Promising and evidence-based practices in vocational rehabilitation: Results of a national Delphi study

BACKGROUND: Recently, Leahy and his colleagues ( Anderson, Leahy, Valle, Sherman, & Tansey, 2014 ; Del Valle, Leahy, Sherman, Anderson, Tansey, & Schoen, 2014 ; Leahy, Leahy, Chan, Lui, Rosenthal, Tansey, Wehman, P, & Menz, 2014 ; Sherman, Leahy, Del Valle, Anderson, Tansey, & Lui, 2014 ; Tansey, Bezyak, Chan, Leahy, & Lui, 2014 ) completed a comprehensive qualitative case study of four state VR agencies (Maryland, Mississippi, Texas, and Utah) to identify promising or evidence-based practices that can be used to improve management and clinical rehabilitation counseling practices. Fourteen promising or evidence-based VR practices were reported by administrators, supervisors, and counselors in those four VR agencies as useful for improving psychosocial and employment outcomes of persons with disabilities receiving services from state rehabilitation agencies. OBJECTIVE: The purpose of this article is to describe the outcomes of a Delphi study of experts on evidence-based VR practices. METHODS: A Delphi study was conducted to obtain the consensus of 35 national experts in vocational rehabilitation (VR) on the relevance and levels of scientific evidence of 26 promising or evidence-based VR practices in state agency settings. RESULTS: Consensus was achieved through three rounds of the Delphi process. National experts rated the employment-based interventions as highly relevant to state VR service delivery practices, but rated their scientific evidence in the lower end of the hierarchy of evidence. Experts rated psychosocial and counseling interventions, except for motivational interviewing and working alliance, as less relevant to state VR, but as having high levels of scientific evidence. CONCLUSION: This study represents an important step towards identifying specific promising or evidence-based VR practices in state agency settings that could be used to improve psychosocial and employment outcomes for people with disabilities. The results can also be used to plan the in-service training agenda for state VR agencies in terms of professional development and in pre-service academic programs to ensure that rehabilitation counseling students are adequately trained in relation to these promising or evidence-based VR practices.