance services needs to address the broader context of technology use in our society, including the necessary clinical competence and infrastructure necessary to ensure client safety (Bourgeois et al, 2022). Moving forward, it is incumbent that training programs focus on teaching the ethical use of technology as part of rehabilitation counseling practice (Bernacchio & Wilson, 2018).…”