164 RCB 46:3 pp (2003)

Transcription

1 164 RCB 46:3 pp (2003) Counselors Multicultural Competencies and Vocational Rehabilitation Outcomes in the Context of Counselor Client Racial Similarity and Difference James Bellini Syracuse University This investigation explored the relationship between rehabilitation counselors multicultural competency and vocational rehabilitation (VR) outcomes in the context of counselor client racial similarity and difference for individuals with disabilities who were served in a large northeastern state VR agency. The results demonstrated significant main effects as well as complex interaction effects among client race, counselor race, and counselor multicultural competency in relation to rehabilitation rate and vocational training rate. Thus, clients from different racial groups experienced different outcomes in the VR process in this agency as a function of the counselors race and multicultural competency. The current findings are discussed in relation to previous studies of VR service equity for persons with disabilities from underrepresented groups, and recommendations for future research are provided. The provision of culturally competent and effective rehabilitation counseling services to ethnic minority persons with disabilities is one of the most significant contemporary challenges facing the rehabilitation counseling profession (Alston & Bell, 1996; Middleton et al., 2000). The 1992 amendments to the Rehabilitation Act of 1973 established the Rehabilitation Cultural Diversity Initiative (RCDI) to (a) address the disproportionately higher rates of disabilities among minority individuals and (b) enhance the quality of rehabilitation services provided to these populations (Jenkins, Ayers, & Hunt, 1996). The preamble to the 1992 amendments states that persons with disabilities from ethnic and racial minority backgrounds have experienced unequal access to vocational rehabilitation (VR) services, less effective services, and less successful outcomes than European Americans with disabilities served in VR programs. Thus, the perception of long-term inequities in rehabilitation service provision for persons from ethnic minority backgrounds is the compelling rationale for the RCDI. The overriding goal of this federal initiative is to improve access, quality of services, and employment outcomes of persons with disabilities from minority backgrounds who are served in the state federal VR program. The RCDI also made the training of more ethnic minority counselors to work in the state federal VR program a priority. Closely paralleling the RCDI, the last decade has also witnessed increased interest in multicultural issues in rehabilitation counselor education (Alston & Bell, 1996; Davis & Rubin, 1996; Schaller, Parker, & Garcia, 1998). Thus, to meet the challenge of providing effective VR services to persons with disabilities from ethnic minority backgrounds, the rehabilitation counseling profession has devoted greater attention to cultural issues in rehabilitation and to the specific multicultural knowledge and skills needed by rehabilitation counselors in an increasingly diverse society.

2 Volume 46, No. 3 (Spring 2003) 165 The RCDI and increased attention to multicultural issues in rehabilitation clearly have a common impetus and a common underlying logic. Key assumptions associated with the RCDI mandate to train more ethnic minority counselors to work in state VR agencies are that counselors who share a common racial or cultural background with their clients will exhibit greater sensitivity, provide more effective services, and achieve better rehabilitation outcomes with clients. Similarly, the greater attention given to multicultural issues in rehabilitation counselor education programs has had two important goals: (a) enhancing counselors sensitivity to cultural and racial differences and (b) increasing the awareness, knowledge, and skills of counselors in their work with clients who have different racial backgrounds and values than the counselor (Leal-Idrogo, 1997; Stebnicki, Rubin, Rollins, & Turner, 1999). Although it seems reasonable to expect that more equitable services and more successful rehabilitation outcomes for clients from underrepresented groups are facilitated when the counselor and client share a common racial background or when counselors exhibit greater multicultural competency, very little research in rehabilitation counseling is available that confirms or disconfirms these expectations. In addition, rehabilitation researchers have not empirically tested the proposition that counselors who demonstrate greater multicultural competencies are more likely to achieve successful outcomes when working in a counselor client relationship characterized by racial differences. Service equity in VR for persons from different racial and ethnic groups is the appropriate context for evaluating the role of counselor client racial similarity and counselor multicultural competency in the achievement of VR client outcomes. Considerable research efforts over the past two decades have been devoted to the issue of VR service equity, beginning with the seminal 1980 study by Atkins and Wright. Most of these studies have focused on differences between African American clients and European American clients in terms of access to VR, service provision, and successful outcomes, although a few studies have also included other racial and ethnic client groups. The current review does not include research on the issue of access to VR services (i.e., acceptance rate); instead, it focuses specifically on racial differences in VR service provision and outcomes. Atkins and Wright (1980) used the national Rehabilitation Services Administration (RSA) database from Fiscal Year 1976 and reported that African American clients received fewer vocational training services, received less costly VR services, and experienced less successful outcomes than did European American clients. Atkins and Wright also documented differences in the types of vocational training services provided to African American clients and European American clients. In their review of the Atkins and Wright study, Bolton and Cooper (1980) commented that the differences in VR services and outcomes were relatively small and not necessarily a reflection of discriminatory practices in the VR program. Bolton and Cooper reanalyzed these data and reported that the median difference in service costs for African American clients and European American clients was approximately $120. Using VR data drawn from the eastern geographical region of the United States, Danek and Lawrence (1982) examined the contribution of counselor client racial similarity to rehabilitation outcomes after taking into account the contribution of other key client variables. Danek and Lawrence reported that counselor client similarity did not significantly predict successful closure after taking other variables into account; however, client race did significantly predict successful closures, with European American clients having a higher success rate than African American clients. Danek and Lawrence also reported that counselor race significantly predicted successful closure but did not identify the direction of this difference. Finally, it is noteworthy that the total set of eight client and counselor variables used by Danek and Lawrence accounted for approximately 6% of the variation in successful closure, and the interaction of client and counselor race accounted for less than 1% of this variation. As part of an evaluation of the state federal VR program, the U.S. General Accounting Office (U.S. GAO; 1993) used national data from Fiscal Year 1988 and included findings that are relevant to the issue of service equity for persons from minority backgrounds in state VR programs. The U.S. GAO reported that African American clients received slightly more services overall than did European American clients, but the former received fewer services than did Hispanic or Native American clients. The U.S. GAO also reported that most racial groups received, on average, less costly VR services than did European American clients, and it documented similar differences in the types of VR services (including vocational training services) as those reported by Atkins and Wright. Finally, the U.S. GAO found that African American clients were less likely to be closed rehabilitated than were European American or Hispanic clients, although the percentage differences in rehabilitation rate across these three groups were small. In a more recent study, Feist-Price (1995) examined the provision of VR services and rehabilitation outcomes for African American clients and European American clients in one southeastern state for Fiscal Years 1990 and Findings indicated that African American clients were less likely to receive all types of vocational training (e.g., college, vocational) than were European American clients and were also less likely to receive other types of services (e.g., restoration, personal adjustment training).

3 166 Rehabilitation Counseling Bulletin Feist-Price also reported that European American clients were more likely to receive externally purchased services associated with VR, but African American clients were overrepresented in the group that received the most costly services. Finally, Feist-Price noted that African American clients were less likely to achieve a successful competitive employment outcome than European American clients; however, as in previous studies, the percentage difference between the two groups was small. Wheaton, Wilson, and Brown (1996) examined VR service provision and outcomes for a large, midwestern state VR agency using data drawn from Fiscal Year They reported that African American clients received significantly more services on average than did European American clients, although race accounted for minimal variations in the total number of services provided (.6%). As in previous studies, Wheaton et al. found that African American clients and European American clients received different patterns of VR services. Using the national RSA database for Fiscal Year 1996, Moore (2001) examined differences in services provided and closure status for VR clients with hearing loss from five groups: African Americans, American Indians, Asian Americans, Hispanics/Latinos, and European Americans. Moore reported that African American clients and Hispanic/Latino clients with hearing loss were less likely to be successfully rehabilitated (Status 26) than were European American clients, although the percentage differences were quite small. Moore also documented differences in specific services provided to clients with hearing loss in these three groups. Two decades of research on differences in VR service provision and outcomes for clients from different racial or ethnic groups has indicated some consistency in findings. Among these are that clients from different racial groups (a) receive different patterns of VR services; (b) differ in the cost of the services provided; and (c) have different success rates following the provision of service. An additional finding across these studies was that the reported differences in VR service provision and outcomes for clients from different racial groups, although statistically significant, are typically quite small. It is noteworthy that despite the implementation of the RCDI and enhanced multicultural training in rehabilitation counselor education programs, only one of these studies examined the impact of counselor client racial similarity on rehabilitation outcomes. To date, no studies have investigated the impact of counselors multicultural competencies on VR service provision and outcomes. This investigation explored the relationship between counselors multicultural competency and VR outcomes in the context of counselor client racial or ethnic similarity and dissimilarity. More specifically, this study examined the effects of client race, counselor race, and counselor multicultural competency on three VR outcomes: vocational training services provided, service costs, and rehabilitation rate. Four research questions reflect these main and interaction effects: 1. Do VR outcomes differ as a function of client race, counselor race, and counselor multicultural competency? 2. Is the relationship between client race and each VR outcome moderated by the race of the counselor? 3. Is the relationship between counselor race and each VR outcome moderated by the counselor s multicultural competency? 4. Is the relationship between client race and each VR outcome moderated by both the counselor s race and the counselor s multicultural competency? The first research question assesses the separate effects of client race, counselor race, and counselor multicultural competency on the three VR outcomes. The second research question examines whether clients of different racial or ethnic backgrounds experience different VR outcomes when they are served by counselors who have similar or dissimilar racial backgrounds. The third research question assesses whether counselors of different racial or ethnic backgrounds have different client outcomes depending on their (counselors ) multicultural competency. The last research question evaluates whether, within counseling relationships characterized by racial similarity and dissimilarity, counselors with higher multicultural competency have different client outcomes than counselors with lower multicultural competency. Participants METHOD The counselor sample consisted of 155 VR agency counselors in a large northeastern state who completed the Multicultural Counseling Inventory (MCI; Sodowsky, Taffe, Gutkin, & Wise, 1994) and a demographic questionnaire in the spring of 2000 and had documented client outcomes in the time period from January, 1, 1998, through September 30, These 155 counselors were primarily women (62.5%), with an average age of 48.7 years (SD = 9.0; range = 25 to 72 years) and 14 years experience as a VR counselor (SD = 9.7; range = 1 35 years). A substantial majority of the counselors (82%) reported they had completed a graduate degree, with 58% possessing a master s degree in rehabilitation counseling, 20% having a related master s degree (e.g., psychology, social work), 6% having an unrelated master s degree, and 16% possessing a baccalaureate degree. Moreover, 129 counselors (83.2%) reported their racial status as European American, and 26

4 Volume 46, No. 3 (Spring 2003) 167 reported their racial status as non European American (which included African American, Hispanic/Latino, Asian American, and multiracial categories). The client sample consisted of all clients in the state VR agency who (a) applied for services from January, 1, 1998, through September 30, 2000; (b) were closed after the initiation of their Individualized Plan for Employment (IPE); (c) were recorded as having a racial or ethnic status of European American, African American, or Hispanic/ Latino; and (d) were served by counselors in the counselor sample. During this time frame, 142,345 clients applied for services, with 49,118 meeting the study criteria. Table 1 provides a breakdown of the racial characteristics of the sample. Of those clients whose cases were closed in the time frame of this study, approximately 60% were European American, 28% were African American, and 12% were Hispanic/Latino. No other demographic data on the clients were provided by the VR agency. Table 1 also provides frequencies associated with the counselors who served these clients. As Table 1 indicates, European American clients were most often served by counselors of the same race (90.7%), and approximately two thirds (67.6%) of African American clients received services from a European American counselor. Hispanic/ Latino clients had the highest proportion of service by minority counselors (48.6%). Instruments The Multicultural Counseling Inventory. The MCI is a 40-item, self-report measure of multicultural counseling competencies based on the multicultural counseling standards proposed by Sue, Arredondo, and McDavis (1992) to the American Psychological Association (Sodowsky et al., 1994). Respondents are asked to rate how accurately each item statement describes them when working in a multicultural counseling situation. The MCI uses a 4-point scale (1 = very inaccurate, 4 = very accurate) to quantify the degree to which items describe their work as counselors. The MCI can be completed in approximately 15 minutes to 25 minutes. The MCI operationalizes the construct of multicultural counseling competencies (MCC) along four dimensions: Knowledge, Awareness, Skills, and Relationship. In this investigation, however, only the total MCI score was used as a global measure of counselors self-reported multicultural competencies. Research has demonstrated adequate reliability and validity for the MCI as a measure of a counselor s selfreported MCC. Sodowsky et al. (1994) reported internal consistency reliability estimates (Cronbach s alphas) of.88 for the MCI total score. Sodowsky (1996) also presented several examples of criterion-related validity evidence for the MCI, including significant change in students MCI scores from the beginning of a multicultural counseling course to its end, significant differences in scores of professional counselors as a function of work with multicultural clients, and significant differences in doctoral students ratings of videotapes of a culturally consistent counselor versus a culturally discrepant counselor. Construct-related evidence for the MCI is derived from confirmation of hypotheses linking MCI scores to several counselor attitude measures, including racial identity attitudes, locusof-control racial ideology, and social inadequacy (Ottavi, Pope-Davis, & Dings, 1994; Sodowsky, Kuo-Jackson, Richardson, & Tiongson-Corey, 1998). Previous research using several different samples has demonstrated linkages between MCI scores and counselors self-reported racial/ ethnic identity, gender, and amount of multicultural training (Pope-Davis & Ottavi, 1994; Sodowsky et al., 1998; Wheaton & Granello, 1998). A definite strength of the MCI is that all items are cast in behavioral terms. To the extent that participants may be more objective in attempting to describe their behaviors than their beliefs, the MCI may more validly assess respondents multicultural competencies by selfreport than other competing measures (Pope-Davis & Dings, 1994). The counselor participants completed the MCI in April of 2000 as part of a previous investigation. Demographic Questionnaire. Counselor participants also completed a demographic questionnaire in TABLE 1. Sample Frequencies for Client and Counselor Groups Client Counselor European American African American Hispanic/Latino Overall a European American 26,684 9,344 3,017 39,045 Minority 2,733 4,486 2,854 10,073 Total b 29,417 13,830 5,871 49,118 a Column represents the total number of clients served in each of the two counselor groups. b Row represents the total number of clients served in each client group.

5 168 Rehabilitation Counseling Bulletin April of For the current study, the counselors selfreported race was drawn from these survey data (see Bellini, 2002, for additional details related to this survey). Outcome Variables For the purpose of this investigation, rehabilitation rate was operationalized as the ratio of successful closures (Status 26) to the total number of closures following the initiation of the IPE (i.e., Status 26 + Status 28). Vocational training rate was the ratio of the number of individuals who received some type of vocational training services as a component of their IPE to all clients closed following the initiation of their IPE. Service cost was the total agency expenditure for services from referral through closure, and it included only direct costs. Data Analyses The VR outcome data for the counselors and clients were supplied by the state VR agency and were coded so that they could be combined with the counselors survey information. These data were then merged with the counselors MCI and survey data using the counselor code number. The hypothesized relationships among counselor race, client race, counselors multicultural competencies, and the three VR outcomes were assessed via separate ANOVAs for each outcome using the SAS general linear modeling procedure (SAS Institute, 1990). This procedure produced an omnibus multivariate significance test for each outcome, separate ANOVAs to assess the statistical significance of each independent variable on each outcome, and post hoc pair-wise comparisons for interaction effects. Counselor race, client race, and MCI total score were entered into each analysis as main effects. Interaction terms for the interaction of client race and counselor race; MCI total and counselor race; and the three-way interaction of client race, counselor race, and counselor MCI total score were also entered. These last three terms were included in the analyses to evaluate whether the relationships between counselor race and the VR outcomes were mediated by the values of client race, counselors multicultural competencies, and the combination of client race and counselors multicultural competencies, respectively. Finally, to aid in the interpretation of the complex interactions among client race, counselor race, and counselor multicultural competency in relation to the VR outcomes, counselors were grouped into higher and lower MCI groups based on a median split of the MCI total score distribution. Counselors in the lower half of the MCI score distribution had scores ranging from 94 to 127, and counselors in the upper half of the distribution had scores ranging from 128 to 143. Rehabilitation rates and vocational training rates were then calculated for the two counselor groups and the three client groups based on their placement in the MCI score distribution. RESULTS In the current investigation, the internal reliability estimate (Cronbach s alpha) for MCI total score was.89. The mean MCI total score was (SD = 13.19) for European American counselors and (SD = 9.93) for minority counselors. Table 2 provides the means and standard deviations for the three VR outcomes rehabilitation rate, vocational training rate, and service costs. As Table 2 indicates, the average rehabilitation rate across the three client groups and two counselor groups was.74, the average vocational training rate was.29, and the average service cost was $ Thus, approximately 74% of all cases in which the IPE was implemented were successful closures, and 29% of cases included the provision of vocational training services. The full set of independent variables were significantly associated with each of the three VR outcomes: for rehabilitation rate, F(11, 49,117) = 49.68, p <.0001; for vocational training rate, F(11, 49,117) = 68.43, p <.0001; and for service cost, F(11, 49,117) = 12.13, p < The variance accounted for in the dependent variables was very small, however, with the model accounting for 1.1% of the variation in rehabilitation rate, 1.5% of the variation in vocational training rate, and.2% of the variation in service cost. For rehabilitation rate, each of the independent variables and their interaction effects was statistically significant: for counselor race, F = , p <.0001; for client race, F = , p <.001; for MCI total score, F = 43.70, p <.0001; for the interaction of counselor race and client race, F = 6.64, p <.001; for the interaction of counselor race and counselor MCI score, F = 5.14, p <.02; and for the three-way interaction of counselor race, client race, and counselor MCI score, F = 12.65, p < Each post hoc pair-wise comparison of means for the different client groups and for the interaction of counselor race with client race was also statistically significant (p <.05). For vocational training rate, each of the independent variables and interaction effects was statistically significant: for counselor race, F = , p <.0001; for client race, F = 25.84, p <.0001; for MCI total score, F = 43.75, p <.0001; for the interaction of counselor race and client race, F = 10.89, p <.0001; for the interaction of counselor race and MCI total score, F = 5.08, p <.02; and for the three-way interaction of counselor race, client race, and counselor MCI score, F = 27.78, p < Each post hoc pair-wise comparison of means for the different client

6 169 TABLE 2. Rehabilitation Rate, Rate of Vocational Training Services Provided, and Service Costs for Counselors and Five Racial Client Groups, January 1998 to September 2000 Client race European American African American Hispanic/Latino Overall a Outcome Counselor variable race M (SD) M (SD) M (SD) M (SD) Rehabilitation rate White.78 (.42).71 (.45).72 (.45).76 (.43) Minority.74 (.44).65 (.48).71 (.45).69 (.46) Overall b.77 (.42).69 (.45).72 (.45).74 (.44) Vocational training rate White.28 (.45).24 (.42).30 (.46).27 (.44) Minority.37 (.48).38 (.49).39 (.46).38 (.49) Overall b.29 (.45).28 (.45).34 (.47).29 (.46) Service cost (in $) White $ ($869.90) $ ($820.00) $ ($990.40) $ ($868.50) Minority $ ($1,034.00) $ ($1,010.30) $ ($1,155.20) $ ($1,060.00) Total b $ ($886.50) $ ($886.50) $ ($1,074.00) $ ($911.50) a Overall column represents the average rates on outcome variables for counselor groups. b Total row represents the average rates on outcome variables for client groups.

7 170 Rehabilitation Counseling Bulletin groups and for the interaction of counselor race with client race was also statistically significant (p <.05). Only counselor race, F = 43.65, p <.0001, and client race, F = 19.47, p <.0001, were significantly related to service costs. MCI total score and the three interaction terms were not significantly related to this outcome. The data presented in Table 2 indicate the direction of the significant main effects of counselor race and client race on the three outcomes, as well as the direction of the significant interaction effects of counselor race and client race on rehabilitation rate and vocational training rate. Overall, European American counselors had significantly higher rehabilitation rates (.76) than did minority counselors (.69). European American clients had significantly higher rehabilitation rates (.77) than Hispanic/Latino (.72) and African American (.69) clients. Reflecting the interaction effect of counselor race and client race, European American clients who were served by European American counselors had the highest success rate of any subgroup (.78), whereas African American clients served by minority counselors had the lowest rehabilitation rate (.65). European American clients who were served by minority counselors also had high success rates (.74), and Hispanic/Latino clients had approximately equivalent rehabilitation rates regardless of the racial status of the counselor. Thus, the differential effects of counselor racial status and client racial status were most strongly indicated for the European American and African American client groups. As Table 2 indicates, minority counselors provided vocational training services at a significantly higher rate (.38) than did European American counselors (.27), and Hispanic/Latino clients (.34) were significantly more likely to receive these services than were European American clients (.29) or African American clients (.28). Minority counselors provided vocational training services at high rates to all three client groups (.37,.38, and.39 for European American, African American, and Hispanic/ Latino clients, respectively), whereas European American counselors provided these services more often to Hispanic/ Latino clients (.30) and European American clients (.28) than to African American clients (.24). Thus, the differential effects of counselor race and client race on vocational training rate were most pronounced for European American counselors working with African American clients. Average service costs were significantly higher for African American and Hispanic/Latino clients than for European American clients, and they were higher for minority counselors than for European American counselors. The standard deviations associated with service cost means were very high for all three client groups, indicating substantial within-group variation in costs. Hispanic/ Latino clients had the highest average service costs among the three client groups, and Hispanic/Latino clients who were served by minority counselors had the highest average service costs of any client/counselor subgroup. Table 3 presents the rehabilitation rates and vocational training rates for the higher and lower MCI counselor groups and sorts these by the two counselor groups and the three client groups. These data reflect the nature of (a) the interaction of counselor race and multicultural competency and (b) the three-way interaction of counselor race, client race, and counselor multicultural competency on the two outcomes. The statistical analysis indicated small main effects for counselor multicultural TABLE 3. Rehabilitation Rate and Vocational Training Rate of Three Client Groups for Counselors with Higher and Lower MCI Scores Counselor Client Rehabilitation rate Vocational training rate European American Low MCI European American High MCI Low MCI African American High MCI Low MCI Hispanic/Latino High MCI Minority Low MCI European American High MCI Low MCI African American High MCI Low MCI Hispanic/Latino High MCI Note. MCI = Multicultural Counseling Inventory. Counselors in the low MCI group had MCI total scores ranging from 94 to 127, and counselors in the high MCI group had MCI total scores ranging from 128 to 143, based on the median split of the score distribution.

8 Volume 46, No. 3 (Spring 2003) 171 competency on both rehabilitation rate and vocational training rate, with counselors who indicated higher selfreported competencies evidencing slightly higher rehabilitation and vocational training rates overall. However, the data presented in Table 3 indicate that the effects of multicultural competencies on these outcomes were different for European American counselors versus minority counselors. As Table 3 indicates, European American counselors with higher MCI scores had higher rehabilitation rates with all three client groups than did European American counselors with lower MCI scores, and these differences were most pronounced for the African American and Hispanic/Latino client groups. Minority counselors with higher MCI scores had considerably lower rehabilitation rates with African American and Hispanic/Latino clients than did minority counselors with lower MCI scores. Minority counselors with higher and lower MCI scores had equivalent rehabilitation rates with European American clients. For vocational training rate, the post hoc analysis indicated that European American counselors with higher MCI scores had slightly lower vocational training rates for European American clients and African American clients than did European American counselors with lower MCI scores. However, European American counselors with higher MCI scores had considerably lower vocational training rates with Hispanic/Latino clients. Minority counselors with higher MCI scores had higher rates of vocational training for all three client groups than did minority counselors with lower MCI scores, with the most pronounced differences indicated for African American and Hispanic/Latino clients. These data indicate that the relationships between (a) counselor MCI score and rehabilitation rate and (b) counselor MCI score and vocational training rate are reversed for European American and minority counselors, reflecting the interaction effect of counselor race and multicultural competency on the two outcomes. In addition, the three-way interaction among counselor race, counselor MCI score, and client race was strongest for European American clients in the case of rehabilitation rate, and strongest for Hispanic/Latino clients in the case of vocational training rate. DISCUSSION The 1992 amendments to the Rehabilitation Act state that clients from underrepresented groups experience less favorable outcomes in the rehabilitation process than European American clients, including lower success rates, less frequent provision of vocational training, and lower agency costs associated with rehabilitation. The results of this investigation provide some support for the proposition that clients from underrepresented groups experience less effective VR services and outcomes, but other study findings directly contradict this thesis. Given the exploratory nature of this study, the variable relationships identified in the findings should be regarded as tentative pending confirmation in future research. As has been demonstrated in previous research, the findings indicate that in the particular VR agency used in the study, African American clients and Hispanic/Latino clients experienced poorer rehabilitation rates overall than did European American clients. Also, despite the fact that the African American clients were provided vocational training at approximately the same rate as European American clients, they were less likely to receive these services when served by a European American counselor. Contrary to expectations, Hispanic/Latino clients were provided vocational training services at higher rates than were European American clients, and average service costs were higher for African American and Hispanic/ Latino clients than for European American clients. Some of the disparities identified in this analysis therefore actually favored African American clients and Hispanic/ Latino clients. Over the past several years, the state VR agency under study has devoted considerable efforts to hiring more counselors from underrepresented groups, enhancing the multicultural competencies of counselors, and improving the quality of services and outcomes to persons with disabilities from ethnic minority backgrounds. The study finding of disparities in regard to service costs and vocational training rate that favored clients from ethnic minority backgrounds may reflect agency efforts in meeting the mandate of the RCDI. It is also noteworthy that despite vocational training rates that were comparable and average service costs that exceeded those dedicated to European American clients, the rehabilitation rate for African American clients was lower than that of the other two client groups. It is possible that this lower rate reflects enduring social inequities, such as higher jobless and unemployment rates, that transcend the VR service system. These analyses provide evidence for complex, statistically significant interaction effects among the three independent variables in relation to rehabilitation rate and vocational training rate. Not only did clients from different racial groups experience different outcomes in the VR process, they experienced different outcomes as a function of the counselor s race and the counselor s multicultural competency. In particular, African American clients and Hispanic/Latino clients who were served by European American counselors were more likely to experience a successful rehabilitation when their counselor had greater multicultural competency; however, they were less likely to receive vocational training services from these counselors. European American clients who were served by minority counselors were somewhat more likely to receive

9 172 Rehabilitation Counseling Bulletin vocational training services when their counselors had greater multicultural competency. Contrary to expectations, African American clients and Hispanic/Latino clients were less likely to achieve a successful rehabilitation when their minority counselor reported higher multicultural competency, although they were more likely to receive vocational training services as part of their IPE from these counselors. The study findings also indicate that (a) minority counselors provided vocational training at higher rates overall but achieved lower success rates with clients, and (b) European American counselors were less likely to provide vocational training but achieved higher success rates with clients. These patterns were accentuated for minority and European American counselors who reported higher multicultural competencies. Thus, it appears that minority counselors and European American counselors with higher multicultural competencies made somewhat different service provision decisions to meet their clients rehabilitation needs. European American counselors more often implemented a workforce entry strategy that did not include vocational service provision, whereas minority counselors seemed to favor an employability enhancement strategy that included vocational service provision. Both strategies may be legitimate responses to the counselors perceptions of clients rehabilitation needs. Although client race, counselor race, counselor multicultural competency, and their interaction terms each had a statistically significant association with rehabilitation rate and vocational training rate, the magnitude of these effects on the two outcomes was very small. In the context of previous research, these results are not surprising, for two important reasons. First, over the past two decades, research has generally uncovered small but statistically significant differences in access to rehabilitation, rehabilitation services, and outcomes for persons from underrepresented groups (Danek & Lawrence, 1982; U.S. GAO, 1993; Wheaton et al., 1996). Second, previous research has suggested that the multiple determinants of VR outcomes can be grouped into four major classes of variables: client characteristics (e.g., education level, age), counselor characteristics (e.g., agency experience, level and type of education), characteristics of service provision (e.g., caseload size, particular services provided), and macroeconomic indicators (e.g., overall county or state unemployment rates; Barrett et al., 1978; Bolton, Bellini, & Brookings, 2000; Eber, 1966). As these previous studies indicated, the inclusion of additional predictor variables that represent these four categories of VR determinants results in much improved prediction of VR outcomes. Given that this investigation assessed the relationships between selected VR outcomes and a small set of independent variables that included only one client variable (i.e., client race) and two counselor variables (i.e., counselor race and counselor self-reported multicultural competency), it is to be expected that the magnitude of associations observed in this study was quite small. Overall, these findings indicate that client race, counselor race, and counselor multicultural competency do not constitute highly influential determinants of rehabilitation outcomes; however, they do have a measurable impact. Several limitations of this research should be noted. First, the causal comparative nature of the research design limited the degree to which causality could be ascribed to the observed variable relationships. Several counselor and client variables that were not included in these analyses are known to directly influence client outcomes and may moderate or supersede the variable relationships explored in this study. For the current study, the VR agency supplied only client racial and VR outcome data, which also severely limited the description of this sample. Future studies should assess the impact of cultural and multicultural competency variables on rehabilitation outcomes while controlling for counselor and client variables that are known to impact client outcomes. Second, the fact that the sample used in this study was drawn from one state VR agency potentially limits the generalizability of the findings. An additional limitation of the research pertains to the decision to collapse several racial categories for counselors into a single minority counselor category for the purpose of the analysis. This decision was warranted because of the very small cell values for the various counselor ethnic minority categories; however, it resulted in a weaker operationalization of counselor client racial similarity, which was defined in some cases as an African American counselor working with an African American client and in other cases as an Asian American counselor working with a Hispanic/Latino client, and so forth. Clearly, these counselor client dyads do not accurately reflect racial similarity. At best, they reflect a common dissimilarity when compared to the majority European American culture. This investigation represents an initial exploration of the association between counselors multicultural competency and VR outcomes in the context of counselor client racial similarity and dissimilarity. As a practical matter, ongoing evaluation of VR outcomes for clients from different racial or ethnic groups is needed to monitor the effectiveness of VR services for these traditionally underserved populations. Additional research is needed to explore the differences in rehabilitation success rates for various client groups and for European American counselors and minority counselors observed in this study, as well as counselors disparate use of vocational training services for clients. Moreover, given the small numbers of minority counselors in most state VR agencies (Whitney- Thomas, Timmons, Gilmore, & Thomas, 1999), future investigators will need to sample counselors from multiple states to ensure sufficient numbers of non European American counselors to more accurately operationalize

10 Volume 46, No. 3 (Spring 2003) 173 the construct of counselor client racial similarity. Further confirmation of empirical relationships among counselor client racial similarity and difference, counselor multicultural counseling competency, and valued rehabilitation outcomes is needed to advance our understanding of the multicultural competency construct and to provide additional validation for continued emphasis on multicultural training for both counselors-in-training and practicing rehabilitation counselors. ABOUT THE AUTHOR James Bellini, PhD, CRC, is an associate professor in counseling and human services at Syracuse University. His current research interests include equity issues in disability and rehabilitation policy, state federal vocational rehabilitation, and rehabilitation measurement and program evaluation. Address: James Bellini, Counseling & Human Services, 264 Huntington Hall, Syracuse University, Syracuse, NY, ; jlbellin@syr.edu AUTHOR S NOTE I wish to thank Dr. Gerlene Ross, director of special projects, for her encouragement and for the agency administrative support that enabled me to complete this study. I also want to thank Dr. Steven Bossert, former dean of the School of Education at Syracuse University, for providing the research grant that made the study possible. REFERENCES Alston, R. J., & Bell, T. J. (1996). Ideological synthesis of multiculturalism and rehabilitation education. Rehabilitation Education, 10, Atkins, B. J., & Wright, G. N. (1980). Three views: Vocational rehabilitation of Blacks: The statement. Journal of Rehabilitation, 46, 40, Barrett, L., Collignon, F., Dodson, R., Langlois, S., Rogers, J., & Shea, S. (1978). Implementing the Rehabilitation Act of 1973: The vocational rehabilitation program response. Berkeley, CA: Berkeley Planning Associates. Bellini, J. 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