What Does a Rehabilitation Counselor Do?
A rehabilitation counselor is a mental health professional who helps patients recover from traumatic incidents. Many patients are adapting themselves to a life of differing abilities. Where an occupational therapist helps these patients cope with their new physical reality, a rehabilitation counselor works with the psychological issues inherent in this process. Their ultimate goal is to help their clients learn to live happy and independent lives.
These therapists might help their clients with a variety of counseling approaches. One of the chief approaches is often cognitive therapy. This modality helps patients re-frame their situation and learn to combat self-defeating mental scripts. They may also need help learning to communicate their needs to loved ones as well as strangers, who may not offer much compassion.
Who Do They Work With?
A rehabilitation counselor works with anyone with a disability who needs assistance learning to cope with life as an independent person. Many of their clients may face seemingly overwhelming frustrations, fears, or other difficulties that need attention from a mental health counselor. The possible client base can include those who are acclimating to life in a wheelchair, the mentally disabled, and persons who are missing or have lost function of limbs or organs, such as eyes.
The client base can include people of all ages, veterans, people new to their disabilities, or people born with challenges from birth. Even those who have been living with their disabilities since birth may struggle to transition into an independent living situation. Not only do they need assistance learning new skills such as cleaning, cooking, and perhaps even dressing themselves, they face psychological obstacles to growth. Since the potential client population is diverse, therapists may seek to specialize in a specific population or age group.
For instance, many rehabilitation counselors specialize in the veteran population. These valiant souls may have additional issues on top of a physical, battle-related injury. Many veterans suffer from PTSD which causes some to fall into a substance abuse disorder. In fact, many rehabilitation clients may seek solace in alcohol or drugs. Addictive substances are often an accessible palliative that rehabilitation clients use to numb their physical and psychological pain.
Why Do We Need Rehabilitation Counselors?
Rehabilitation counselors practice as a specialty to themselves because their duties cross over into so many non-mental health areas. Not only do rehabilitation counselors work with people as they learn to cope with life in a wheelchair, without a limb, or some other physical difficulty, but they must often help them find the resources they need. This requires special training so that the counselor knows exactly what sort of medical devices they need or how to properly set up an apartment for these patients when they are in need.
Further, rehabilitation counselors might work with clients who are struggling to get back to work. This might involve visiting work sites to help patients manage the various psychological challenges they face. Depending on the client's abilities or difficulties, the counselor may even act as a sort of job trainer. Those with cognitive deficits in particular may need a hands-on approach as they acclimate to a new job.
In this regard, rehabilitation counselors are asked to be part social worker, part occupational therapist, part ADA consultant, and part psychotherapist. Most counselors are not trained to handle this sort of varied caseload nor can medical professionals juggle all of the psychological factors. Thus, rehabilitation counseling is a profession that demands dedicated academic training that addresses the multi-faceted professional demands their clients represent.
What Issues Might Rehabilitation Counselors Deal With?
Rehabilitation counselors deal with a myriad of issues that include the strictly psychological, as well as more practical matters. For instance, they may work on a treatment team that includes medical doctors, physical therapists, occupational therapists, nurses, and social workers. Rehab counselors thus need to have strong communication skills so that their client receives the best treatment possible.
Even when they see clients apart from a comprehensive treatment team, they must be able to tackle issues such as a patient's medical equipment. For instance, the patient may need a new walker, wheelchair, or even grab bars for their shower. The counselor may need to advocate for their client to insurance companies or even landlords who may be reticent to outfit an apartment for a disabled tenant.
Rehabilitation clients often have secondary psychological and behavioral issues that complicate their primary disability. Some might face substance abuse disorder. After all, many people seek to medicate the pain of a trauma with alcohol or drugs. Those with great physical trauma may have developed a dependency to their opioid pain medications. Others may have been prescribed an addictive benzodiazepine. The rehab counselor then needs to help their client navigate to sobriety, either by helping them personally or by helping them find a specialist.
How to Become a Rehabilitation Counselor
Students who are eager to become rehabilitation counselors should start out with a counselors bachelor’s degree. The most optimal degree programs are psychology, social work, or counseling. Though students won't be able to work in the field with only a bachelor’s degree, it may be possible to find experiential learning opportunities in a related field. For instance, students can likely find part-time work as a caregiver for someone who is struggling with an injury or other long-term difficulty. Since these jobs are so varied, it may be possible to devote a few hours each week to working with a disabled person while earning a few extra dollars.
Along the way to a degree, students might take classes such as:
- Developmental Psychology: This course details the various theories of development as described by several psychologists. Students are often required to complete a fieldwork study as part of this course.
- Cognitive Psychology: This course details the fundamentals of cognition including issues related to perception, memory, language, and reasoning, among others.
- Research Methods: This course requires that students create a research study of their own. Along the way, students study statistics and the fundamentals of social and behavioral research.
- Abnormal Psychology: Students learn to diagnose a variety of psychological problems using criteria delineated in the most current version of the Diagnostic and Statistical Manual of Mental Disorders.
A master’s degree is required to practice as a rehabilitation counselor. While one's bachelor’s degree can provide a necessary foundation, the master’s degree is where students hone their knowledge and skills for the profession. Depending on the program, graduate students may specialize in certain issues or populations that will inform their practice later on.
While still in school, graduate students may take some of the following courses:
- Vocational Development: This course covers the spectrum of knowledge related to vocational development. Theoretical approaches are covered, as are occupational titles, the jobs outlook handbook, and more.
- Lifespan Human Development: This course builds on student knowledge that carries over from their undergraduate studies. The entirety of the human lifespan is considered with special consideration given to cognitive development. Other pertinent factors such as gender, socioeconomics, culture, disabilities, and race are also included.
- Sociocultural Issues in Counseling: This course teaches students to put their clients in their proper context vis-a-vis their sociocultural realities.
- Case Management and Planning: This course helps students understand how to find the resources their clients need to recover and thrive.
A doctorate in rehabilitation counseling is not necessary to work as a professional counselor. However, counselors with doctoral credentials can earn more, enjoy elevated status, and find tenure-track positions in academia. PhD programs are designed to help students develop as counselors, supervisors, researchers, teachers, leaders, and advocates for their clients and the profession in general.
To help achieve these goals, students may take courses that include the following:
- Quantitative Methods: This course covers data collection methods and ways to represent that information with graphics. Students who are interested in research should focus on this and other courses that relate to statistics and analysis.
- Ethics in Counseling: The ethical and legal issues surrounding rehabilitation counseling are covered in this course. Some states include an ethics portion in their licensure rubric and every counselor has ethical laws they must follow, so courses like this will be immensely helpful.
- Theoretical Foundations in Counseling: Students will explore the various models that inform the practice of rehabilitation counseling. The course covers topics such as personality theory, behavior change, and career development.
- Clinical Practice Practicum: Students will work under a licensed supervisor in one of many possible settings. This supervised time can be counted towards licensure, if necessary.
Every counselor must complete a certain number of supervised hours in their field before they can attain licensure from their state boards. In general, states require the equivalent of one to two full years of full-time work before they confer a license. Specifically, state experience requirements tend to be from 2,000 to 3,000 hours, though some states require up to 4,000 hours. Students can also use their internships as a way to gain hours that count towards their state's requirement. Nevertheless, students frequently find that they still must complete their experience requirement after graduation.
Most states require that a certain number of the total required time include face-to-face hours with the candidate's supervisor. There are also states that have multiple licensure levels so that students can carry lower-level credentials prior to completing full licensure. Some states even count certain educational credits toward their experience requirement. For instance, Alabama allows counseling candidates to offset 1,000 experience hours for 15 semester hours gained after the candidate's 48 required graduate-level semester hours.
Since every state has their own rules and regulations, it's important that rehabilitation counseling students investigate those requirements. Each state is also liable to change their regulations from year to year. Often these changes benefit the candidate, as when experience hours are reduced, but they may become more stringent, which is vital to know.
Every counselor is required to pass an examination for licensure. There are many national exams that states may choose to require, and licensing boards often select one or two. However, some boards may recognize satisfactory scores on some other test if the candidate was licensed and is in good standing in another jurisdiction. Examinations include the National Counselor Examination, the National Clinical Mental Health Counselor Examination, the Certified Rehabilitation Counselor Examination, and the Examination of Clinical Counselor Practice.
Some states include an ethics examination for candidates. California, for example, requires its Law and Ethics Examination to be passed by any looking for state licensure. Other states have similar requirements and may use different names for their state-specific exam. Colorado, for instance, refers to its exam as the Colorado Jurisprudence Exam.
Each state has its own rules governing licensure. However, every state requires that all counselors be licensed and in good standing to practice their profession. This is a legal requirement that can result in fines and other punishment if it is not followed. Since insurance companies are unlikely to insure an unlicensed counselor, any complaints of professional liability for an unlicensed counselor would also be paid out of pocket. If insurance is procured under false pretenses, fraud charges are also likely.
For instance, Pennsylvania law states that anyone who practices psychiatry without a license is subject to fine and imprisonment. Specifically, these bad actors are fined $1,000 for the first offense or undergo six months in jail. The second offense results in a fine of at least $2,000 or a jail sentence of at least six months. Keep in mind that former clients and others may file civil suits for malpractice or fraud.
Where Do Rehabilitation Counselors Work?
Rehabilitation counselors are found practicing their profession in a variety of environments. Many work in private practice, but others might work in state vocational rehabilitation agencies, mental health agencies, hospitals, brain injury centers, and other settings. It’s common for rehabilitation counselors to work with the Veterans Administration, where they help former soldiers rejoin civilian life. They also work with inmates or parolees from state or federal correctional facilities who need vocational counseling.
Rehab counselors might also work for drug and alcohol rehabilitation programs. Many who suffer with substance abuse disorders are likely to have difficulties with work. They need the sort of comprehensive attention that a specialist can offer. Not only can they discuss the psychological issues that underpin their addiction, but they can also learn to overcome those problems and rejoin the world as a fully functioning member of society.
Since the field is so wide ranging, rehabilitation counselors can pursue careers that encompass many different avenues. For instance, a single professional might contract with a number of clients on a part-time basis as well as maintaining a private practice. Part of their week might find a counselor in their office, working in the local prison, or at the VA hospital. It's also possible to work for a college or university as a career counselor.
Rehabilitation counselors earn a healthy salary in the pursuit of helping their clients attain a healthy, happy life. According to Payscale.com, the average salary for all professionals in the field is $46,000. By mid-career, the field is shown to pay $50,000 and late-career rehab counselors earn closer to $60,000. These statistics are based on fewer than 100 salaries, however. Further, many work under different job descriptions, especially those in private practice. There are also many ways to raise one's salary.
For instance, counselors of all sorts see their salaries rise with a doctoral degree. It's also possible to earn more when they step out of a counseling role and take on managerial duties. For instance, a rehab counselor might join the ranks of hospital administration. They can also work under titles such as case manager, consultant, addictions counselor, or vocational therapist. Each of these titles has its own pay rates, which may be similar to the pay stated for a rehabilitation counselor.
The employment outlook for rehabilitation counselors is looking quite rosy. Currently there are 120,000 jobs in the field, and that number promises to grow. In fact, the Bureau of Labor Statistics (BLS) projects that the occupation is slated to grow by 10% between the years 2019 – 2029. The agency describes this growth as much faster than average. This might be due to the increased number of individuals who have insurance to cover rehabilitation therapy and the fact that there are a large number of veterans who need assistance.
In fact, the largest employers for rehab counselors seems to be state governments who employ almost 15,000 rehabilitation professionals. State government also pays well, as the BLS reports a mean salary of $53,000. When state benefits are added to that number, the total compensation package for a rehabilitation counselor is quite generous.