Both the life expectancy and numbers of older people with intellectual disabilities are growing. Until recently, ageing with a disability had not been a major consideration for Australian policy makers and service providers. The situation was similar in countries such as the United States of America and United Kingdom where, unlike aged care, disability policy and practice had not evolved to meet needs. Ageing with long standing disability has now been specified by the Australian government as a priority area. This paper reports results of consultations held with consumers, their organisations, service providers and government in order to explore quality of life and service provision issues for people with long standing disabilities. It reports these issues and uses themes emerging from consultations to structure previously published information specifically related to ageing with an intellectual disability. Seven broad themes are discussed which relate to: life experiences; attitudes, skills and knowledge of consumers; attitudes skills and knowledge of community and service providers, the nature of service provision; the ageing of family care givers; financial security; and ageing in place. It is concluded that disadvantages and barriers experienced throughout life influence well being and quality of life in old age.

This paper examines defining features and principles of quality of life as discussed in the literature on disability. It is suggested that many features of such a model require examination and changes to some of our approaches to rehabilitation, and professional values. It is also argued that the concept has serious implications for research, and opens up new ways of viewing aspects of methodology. Finally, the article suggests that quality of life as formulated in the paper has implications beyond disability and its acceptance challenges policy and management practices as viewed within an economic rationalist framework.

We examined relations between organisational perceptions (organisational commitment, organisational climate), personal evaluations (occupational self efficacy, skills/competencies) and subsequent job satisfaction (extrinsic and intrinsic) among a group of 101 New Zealand rehabilitation case managers. Analyses indicated that organisational commitment, organisational climate and perceived skills/competencies made a significant contribution to the prediction of extrinsic job satisfaction while organisational climate alone was a significant predictor of intrinsic job satisfaction. Despite a number of limitations, the findings have implications for the understanding of die occupational dynamics of rehabilitation service provision and illustrate the importance of a continued research focus on the antecedents and consequences of job satisfaction in rehabilitation professionals.

This paper discusses the potential limitations, and barriers to acceptance, of qualitative research methodologies. Qualitative research has been dismissed for consisting of small unrepresentative samples that limit the generalisability of findings, for lacking reliability and validity, for providing analyses that mask the individual differences that it purports to highlight, and for being too subjective. It was argued that these criticisms have to be considered against a different set of criteria to those applied to quantitative research. Moreover, the rationale behind qualitative research can provide rehabilitation counsellors with a better understanding of living with disability. This paper seeks to encourage rehabilitation counsellors to (a) gain insight into the different perspectives of persons with disabilities; (b) develop their clinical or knowledge base; and (c) be self-reflexive and critically self-examine their interaction with clients.

This study sought the views of 22 Victorian rehabilitation counsellors (RC's) about what they do to try and engage reluctant clients, the behaviour such clients exhibit, whether RC's discuss the reluctance and the mandatory nature of participating in rehabilitation with their clients, and how RC's choose to respond to reluctance. RC's reported that reluctance was most often a result of clients' emotional adjustment difficulties, and that the most difficult clients to engage were those who were passively disengaged rather than those who were initially angry or hostile. Engagement relied on RC's uncovering the clients' own goals for participating in rehabilitation. Implications of the findings for practice, and the need for a model of client reluctance in rehabilitation are discussed.

Research on horticultural therapy approaches suggest that its positive impact on clients may extend beyond direct rehabilitation or vocational gains to more generally improved well-being. Persons in rehabilitation programs may relate to gardening as a previously enjoyed past time, or as a new activity for either leisure or employment purposes. While gardening is a popular leisure activity in many countries, few studies have looked at what specific gardening activities community-based populations pursue. As part of a larger mail-out survey looking at gardening interests of mid-aged women, a sub-sample of physically disabled women was compared to healthy age-matched women on gardening activities and interests. Physical and psychological functioning and well-being were also sampled. Both groups completed the SF-36 Health Survey for Australia/New Zealand, the Symptom Checklist-90-Revised, and a gardening questionnaire tapping gardening activities and hours per month on these activities, as well as the reasons for pursuing gardening. Group differences emerged on physical and psychological functioning variables, but for virtually all gardening variables, group differences were minimal. Overall findings suggest that for this sample of mid-aged women, the presence of physical disability or limitation did not adversely affect their access to and enjoyment of gardening activities.

The provision of care to a relative with a traumatic brain injury (TBI) has been shown to be distressing for the primary caregiver (usually the spouse or parent). Much research has examined factors which affect caregiver adjustment to brain injury. However, the impact of caregiver cognitions, in particular irrational beliefs, as a potential factor in poor adjustment, has received little if any attention in the TBI caregiving literature. This article provides a review of predictors of TBI caregiver adjustment and a discussion of the cognitive model and the impact of irrational beliefs on adjustment. As caregivers are central to the rehabilitation process, there is a need for research into irrational beliefs and TBI caregivers as well as the development of interventions which focus specifically on the caregiver's beliefs and perceptions of events.

New Zealand's Accident Compensation Corporation (ACC), which provides no-fault 24-hour cover for accidents, has been the subject of continuous debate since its inception in 1974. This article provides an up-to-date summary of changes to the legislation and how they have, or might, impact on providers and consumers of services. An attempt is made to look at the outcomes for ACC claimants in different broad categories. Although the ACC system has shown itself over time to be fairly resilient in the face of change, providers and consumers may not agree that the amount of change has delivered a better product for New Zealand.

Volunteer programs have been used to alter attitudes, provide long-term knowledge towards mental illness and increase the quality of life of consumers receiving volunteer services. Sixteen volunteers completed an 18-hour training program and in pairs worked with 11 consumers over 4 months. Sixteen volunteers completed training measures of knowledge and attitudes scales. Pre and post program quality of life and behavioural functioning measures were taken on 5 consumers. Volunteers maintained their knowledge of mental illness over 6 months and had significant increases in their comfort in interactions with people who have mental illness. Case managers, consumers and volunteers all reported high levels of satisfaction with the program but there were no significant changes in behavioural functioning or quality of life for consumers over 4 months of receiving volunteer support. High levels of client disability and the need for longer term follow-up were identified as factors needing to be addressed in future studies.

Notwithstanding the current debate over the use of the term “addiction” to describe certain types of problematic internet use, it is clear that a significant number of people engage in excessive internet use despite its interference with their everyday life. There is also growing evidence to suggest that increasing numbers of regular internet users are using the net for the purposes of accessing pornographic material and adult chat. In a qualitative descriptive framework, this study examines evidence from recovering cybersex addicts to illuminate aspects of the recovery trajectory for persons negatively affected by excessive use of the internet for the purposes of sexual gratification. Significant disruption to functional daily activities was variously reported and included occupational and social impairment, depression, impotence, and relationship breakdown. The paper further examines the therapeutic recovery issues with this addiction and comments on the role of rehabilitation counsellors in this process.