Selected factors associated with quality employment outcomes.

Research suggests employment rates among people with disabilities have remained constantly low (i.e., between 29%-34%) over the past fourteen years (Harris & Associates, 1998; U.S. Census Bureau, 2002). Subsequently, there has been a dramatic increase in the amount of interest and attention directed to the need for the improvement of the state vocational rehabilitation system's capacity to achieve employment outcomes, particularly among consumers with significant disabilities. Much of this interest and attention has been stimulated by two factors. First, public reaction and legislative mandates highlight the need for increased focus on the qualifications of personnel who provide vocational rehabilitation services. In fact, demands from consumer groups, advocates of people with disabilities and the Comprehensive System of Personnel Development (CSPD) initiatives promoted the establishment of specific requirements to ensure a fully qualified workforce of existing and future personnel in state vocational rehabilitation agencies (Rehabilitation Act Amendments, 1992, 1998). Second, empirical evidence suggests that specific variables are related to successful rehabilitation outcomes. The results of a series of replication studies demonstrate a positive relationship between counselor education, years of experience in the state vocational rehabilitation system and employment outcomes, particularly for consumers with significant disabilities (Szymanski, 1991; Szymanski & Danek, 1992; Szymanski & Parker, 1989).

Szymanski and Parker (1989) found that counselors with master's degrees in rehabilitation counseling were not only more effective but were also more cost-effective in serving consumers with significant disabilities than their counterparts with bachelors and unrelated degrees. Specifically, these counselors achieved higher competitive closure rates and spent fewer case services dollars on non-competitive closures. Further, this superiority was maintained through ten years or more of work experience with the state vocational rehabilitation agency. Szymanski's (1991) extended study provided further evidence to support the hypothesis that counselors with master's degrees in rehabilitation counseling or related master's degrees had higher competitive closure rates for consumers with significant disabilities than counselors with unrelated degrees who worked with similar consumers. This study also suggested that consumers with significant disabilities who were served by less experienced counselors (i.e., less than 10 years) with unrelated bachelors or master's degrees had less successful employment outcomes.

Similarly, Szymanski and Danek (1992) found counselors with master's degrees in rehabilitation counseling had higher rates of competitive outcomes for consumers with significant disabilities when compared with counselors with unrelated bachelors or master's degrees. Additionally, they found counselors with unrelated degrees were more cost-efficient in service provision to these consumers. Although these researchers acknowledged the need to include more adequate rehabilitation outcome measures, the addition of quality employment outcome measures is not included in recent literature reviews. Furthermore, since the establishment of the Comprehensive System of Personnel Development (CSPD) requirements, little evidence has been offered to demonstrate that state vocational rehabilitation agencies' investment in this initiative are paying off with improved quality employment outcomes.

Successful placement of individuals with disabilities is an important goal for rehabilitation counselors because of the high unemployment of people with disabilities and the complex process of rehabilitation. Likewise, job satisfaction has been noted to be an important counseling goal for individuals with disabilities. One theory of job satisfaction is based on a person's evaluation of whether one gets what he/she wants from a job. The amount of job satisfaction is related to the degree the job provides results which are congruent with what the person desires (Vroom, 1964).

Few studies have investigated job satisfaction among participants going through the rehabilitation process (Houser & Chance, 1993; Lam, Char & Thorpe, 1988; Roessler, Rumrill, & Fitzgerald, 2004). Researchers in these studies found that respondents were less satisfied with pay, amount of work to do and chances for advancement. While the need and cost for health care services are high, a large number of individuals with disabilities often cannot gain adequate coverage in the private insurance market. Many of these individuals describe how earnings from work can compensate for the loss of cash benefits, but cash earnings alone could not buy health care coverage (Roessler, et al.) Lain and associates found that rehabilitation counselors were less concerned about whether their consumers got what they want from jobs than they were in successfully placing these consumers in jobs. If the issue of job satisfaction is ignored, a basic component of matching people to jobs is undermined.

Unprecedented changes in the demography of our nation are evolving with people from diverse backgrounds, accounting for an increasing proportion of the population with a continuing rise in occurrence of disability conditions (U.S. Census Bureau, 2002). Ample evidence in rehabilitation literature (Atkins & Wright, 1980; Dzeikan & Okocha, 1993; Moore, 2001; Wilson, 2002) and the U.S. Surgeon General's Report (2001) have suggested that people of color are underserved and ineffectively served in human services programs in comparison to Whites in America. One of the common factors that are thought to contribute to the ineffective delivery of rehabilitation counseling services to persons from diverse cultural-ethnic-racial groups relates to the lack of cultural competence among the counselors who serve these persons (Kundu, Dutta & Walker, 1997). With this in mind, it is important that rehabilitation counselors in general and their professional associations in particular advocate for an increased level of multicultural counseling training at the pre-service and in-service levels of our professions. Although the suggestions stated above may seem reasonable to support, it is important to note that no studies have been conducted that examine the relationship between rehabilitation counselors' level of cultural competence and successful employment outcomes.

Research has also shown that attitudinal barriers more often than physical and technological barriers, prevent people with disabilities from engaging in gainful competitive employment (Rubin & Roessler, 2001). However, a paucity of empirical evidence is available that focuses on the relationship between attitudes of rehabilitation counselors and employment outcomes.

The purpose of this study, therefore, is to elucidate possible linkages that may exist among selected factors and quality measures of employment outcomes in the state rehabilitation system. The selected factors include education level/specialty, number of years of experience in the state vocational rehabilitation system, level of cultural competency, and attitudes toward people with disabilities. Quality measures of employment outcomes include weekly earnings, number of hours worked per week, medical insurance coverage status at closure, and whether insurance benefits were provided by the employer at closure.

While accounting for consumers' race/ethnicity and severity of disability, the following research hypotheses were tested. Counselors with master's degrees in rehabilitation were expected to have better quality employment outcomes than those with other degrees. Counselors with more than 10 years of experience would have better quality employment outcomes than those with less experience. Higher counselor self-reported cultural competence (awareness, knowledge, and skills) would be positively related to quality employment outcomes. Counselors who perceived themselves as having more positive attitudes toward people with disabilities were expected to have better quality employment outcomes.

Method

Procedure

After obtaining approval from the host institutional review board and the director of a small western state vocational rehabilitation agency, a survey packet was sent to rehabilitation counselors (n = 39) inviting them to participate in the study. The packet consisted of an introductory cover letter, a demographic questionnaire, the Multicultural Awareness, Knowledge and Skills Scale--Counselor Edition--Revised (Kim, Cartwright, Assay, & D'Andrea, 2003), and the Attitudes Toward Disabled Persons Scale-A (Yuker & Block, 1986). The introductory cover letter described the purpose of the study, anonymity of the participants, voluntary participation, instructions on completing the survey, and the fact that the return of the survey packet served as the consent to participate.

Counselors were asked to mail completed demographic questionnaires and surveys in pre-addressed envelopes to the researcher. The demographic questionnaire included items pertaining to counselors' gender, race/ethnicity, disability status, number of years of experience in the state vocational rehabilitation system, educational level/specialty, CSPD participation, certification status, and type of caseload (i.e., general, specialized). Counselor educational level /specialty included five categories: (1) master's degree/rehabilitation counseling; (2) master's degree related area (e.g., counseling); (3) bachelor's degree/rehabilitation counseling; (4) master's or bachelor's degree/unrelated area, and (5) less than a bachelor's degree.

Two follow-up phone calls were made to non-respondents asking them to complete and return the survey packets. Of the 39 packets sent out, 32 completed packets were returned (82% response rate). Statistical analyses were based on the 32 useable questionnaires.

Additionally, state agency databases of cases closed rehabilitated (N = 882) by those 32 counselors during fiscal years 2000 through 2002 were reviewed. Consumer data included race/ethnicity, severity of disability, weekly earnings, number of hours working per week, medical insurance coverage status at closure and whether the employer provided insurance benefits at closure.

Instruments

The MAKSS-CE-R is based on the Multicultural Awareness, Knowledge and Skills Scale--Counselor Edition (MAKSS-CE; D'Andrea, Daniels & Heck, 1991), which is one of the first widely published instruments designed to assess the three domains of competence (awareness, knowledge, and skills) that are based on the Sue et al. (1982) model of cross-cultural counseling. Sue et al. suggested along the awareness dimension that a culturally skilled counselor has awareness of "his/her own values and biases and how they may affect minority clients" (p.49). In the knowledge dimension, Sue et al. noted that a culturally competent counselor has "specific knowledge and information about the particular group he/she is working with "(p.49). These multicultural theorists also suggested that the culturally skilled counselor "must be able to read and receive both verbal and nonverbal messages accurately and "appropriately" "(Sue et al, p.49).

The MAKSS-CE-R contains 33 items comprising of a 10-item Awareness subscale (Awareness-R), a 13-item Knowledge subscale (Knowledge-R), and a 10-item Skills subscale (Skills-R). Sample subscale items are shown in Table 1. Responses on the MAKSS-CE-R are measured using three different 4-point Likert type scales (1 = very limited to 4 = very aware, 1 = very limited to 4 = very good; 1 = strongly disagree to 4 = strongly agree) with higher scores representing competence. In terms of internal consistency of the MAKSS-CE-R's scores, Kim et al. (2003) reported coefficient alphas of .71 - .80 for Awareness-R, .85 - .87 for Knowledge-R, .85 - .87 for Skills-R, and .81 - .82 for the entire MAKSS-CE-R. Subsequent confirmation of the factor structure via confirmatory factor analyses provided evidence of validity of the scores on the MAKSS-CE-R and its subscales (Kim et al., 2003). Furthermore, the MAKSS-CE-R and its subscale scores were found to differentiate individuals who have taken a course in multicultural counseling from those who have not and persons with more experience with racially/ethnically different consumers from those with less experience (Kim et al.).

The Attitudes Towards Disabled Persons Scale-A (ATDP-A) consists of 30-items that measure attitudes toward people with disabilities in general (Yuker & Block, 1986). Sample statements include: (1) Most disabled people are more self-conscious than other people; (2) Most nondisabled people would not want to marry anyone who is physically disabled; (3) Most disabled persons are different from nondisabled people. Participants respond to each item by indicating the extent of their agreement or disagreement on a Likert-type scale from +3 (agree very much) to--3 (disagree very much). The ATDP-A total scores range from--90 to +90 with higher scores reflecting positive and accepting attitudes and low scores reflecting negative and rejecting attitudes. The average reliability coefficient of the ATDP-A scale is near .80. Research has suggested support for the reliability and validity of the ATDP scales (Yuker & Block, 1986).

Data Analyses

Models of analysis of variance and regression analyses were used to determine the factors associated with quality employment outcomes. Analyses of covariance were conducted with counselor educational level/specialty and number of years of experience in the state vocational rehabilitation system. Counselor educational level/specialty included five categories: (1) master's degree/rehabilitation counseling; (2) master's degree related area (e.g., counseling); (3) bachelor's degree/rehabilitation counseling; (4) master's or bachelor's degree/unrelated area, and (5) less than a bachelor's degree. Number of years of experience was categorized as follows: (1) less than one year; (2) one to three years; (3) four to six years; (4) seven to nine years, and (5) 10 years or more to compare to previous research findings. Quality of employment outcome was the dependent variable and was operationally defined as weekly earnings, number of hours worked per week, medical insurance coverage status and whether insurance benefits were provided by the employer at closure. Higher weekly earnings, more hours worked, medical coverage at closure and employer-sponsored insurance were considered higher quality employment outcomes. Consumer race/ethnicity and severity of disability were covariates. Contrast results and means were computed to address research hypotheses one and two.

To address the third hypothesis, three hierarchical multiple regression analyses were conducted one each for the four employment outcome variables. For each outcome variable, the consumer's race/ethnicity and severity of disability were entered in Step 1, and multicultural counseling awareness, knowledge and skills were entered in Step 2.

To address the fourth hypothesis, three hierarchical multiple regression analyses were conducted one each for the four employment outcome variables. For each outcome variable, consumer's race/ethnicity and severity of disability were entered in Step 1, and the ATDP-A scores were entered in Step 2.

Results

Descriptive Results

Counselor Characteristics. The majority (62.5%, n = 20) of the respondents were female, while 37.5%, (n = 12) were male. Self-reported race/ethnicity of the sample was 71.9 %, (n = 23) Asia Americans/Pacific Islanders; 12.5%, (n = 4) Caucasians; 6.3 %, (n = 2) African Americans and 3.1%, (n = 1) Hispanics/Latino Americans. Most counselors (59%, n = 19) had worked 10 or more years in the state vocational rehabilitation system, 22% (n = 7) had worked between one and throe years in the state vocational rehabilitation system, and 19% [LAMBDA] = 6) had worked between 4 and 6 years in the state vocational rehabilitation system. Few respondents (12.5%, n = 4) identified themselves as individuals with disabilities.

Nine counselors (28.1%) reported that they possessed a master's degree in rehabilitation counseling, and nine other counselors (28.1%) reported having degrees (i.e., master's, bachelor's) in an unrelated area. While eight (25%) reported having a bachelor's degree in rehabilitation counseling, four (12.5%) reported having a master's degree in a related area, and two (6.3 %) reported having less than a bachelor's degree. The majority (59.4%, n = 19) indicated they were CSPD participants and did not yet hold counselor certification, while 40.6% (n = 13) indicated they were not CSPD participants, but held counselor certification (CRC). Twenty-two counselors (68.8%) reported that they served a general caseload, seven (21.9%) reported that they served both general and specialized cases, while three (9.4%) reported that they served a specialized caseload.

Employment Outcome Data. Of the 882 cases closed rehabilitated, 65.4% (n = 577) of the consumers were classified as having significant disabilities. Data indicated that the majority of rehabilitants (66.8%, n = 589) were Asian American/ Pacific Islander; 31.3 % (n = 276) were Caucasian and 1.8% (n = 16) were African American. Less than 1% (n = 1) were Native American/Alaskan, while no Hispanic/Latino American consumers were represented.

The mean weekly earnings were $245.72 with an average of 29 hours worked per week. Data showed that the majority of rehabilitants (55.8%, n = 492) had medical coverage at closure, and 40.4% (n = 356) of these rehabilitants' insurance coverage was provided by their employers.

Statistical Analyses

Educational level/specialty. A multivariate analysis of covariance indicated an overall significant difference for counselors' educational level/specialty (Wilks'? = .916, F (4,618) = 14.185, p = .000). Follow-up univariate F-tests revealed significant differences on all four employment outcome variables (i.e., rehabilitants' weekly earnings, F (4,621) = 5.459, p = .000; number of hours worked per week, F (4, 621) = 3.768, p = .005; average number of rehabilitants who had medical insurance coverage at closure, F (4, 621) = 11.230, p = .000; and average number of rehabilitants whose insurance benefits were provided by the employer at closure, F (4, 621) = 2.473, p = .043). Tests of simple contrasts indicated that counselors with less than a bachelor's degree closed cases of rehabilitants with a significantly greater weekly income than counselors with a master's degree in rehabilitation counseling, p = .000, counselors with a master's degree in related area, p = .001; counselors with a bachelor's degree in rehabilitation counseling, p = .002, and counselors with degrees in an unrelated area, p = .001. See Table 2 for the average weekly incomes.

Similarly, tests of simple contrasts indicated that counselors with less than a bachelor's degree closed cases of rehabilitants whose weekly work hours were significantly greater than counselors with a master's degree in rehabilitation counseling, p = .001, counselors with a master's degree in a related area, p = .004, counselors with a bachelor's degree in rehabilitation counseling, p = .020, and counselors with degrees in an unrelated area, p = .018. See Table 2 for the average weekly work hours.

However, in terms of medical insurance coverage at closure, tests of simple contrasts indicated that counselors with less than a bachelor's degree had a significantly lower number of cases with rehabilitants who had medical coverage at closure than counselors with a master's degree in rehabilitation counseling, p = .000, counselors with a master's degree in a related area, p = .000, counselors with a bachelor's degree in rehabilitation counseling, p = .017, and counselors with degrees in an unrelated area, p = .000. See Table 2 for the average number of cases with medical insurance coverage at closure.

For the number of rehabilitants whose insurance benefits were provided by the employer, the results are less clear. Nonetheless, tests of contrasts indicated that counselors with a master's degree in rehabilitation counseling and those with a bachelor's degree in rehabilitation counseling had a significantly higher number of rehabilitants whose insurance benefits were provided by the employer than counselors with a master's degree in a related area, p = .027 and p = .041, respectively. See Table 2 for the average number of rehabilitants whose insurance benefits were provided by the employer at closure.

In summary, these results provide partial support for the first hypothesis. Specifically, support was observed for the dependent variables of medical insurance coverage at closure and insurance benefits provided by employers.

Years of experience. No significant differences were found between the number of years of experience in the state vocational rehabilitation system and two of the employment outcome variables. Hence, the second research hypothesis was not supported.

Cultural competency. Significant differences were observed between counselors' perceived level of cultural competency and several employment outcome variables:

1. A positive relationship was found between perceived level of multicultural knowledge and weekly earnings ([beta] = .09, t = 2.405, p = .016); rehabilitants whose counselors reported having higher levels of multicultural knowledge tended to have higher weekly earnings.

2. A negative relationship was found between perceived level of multicultural skills and weekly earnings ([beta] = -.16, t = -4.480, p = .000) rehabilitants whose counselors reported having higher levels of multicultural skills tended to have lower weekly earnings.

3. A negative relationship was found between perceived level of multicultural skills and the number of hours worked per week ([beta] = -.14, t = -4.064, p = .000); rehabilitants whose counselors reported having higher levels of multicultural skills tended to work fewer hours per week.

4. A negative relationship was found between perceived level of multicultural awareness and number of rehabilitants who had medical coverage at closure ([beta] = -.09, t = -2.504, p = .012); rehabilitants whose counselors reported having higher levels of multicultural awareness tended to have no medical coverage at closure.

5. A positive relationship was found between perceived level of multicultural skills and number of rehabilitants who had medical coverage at closure ([beta] = .21, t = 5.906, p = .000); rehabilitants whose counselors reported having higher levels of multicultural skills tended to have medical coverage at closure.

Hence, the third hypothesis was observed with partial support.

Attitudes toward people with disabilities. No significant differences were found between counselors' perceived attitudes toward people with disabilities and the quality of employment outcomes of consumers rehabilitated. Hence, the fourth hypothesis was not supported.

Discussion and Implications

The purpose of this study was to extend knowledge regarding the relationship between selected factors and employment outcome measures in the state vocational rehabilitation system. The hypotheses tested whether educational level/ specialty, years of experience, level of cultural competency, and attitudes toward people with disabilities were associated with selected quality employment outcome measures, particularly among consumers with significant disabilities from racially/culturally diverse groups. As suggested by Gilbride, Thomas and Stensrud (1998) a more comprehensive view of the impact of employment and rehabilitation services on consumers' lives was investigated. By focusing on qualitative, as opposed to more traditional quantitative measures, (i.e., counting the number of status 26 closures and salary level), additional factors were considered (i.e., number of hours worked per week, medical insurance coverage status at closure, employer-sponsored benefits at closure).

Findings related to differences among educational level/specialty, years of experience and quality employment outcomes were counter to expectations and appeared inconsistent with findings from related studies. Similarly, the results reflecting the relationship between cultural competence and quality outcome measures were mixed and inconclusive. The most significant finding may have been that cultural competency skills versus knowledge appeared to be distinct variables, which have a differential impact on quality employment outcomes. Due to the dearth of available empirical studies in rehabilitation, counseling, psychology, and other related mental health fields that have evaluated counselor characteristics and client outcomes, a focus group strategy was applied to assist in the interpretation of the findings. A meeting was conducted with supervisory staff in a state vocational rehabilitation agency for this purpose. In addition, discussions were held with other experts in the field to elicit reactions to the findings and to generate possible explanations. Respondents suggested that one plausible explanation was that counselors with less educational preparation possibly could more easily concentrate on quality employment outcomes since the expectations for closure rates and managing larger and more complex caseloads were not as great for them in comparison to their counterparts with higher degrees.

Respondents also hypothesized that counselors with less years of experience may not have assimilated into the rehabilitation work culture in which one "learns to play the numbers game." Respondents agreed that despite the increased awareness of the need to improve outcome measures and intense questioning of the efficacy of the vocational rehabilitation system, emphasis on the single criterion measure of "rehabilitated" case closures (status 26) remains a primary justification for continued funding of the publicly supported rehabilitation effort. Thus, respondents suggested that to survive in this work culture, many counselors focus on meeting and exceeding this expected service outcome.

It is significant that both counselors with degrees in rehabilitation counseling and those who perceived themselves with higher levels of multicultural competency skills had a higher number of rehabilitants with medical coverage at closure. Conceivably, the rigor in rehabilitation counselor training programs with an emphasis on multicultural competency (Cartwright, 2001), had a positive impact on counselors placing an emphasis on the importance of retaining medical benefits as a key placement issue. It might be surmised that since the majority of counselors were also members of racially/culturally diverse groups, perhaps they were more actively involved in a greater range of culturally diverse activities. Conceivably, because of these interactions these counselors were more understanding of how cultural issues relate to the help-seeking behaviors of their consumers.

One would assume that those with more positive attitudes towards individuals with disabilities would more likely achieve higher quality employment outcomes. The finding that there were no significant differences between counselors' attitudes and quality employment outcomes may suggest that the results were possibly affected by social desirability factors. It is possible that since the ATDP-A is a self-report measure and counselors were knowledgeable and more aware of the nature of positive attitudes toward people with disabilities, scores were influenced by these factors. It may also be hypothesized that while possessing a positive attitude toward persons with disabilities is a desirable factor among counselors, it may have a limited impact on the ability to "to deliver" on that attitude in terms of outcomes. This may suggest an area for further research.

The present study had several limitations. The results were limited to counselors in one state vocational rehabilitation agency and may not be generalized to counselors in other state agencies across the nation. In particular, the agency may not be typical of all rehabilitation agencies because the majority of counselors and consumers were both members of culturally diverse populations. The impact of culture also may have had significant implications for both the assessment instruments used and the ultimate results. Adding to the uniqueness of the population matrix was the small sample size of counselors. Both of these factors limit the external validity of the findings.

The labor market conditions reflecting a higher number of non-professional positions (i.e., heavily service-oriented, part-time) may not be comparable to that found in other states. Thus, the results may not be generalized to counselors and consumers in areas not represented in the sample. Also, although the research design involved a series of measures over a period of three years, perhaps this design did not allow for a full determination of program effect.

It is important that rehabilitation educators, rehabilitation administrators and managers, as well as legislators make a greater effort to assess success beyond counting status 26 closures. Other valuable benefits of work must be emphasized, including employment benefits, improved self-esteem, personal growth, increased opportunities for socialization and improved quality of life (Gilbride et al., 1998, Hasnain, Sotnik, & Ghiloni, 2003). Recognizing the importance of improving the state vocational rehabilitation system's capacity to achieve better employment outcomes, culturally responsive strategies must be employed among consumers with significant disabilities and those from culturally, ethnically, and linguistically diverse populations.

The present study represents one attempt to assess factors associated with quality employment outcomes. It suggests that some factors are associated with quality employment outcomes, and, at least some of these factors represent qualities that can be developed. However, unexpected and mixed findings strongly suggest the need and importance of further research. Future studies should examine employment outcomes over a longer period of time and include larger sample groups within state vocational rehabilitation agencies from geographically diverse areas in the United States.

Authors Note

The authors thank Jerry Wang who assisted with state agency database collection, Kalani Chapman who assisted with data entry, Michael D'Andrea and Bob McConnell who assisted with editing the manuscript.

References

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Dzeikan, K.I., & Okocha, A.G. (1993). Accessibility of rehabilitation services: Comparisons by racial ethnic status. Rehabilitation Counseling Bulletin, 36, 183-189.

Gilbride, D.D., Thomas, J.R., & Stensrud, R, (1998). Beyond status code 26: Development of an instrument to measure the quality of placements in the state-federal program. Journal of Applied Rehabilitation Counseling, 29, 3-7.

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Kim, B.S.K., Cartwright, B.Y., Assay, P.A., & D'Andrea, M.J. (2003). A revision of the multicultural awareness, knowledge, and skills survey-counselor edition, Journal of Measurement and Evaluation in Counseling and Development, 36, 161-180.

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Moore, C.L. (2001). Racial and ethnic members of under-represented groups with hearing loss and VR services: Explaining the disparity in closure success rates. Journal of Applied Rehabilitation Counseling, 32, 15-20.

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Brenda Y. Cartwright

University of Hawaii

Bryan S.K. Kim

University of California

Brenda Y. Cartwright, Ed.D,; Department of Counselor Education College of Education, University of Hawaii, 1776 University Avenue; WA2-221, Honolulu, HI 96822. Email: [e-mail]

Table 1. Sample Items from the Multicultural Awareness,
Knowledge, and Skills Survey-Counselor
Edition-Revised (MAKSS-CE-R)

Subscale/Item

Awareness

(1)      The human service professions, especially counseling
         and clinical psychology, have failed to meet the mental
         health needs of ethnic minorities.

(2)      The criteria of self-awareness, self-fulfillment, and
         self-discovery are important in most counseling
         sessions.

Knowledge

(1)      At this point in your life, how would you rate your
         understanding of the impact of the way you think and act when
         interacting with persons of different cultural backgrounds?

(2)      How well do you think you could distinguish "intentional"
         from "accidental" communication signals in a multicultural
         counseling situation?

Skills

(1)      How would you rate your ability to effectively consult with
         another mental health professional concerning the mental
         health needs of a client whose cultural background is
         significantly different from your own?

(2)      How would you rate your ability to identify the strengths
         and weaknesses of psychological tests in terms of their
         use with persons from different cultural/ethnic
         backgrounds?

Table 2. Educational Level/Specialty and
Average Employment Outcomes for Sample

                       Weekly            Hours
Level/Specialty        Earnings ($)      Worked
                         M        SD       M        SD

Master's/Rehab.        227.21   191.17    27.63    11.20
Master's/Related       215.11   147.80    26.83    11.83
Bachelor's/Rehab.      248.45   164.39    29.16    10.75
Degree/Unrelated       259.42   212.03    29.80    11.86
Less than Bachelor's   363.40   229.87    33.15    10.01

                       Employer
                       Medical           Provided
Level/Specialty        Coverage          Insurance
                         M        SD       M        SD

Master's/Rehab.          0.63     0.48     0.61     0.49
Master's/Related         0.59     0.49     0.49     0.50
Bachelor's/Rehab.        0.47     0.50     0.65     0.48
Degree/Unrelated         0.61     0.49     0.64     0.48
Less than Bachelor's     0.28     0.45     0.63     0.49