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Balancing intuition and reason: tuning in to indecision.

Although much attention has been given to the importance of choice and decision making in the rehabilitation counseling literature, there is a gap in the area of identification of the decision making style of consumers in the counseling relationship. This analysis is critical for clinical use and encouraging personal growth. One of the most important human skills is our ability to use judgment and make choices, in other words, to make decisions. Both at personal and interpersonal levels, decisionmaking skill strongly affects quality of life. For this reason, collaborative decision making has been addressed within literature related to disability and rehabilitation counseling, which promotes empowerment, advocacy, quality of life and a revised perspective of the rehabilitation professional's role in the counselor and client relationship (e.g., Bolton & Brookings, 1996; Donnell, Lustig, & Strauser, 2004; Koseiulek, 1999, 2004; Livneh, 2005; Roessler & Livneh, 1999; Smart, 2001; Schriner, 1995; Scotch & Schriner, 1997).

The rehabilitation literature encourages assessment of problem solving skills as part of the vocational planning process for those individuals who are felt to be experiencing difficulties in making choices (Syzmanski & Parker, 1996, Rubin & Roessler, 2001, Zunker, 2002). To promote effective decision making in the counseling process, rehabilitation professionals may benefit from understanding the basics of the neuro-cognitive mechanics of decision making. The focus of this paper is on the interrelationship between cognitive psychology decision making theories and their application to rehabilitation process.

Cognitive psychology's classical decision making theories offer empirical support for individual decision making strategies. Related processes include rationalization, maximization, decision avoidance, and omission. It had been demonstrated that these and other cognitive processes, used alone or in tandem, can advance or contribute to circumvention in decision making. Theoretically, these strategies suggest considerable intelligence and economy rather than failure of a decider to act in an intelligent way (Hartung & Bluestein, 2002). It can therefore be argued that a fair perspective must be given to any individual's decision making processes. Rehabilitation counselors must ask the appropriate questions of their clientele to determine how individuals go about making decisions. Once a decision making style has been identified, the counselor can then present information and frame choices in a complementary rather than conflicting manner.

Decision Making in Rehabilitation Literature

Decisions Empower Consumers

If a person is to experience personal satisfaction, quality of life and empowerment, they must have the ability to make choices and decisions regarding his or her own life (Kosciulek, 1999). Rehabilitation professionals are prepared to provide an individual with disability assistance in achieving their goals. As described by Banja (1990), rehabilitation is a holistic and integrated program of medical, physical, psychological and vocational interventions that empower a person with a disability to achieve a personally fulfilling, socially meaningful and functionally effective interaction with the world. Rehabilitation counselors believe that there are multiple ways for individuals with disabilities to move from one point to another in order to reach their goals. Rehabilitation counselors also know the importance and the difficulty of plotting this course in time.

Decisions have been described as changing an ongoing state or process into a new state or process, in other words as crossing points in time (Malle, 2001). At points of decisions, the automatic flow of past into future is interrupted and the individual takes control. Therefore every decision which a person makes creates a new future and a set of virtually infinite consequences. For rehabilitation counselors it is imperative to plot these points in time. It is important to communicate to people with disabilities who are often overwhelmed by the systems with which they are involved, that they have a voice and the ability to make choices. There is a critical need to communicate to persons with disabilities that personal power resides within the decision making process. Facilitating the awareness of decisions as both anticipating and creating the future can provide power over and insight into future. Knowledge of classical decision making theories will enhance the rehabilitation professional's ability to understand decision making processes and to provide these needed interventions.

The unifying theme of the Consumer Driven Theory of Empowerment is that individuals with disabilities have the primary authority to make choices regardless of the extent of their disability (Kosciulek, 2004). Likewise, other authors have promoted the rehabilitation counselor's role in delivering empowerment and choice making opportunities (Batavia, 2002; Batorski & McAlpin, 1992; Bolton, 1997; Curl & Sheldon, 1992; Emener, 1991; Schriner, 1995). People with disabilities are being encouraged to take an active role in the decision making process. In fact, policy has shifted the controls from the provider to the receiver of services (Batorski & McAlpin, 1992). This change in control of services from external groups to consumer groups is a timely and very positive solution as research has shown that the change has resulted in a higher degree of consumer motivation to participate in services (Batavia, 2002; Curl & Sheldon, 1992). In addition, a greater sense of dignity for the consumer is related to increased control in decision making responsibilities (Emener 1991; Kosciulek, 2004).

With this new path of control comes an increased responsibility on the part of rehabilitation professionals to educate consumers to make reasonable choices (Curl & Sheldon, 1992). This includes assessing skills and building communication, discussing the rationale and risks of various decisions, identifying alternatives, and promoting independent skills demonstration (Syzmanski & Parker, 1996; Zunker, 2001). The rehabilitation counselor is seen as the educator and advisor, while the consumer acts as the participant and ultimately the evaluator of his or her own choice making techniques (Curl & Sheldon, 1992; Kosciulek, 2004).

Taking responsibility for anticipating one's future can present one of life's major difficulties. A person's intentions are never fully represented in all of their choices because one can never predict all of the potential consequences (Malle, B, 2001). Uncertainty about consequences can be for self and others, for short- and long-term. Another area of difficulty in decisions is conflict (Malle, B, 1995). Every choice implies at least two options, each of which has positive and negative consequences. Whatever option you choose, you will have to accept some negative features or consequences of the chosen option and forego some positive features/consequences of the unchosen option. A last source of difficulty is the impact of a decision. Even if you have little uncertainty and little conflict, decisions with major and potentially irrevocable consequences are difficult. This is a very important factor for persons with disabilities.

Starting a new career, making a transition from school to work, changing jobs, starting a new job or returning to work after a period of absence are the causes of varying levels of apprehension for most individuals. Apprehension may translate into stress when an individual interprets or appraises a situation as being more than their psychological resources can adequately handle (Lazarus & Folkman, 1984). These levels of apprehension may be higher for a person with a severe disability, who also may be experiencing anxiety related to health-related concerns or have questions about acceptance in the workplace. In addition, the financial stakes involved in making the correct career choice may seem very high for individuals with severe disabilities due to the use of a one- time-only vocational benefit, the trade off of monthly public benefit checks for a paycheck, and concerns regarding the stability of the labor market. As Nobel Prize winner Daniel Kahneman (2002) aptly states, "In experimental research as well as in the real world, the overwhelming majority of decisions are framed as gains and losses."

To facilitate decision making by consumers, rehabilitation professionals must assume a collaborative role with consumers for the purpose of problem identification, solution development, plan development, implementation and assessment of results (Batorski & McAlpin, 1992). In cases where an individual must develop an entirely new career path subsequent to the onset of disability, some consumers may need assistance in acquiring the necessary decision making and problem solving skills to allow them to reach their goals (Batorski & McAlpin, 1992, Bishop, 2005; Emener, 1992; Rubin & Roessler, 2001; Syzmanski & Parker, 1996).

Parson's Vision of the Career Decision Making Process

Theories of career development and career counseling converge on a few critical issues with career decision making and the processes for making decisions being one of them (Phillips, 1998). Most contemporary career decision making theories place a high value on the context in which a person is making a decision, their worldview and life circumstances (Young, Valach & Collen, 2002). In this way current career decision making can be described as holistic as well as individualistic. This focus on individualism is a key connecting factor between applied career decision making and rehabilitation counseling practice.

Parsons (1909) three part model for the wise choice of a vocation continues to provide an essential vision for contemporary career development. Parson's envisioned a practice of vocational guidance with service for others, cooperation and social justice among its core values (Young, Valach & Collen, 2002). Parsons was also an advocate for applying the scientific method to social problems. His was the first formal model of career decision making and it has subsequently been incorporated into other frameworks for conceptualizing, assessing, researching and intervening in the area of career decision making and indecision (Swanson, 1996).

In relationship to decision making, Parson's (1909) envisioned vocational guidance as being a socially active, politically responsible tool, that would help all people to make satisfying vocational choices using "true reasoning" to match knowledge of self with knowledge of the world of work. Work by Phillips (1997) suggests that "true reasoning" as referenced by Parson's is further delineated into two basic types of career decision making models; (a) rational choice models and (b) alternative-to-rational choice models.

Rational Choice Models and Alternative-to-Rational Choice Models

Cognitive psychology has looked at the neuropsychological processes involved in decision making and identified several theoretical approaches to this question. The first discussed will be the rational (normative) and the alternate-to-rational-choice (descriptive) approaches (Tversky & Shafir, 1995). It is important to note that alternate-to rational does not equal irrational. The label signifies a type of theory, not a type of outcome.

Rational models of decision making emphasize the individual decision maker while alternative to rational choice models emphasize the environment or context, i.e. the circumstances surrounding the decision making process. Rational-choice models view the decision maker as objective, methodical, systematic, and un-impulsive. The decision maker is assumed to be capable of obtaining all the information necessary to determine the best choice among alternatives. Alternative-to -rational choice models suggest the decision maker places more value on emotion, intuition, subjectivity and interdependence.

While Shafir and Tversky (1995) posit that rational theories provide a better account of people's normative intuitions than their actual behavior, it is inevitable that deciders will behave in other than rational ways (Phillips, 1997). Based on observations of real life decision making, researchers have discovered that decision makers are limited by incomplete and challenging information and they are not comprehensive in their search for solutions (Kahneman, Slavic & Tversky, 1982). Literature suggests that in these situations, alternate-to-rational decision-making strategies may provide more value to the decider than previously presumed (Simon, 1983; Phillips, 1997). Intuitive strategies for decision making are easily identified and should be seriously explored in addition to rational strategies. For example, the intuitive decider ("I just knew it") may reflect the decider's capacity for quick retrieval of relevant information (Phillips, 1997). The emotional decider ("It felt right") uses emotion as a preemptive function, to direct the deciders attention to what needs to be addressed clearly in a complex decisional environment (Simon, 1983). The imitative or dependent decider, ("Bob said to do it") may reflect a collaborative decision making strategy rather than the passive dependent perspective that this behavior typically is associated with (Phillips, Christopher-Sisk & Gravino, 2001). While utilizing intuition vs. rational choice has not been proven an advantage either philosophically or systematically, it is appropriate to have more than one viewpoint given rehabilitation counseling's multicultural perspective.

Theoretical innovations, empirical inquiry, and advances in technology within the field have increased the ability of rehabilitation professionals to assist people in all stages of life in making wise vocational choices. While rational models of career development reflect the modern era's emphasis on logical positivism and objective science (Savicka, 1993) a postmodern, pluralistic society may interpret true reasoning from a different perspective. What is considered rational may assume different meanings for different people based on their worldview, decision-making style, cultural orientation and life circumstances. The recent trend towards a contextualized viewpoint of decision making processes has revealed multidimensional environmental and social complexities that have previously been unexamined (Phillips,, 2001).

Analyses of Decision Making Theory

Current research in decision-making has taken a departure from its purely rational roots (Dawes, 1988; Kahneman, Slovic & Tversky, 1982). In 1976, Simon made the case that "satisficing" (i.e., making a choice that is good enough) is the most common decision strategy. More recently, empirical research has demonstrated that satisficing, which is a combined term for sacrifice and satisfaction, is an applicable decision tool for every day, real-life situations. Individuals make decision that result in consequences that are less than perfect but which they can feel satisfied in situations where information about all possibilities cannot be known in advance (Todd & Gigerenzer, 2000).

Gigerenzer, et al. (1996) has conducted research which indicates that individuals use fast and frugal heuristics to condense information for quick decision making and judgments. These heuristics form the mechanics that structure environmental information for successful outcomes. He surmises that people are good intuitive probabalists if provided with the correct information from the environment. For example heuristics can include socially adaptive building blocks, such as social norms and emotions of anger or experiences of love, which can act as further heuristic cues for search, stopping, and decision.

Rappoport & Summers (1973) discuss the role of probability and the limits to processing capacity in human judgment. Janis and Mann (1977) refer to probabilities in which for every considered alternative, several payoffs can be identified, and the expected utility of the particular payoff is compared to the probability of that payoff. Tversky and Kahneman (1974) propose that we often use heuristics (anchoring, availability, and representativeness) in making decisions that do not always guarantee a good outcome.

Case Based Reasoning (CBR) has received a fair amount of attention as it relates to naturalistic decision making (Klein & Calderwood, 1988). CBR arose out of cognitive science research in the late 1970s (Schank & Abelson 1977; Schank 1982). Schank and Abelson (1977) proposed that the general knowledge that we gain from experience is encoded in episodic memory as "scripts" that allow us to set up expectations and inferences. New episodes are processed by using dynamic memory structures which contain the episodes that are most closely related to the new episode; this process is called "reminding". Klein and Calderwood (1988) studied over 400 decisions made by experienced decision makers performing a variety of tasks in operational environments and concluded that processes involved in retrieving and comparing prior cases (e.g. from memory) are far more important in naturalistic decision making than are the application of abstract principles, rules, or conscious deliberation between alternatives. More recent psychological and cognitive psychological studies also provide support for the importance of CBR as a problem-solving process in human reasoning, especially for novel or difficult tasks (Izquierdo, Gotts, & Polhill, 2004).

Phillips, Christopher-Sisk and Gravino (2001) propose a Relational Model of Adaptive Decision Making. In a study conducted in 2001, Phillips and colleagues aimed to delineate the relational contexts in which vocational decisions are made. Using the existing data from Bluestein's and colleagues (1997) qualitative study of 58 high school seniors who had completed the transition from high school-to-work, they reviewed the interviews for patterns in the responses which demonstrated the use of others in decision making. The results demonstrated that 86% of the students either accepted help or actively recruited help from others in decision making. The active role of others was largely one in which the deciders were pushed or nudged in a particular direction. Key factors included the age of the decider and the effect of the relational environment. The participants in the study could have been novices in the decision making process thus requiring additional assistance. The effect of the relational environment (parents, friends, etc.) was also important as it could impose itself on the decider to a lesser or greater degree, creating a multifaceted set of dimensions. In this way, the environment may be more active in decision making than had previously been assumed.

In summary, a Panglossian definition of decision making theory would suggest that whatever people do is correct (Stanovitch & West, 2000). If the behavior being displayed is adaptive and helps a person reach their goals, then no error can exist in decision-making regardless of rationality. Johnson and Laird (1983) make a similar point. They suggest that there are no measures absent of controversy, which can clearly assess whether a decision-making error violates logic. Therefore, from an adaptive standpoint, there may not be a true differentiation between normative/prescriptive (rational) and descriptive (alternate to rational) analyses of decision making.

Decision Avoidance and the Role of Regret

To this point, this paper has illustrated that (1) that decision making is a cognitive process (2) there are no good or bad decision makers, only different decision-making styles, (3) that decision making is individualistic influenced by cultural orientation and life circumstances, and (4) that whatever people do is correct, there is no wrong decision, as long as a some decision is made. However within the client-counselor relationship there are impasses and occurrences of indecisiveness on the part of the individual who is receiving services. There is a final area of cognitive decision making theory to address. It concerns those individuals with disabilities with whom we work who appear unable or unwilling to make choices or come to any decisions.

The experience of regret as described by Landman (1993) is an interplay between cognition and emotions. People respond emotionally to events in direct proportion to how easily they can undo the existing state of affairs (Gilovich, Medvec & Chen, 1995). Actions are typically easier to undo than inaction because it is "easier to delete an event from chain of events than it is to insert an event into the chain" (Kahneman & Tversky, 1982, p.173). Current research suggests that an individual's deepest regret surrounds their failure to act (Gilovich, Medvec & Chen, 1995; Kahneman, 1995). Research by Gilovich and colleagues (1995) shows that short-term regret is stronger for actions (e.g., you buy a new car) than for inactions (you decided to stick to your old one), but long-term regret is stronger for inactions. Therefore in the counselor and client relationship, it is important to define whether inactive behavior is due to difficulties in decision making or if inaction is due to other causes (depression, financial restraints, etc.) and to intervene accordingly.

To demonstrate the connection between the behaviors seen and their potential impact on the rehabilitation counseling process, the following cognitive psychology terms have been paired with randomly selected descriptors (in parentheses), which represent behaviors assumed to be barriers in the rehabilitation counseling process. Notice how the intent of the decision making behavior can result in an observed action which may be misinterpreted as problematic behavior.

Decision avoidance (Lack of motivation). Decision avoidance manifests itself as a tendency to avoid making a decision by postponing it or by seeking an easy way out that involves no action or change (Anderson, 2003). Regret theory represents the idea that people take into account emotional reactions to outcomes when making decisions. Regret can be a painful cognitive and emotional experience where one feels sorry for misfortunes, losses, shortcomings or mistakes. They may be actual deeds or entirely mental ones committed by oneself or by another person or group (Gilovich, Medvec, & Kahneman, 1995).

Anticipatory regret (Lack of Assertiveness). Anticipatory regret describes the worries a decider has about losses before a decision has even been made. These salient feelings make it appear that even the best choice might turn out badly (Zeelenberg, 1999). Janis and Mann (1977) speculate that anticipatory regret causes people to think in more detail about a choice before making the choice. This means of decision avoidance suggests that people generally do not consider the merits of current opportunities independent of their past choices. Some researchers believe that the resulting inaction from anticipatory regret could represent an attempt to escape regret rather than avoid it (Tykocinski & Pittman, 1998). In addition, the more difficult the decision is the more likely it is that people take regret into account when deciding (Zeelenberg, 1999). A decision may be difficult because options are close in attractiveness, because there is no explicit knowledge of probabilities related to the decision, because it implies a trade off between two important attributes, or the options themselves are difficult to compare.

Counterfactuals (Resistant to change). It has been demonstrated that decisions can be based on counterfactual thoughts (Tykocinski & Pittman, 1998). Counterfactual thoughts are alternative representations of events or outcomes that could have happened but did not. They serve two functional purposes. They inform individuals of an aversive or negative state, and suggest changes for future behavior. Counterfactual thinking can be upward ("If I had stayed with my old job I would have much more retirement saved.") or downward ("If I had not moved to Michigan I would still have my old counselor"). Upward counterfactuals are imagined alternate scenarios that have better outcomes than reality and they figure prominently in research on regret (Anderson, 2003). Individuals also vary in their tendency to ponder, reflect and to come up with counterfactuals. Individual differences have also been identified in the extent to which people can avoid the experience of regret (Tykocinski & Pittman, 1998) and some people are harder on themselves than others are.

Emotional Amplification (Unrealistic). Emotional amplification (Gilovich, Medvec, & Husted, 1995) refers to the tendency for people to react in stronger ways to events particularly where the outcome may be unknown. Emotional amplification is represented by, "If only's", where results cannot be imagined unless the situation can be viewed clearly or within certain guidelines. Omissions, overgeneralizations and commissions with respect to reference points for decisions cloud decision making ability (Kahneman & Miller, 1986). These individuals may attribute failure to act on mere thoughtlessness, which is morally justifiable or conversely attribute self blame for making the wrong choice. In general, these individuals anticipate dissonance in decision making and their reflective judgment regarding decisions is biased toward the negative. Individuals tend to protect themselves from risky decision through inaction or in this case omission, commission and over amplification of emotions (Josephs, Larrick, Steele, Nisbett, 1992).

Social Imitation and Social Norms (Dependent, Imitative). Gigerenzer (2001) has noted that Homo sapiens is not only the most intelligent, but also the most emotional and social species-one of the very few in which unrelated members of the same species cooperate. Outside of the cognitive building blocks used in development of most theories, Gigerenzer (2001) describes social norms and social imitation as processes that function as decision-making guidelines that keep individual learning and information search to a minimum. Social heuristics such as "eat what others eat" or "prefer mates preferred by others" can guide behavior without much information gathering and bring benefits such as reduced likelihood of food poisoning and social disapproval (Gigerenzer, p. 3306, 2001). Interestingly when "others" are noted in taxonomies of decision making, the decider is described in conflicting terms, as either pathologically dependent or imitative as opposed to emotionally mature by having utilized collaborative efforts to avoid decisional errors (Phillips, et. al, 2001). The negative attributions assigned to the decider who imitates others or decides according to norms, could create a clinical misinterpretation for rehabilitation counselors. Further, the social aspect of decision making is important to consider for those who may lack supports necessary. This emphasizes the importance of social interactions in the lives of the individuals of persons with disabilities. Assessing a clients social and family supports is a critical step in understanding how the individual may approach the decision making process.

The Role of the Vocational Counselor


Rehabilitation counselors are most frequently called upon to assist individuals with a disability in making an appropriate choice in occupational areas that are compatible with the vocational, psychological, and social information gathered (Rubin & Roessler, 2001). Because the individual making the decision expects to experience the consequences of their decision, the motivation to protect oneself from the negative consequences of a bad decision, such as losing services or choosing the wrong career path, is presumably high (Josephs, Larrick, Steele, & Nisbett, 1992). Assessments in decision-making counseling should involve identification of those skills presently lacking but required for the client to conceptualize the problem, to generate sufficient alternatives, to uncover pertinent discriminative details, and to select an appropriate response (Horan, 1979). If any skill deficits have been assessed, intervention in decision-making counseling deals with the application of specific counseling techniques in an attempt to foster the development of the necessary skills (Brown, 2002; Syzmanski & Parker, 1996; Rubin & Roessler, 2001; Zunker, 2002). The interview is the primary assessment tool in decision-making counseling. All schools of counseling recommend that during the early stages of the interview the counselor should pay attention to (positively reinforce) any cognitive, affective, motor, or somatic behavior displayed by the client (Horan, 1979; Cormier & Cormier, 1998).


Literature suggests that intervention should be provided until the individual ultimately feels the correct choice has been arrived at (Horan, 1979; Peterson, Sampson, Lentz & Reardon, 2002, Syzmanski & Hershenson, 2005). Criteria for quality decision making include a wide range of choices, a full range of objectives to be fulfilled, searching for new information relevant to evaluation of all possibilities, taking into account opposite points of view, examining both positive and negative consequences of alternatives and making detailed provisions for implementing the final decision (Janis & Mann, 1977). Most theorists accept the idea that decision-making consists of a number of steps or stages such as: recognition, formulation, and generation of alternatives, information search, selection, and action (Brown, 2002; Horan, 1979). According to Festinger (1954), people will attempt to reduce their dissonance after they have made a difficult decision. They will typically exhibit one or all of the following behaviors:(1) attend to the positive features of the chosen option and forget about the other option; (2) come up with numerous good reasons why they chose the way they did, often being more confident about the quality of their choice immediately after they made it than immediately before; (3) become committed to their decision so that the chosen option becomes part of the self, and people work hard against giving it up. (However it is important be aware that this commitment facilitates people's reluctance to give up a course of action they have invested in, even when facing very good reasons to do so). Finally, sensitivity to challenges to the reasonableness of their decision or defensiveness may be demonstrated.

As part of the rehabilitation counseling process, the individual receiving services receives encouragement for introspection and the development of a personal history of occupational choices (Cormier & Cormier, 1998). During this process, it is important for the counselor to question how the individual feels about their past decisions to determine if they are capable of separating their past choices from the values of their current choices (Hartung & Bluestein, 2002; Krieshok, 1998; Phillips, 1997). Knowing the level of confidence a client has in making decisions is also important. Krieshok (1998) notes that persons who experience the most difficulty in making decisions also tend to have other difficulties including anxiety and other forms of dysfunction in life.

Valence and Decision Making Criterion

Bargh and Barndollar (1996) suggest that individuals have a repository of motives and goals referred to as the "wise unconscious" which affect decision making at the unconscious level. However these unconscious decisions may at first appear on the surface as a processing or decision making error. Given these processing errors counselors need to reassess their strategies in assisting decision makers:

"Pouring vast amounts of information, paying no attention to the valence, and not knowing the relationship to the person's real decision making criterion, may influence decision makers away from alternatives that would have proven most suitable, and lead them to alternatives less well suited to their real decisional criteria (Krieshok, 1998, p. 218)". Therefore, vocational counselors must take into account these individual variances in decision making processes when providing vocational assistance

A factor in the development of an effective relationship between the client and counselor is the development of a strong working alliance (Lustig, Strauser, Rice, & Rucker, 2002). The working alliance is conducive to active participation between clients and counselors in the rehabilitation process (Chan, F., Shaw, L. R., McMahon, B. T., Koch, L., & Strauser, D. 1997). Therefore, before assessing any consumer "dysfunction", the counselor must assess their own behavior carefully. When consumers are not taking action the first assessment a counselor should make is of their own communications. Has the counselor communicated that there is less wrong doing in taking no action, for example "don't do anything without my approval", which may contribute to inaction? According to Anderson (2000), if individuals know that other important individuals attribute less responsibility and wrongdoing to omission, they will be biased toward omission out of avoidance of blame from others for a bad outcome.

Understanding the role of regret and decision avoidance would contribute to facilitating an individual's ability to make a decision to reach their goals in addition to providing the counselor with a more accurate assessment of client decision-making schema when resistance is encountered in the counseling process (Hartung & Bluestein, 2002; Krieshok, 1998; Phillips, 1997). Given this interesting and valuable information regarding human behavior, it is surprising that concepts regarding decisional regret and avoidance have not received more attention in rehabilitation literature.

Recommendations for Future Research and Rehabilitation Counselor Practice

Future Research

Suggestions for future research include learning more about the decision making process from the deciders perspective. To what degree is decision making related to the disability process? Several recent studies have been completed suggesting differences in decision making ability for persons with disabilities (Camille, Coricelli, Sallet, Pradet-Diehl, Duhamel, & Sirigu, 2004; Kleeberg, Bruggimann, Annoni, van Melle, Bogousslavsky, Schluep, 2004; Thorne, Paterson & Russell, 2003). The impact of disability on decision making strategies requires further exploration. In addition, are decisions in all domains made in the same way and can decision making difficulties impact quality of life (Bishop, 2005; Emener, 1991; Kosciulek, 2004).


From a systems perspective, do public and private vocational rehabilitation systems have unrealistic expectations of individual decision making capacity? Janis and Mann (1977) argue that whenever a person is forced to make a decision under great time pressures, the individual tends to perform a panicky and incomplete search of decision options culminating in an inferior or unacceptable result.

Rehabilitation counselor education programs should begin to focus on non- traditional aspects of career decision making in addition to traditional problem solving and decision making models and strategies. Gati (1990) emphasizes that success in career decision making is proportional to the (a) quality of the data on the decision maker, (b) the quality of the data on the career options and (c) the quality of the process of combining the two pieces of information. Rehabilitation education should not dismiss formal models of career decision making because of the number of decision made throughout the rehabilitation process. However keeping information contemporary with findings from other areas of study will allow rehabilitation counselors to optimize their skills for demonstrating "a systematic procedure that, if followed, will lead to the best decision." (Gati, 1990, p. 513). In addition to knowledge of cognitive processes, career decision making models and client goals, Lent (2004) suggests that knowledge of motives, values, resources (client assets and environmental supports) also be taken into account so that once a decision is made, it can be translated into action.


In summary, individuals use rational-choice and alternate-to-rational choice models in decision-making. Criteria for quality decision making include a wide range of choice, a full range of objectives to be fulfilled searching for new information relevant to evaluation of all possibilities taking into account opposite points of view examining both positive and negative consequences of alternatives, making detailed provisions for implementing the final decision (Janis & Mann, 1977). While Shafir and Tversky (1995) posit that rational theories provide a better account of people's normative intuitions than their actual behavior, it is inevitable that deciders will behave in other than rational ways (Phillips, 1997). Literature suggests that alternate-to-rational decision-making strategies may provide more value to the decider than previously presumed (Phillips, 1997; Simon, 1983).Therefore the decision making process is not only complex, it also appears to violate earlier constructions of it as a logical, rational process (Krieshok, 1998).

The role of decision avoidance and regret in career decision making requires additional study. In addition to conceptualizing career decision making as a socially situated process (Hartung & Bluestein, 2002; Kirkpatrick, Johnson & Mortimer, 2002) in the here-and now; we must also take into consideration that purposeful reasoning occurs when individuals make decisions about their future. Rehabilitation professionals should make note of the context in which individuals make decisions (Peterson, Sampson, Pearson & Lenz, 1996), including the client's life circumstances, cultural value orientations and worldview in addition to their decision making styles. The best solution is to incorporate the rational and alternative strategies of decision making to account for both context and the individual. Persons making decisions in the real world must arrive at their conclusions using realistic amounts of time, information, and resources. This is more evident for individuals with disabilities who may be receiving limited services through public or privately funded agencies.

Theoretically, these decision making strategies suggest considerable intelligence and economy rather than failure of a decider to act in an intelligent way (Hartung & Bluestein, 2002). It can therefore be argued that a fair perspective must be given to any individual's decision making processes, either rational or alternative-to-rational choice models. Rehabilitation counselors must ask the appropriate questions of their clientele to determine how this individual goes about making decisions. Once a decision making style has been identified, the counselor can then present suggestions and frame choices in a complementary rather than a conflictual way.

Even though the majority of our decisions are made apart from the context of a formal counseling relationship, decisionmaking is still accomplished (Horan, 1979). Individuals with disabilities should be encouraged rather than discouraged from consulting with others. For instance, the person with a severe disability who consults with an attorney might attempt to return to work after considering the consequences of various alternatives. Similarly, a medical patient might decline elective surgery after thorough discussion with his or her spouse.

The ability to make decisions and choose to create change is one of the most important human skills. This freedom empowers us to enjoy a high quality of life (Emener, 1991, Kosciulek, 2004). The level to which our cognitions and emotions facilitate or restrain us from taking action or challenging the status quo is an interesting area for study, one in which rehabilitation counselors can join cognitive psychologists as significant contributors.


Albert, K. & Luzzo, A. (1999). The role of perceived barriers in career development: A social cognitive perspective. Journal of Counseling and Development, 77(4), 431-436.

Anderson, C. (2003). The psychology of doing nothing: Forms of decision avoidance result from reason and emotion. Psychological Bulletin, 129(1), 139-167.

Banja, J. (1990) Rehabilitation and empowerment. Archive of Physical Medicine and Rehabilitation, 7(1), 614-615.

Bargh, J. A. & Barndollar, K. (1996). The unconscious repository of chronic goals and motives. In P.M. Gollwitzer & J.A. Bargh (Eds.), The psychology of action. New York: Guillford.

Batavia, A. (2002). Consumer direction, consumer choice, and the future of long term care. Journal of Disability Policy Studies, 13 (2), 67-74.

Batorski, R.E., & McAlpin, J. (1992). Instilling consumer based attitudes in students of rehabilitation professions. Rehabilitation Education, 6, 257-264.

Bishop, Malachi (2005). Quality of life and psychosocial adaptation to chronic illness and acquired disability: A conceptual and theoretical synthesis. The Journal of Rehabilitation, 71 (2), 5-13.

Bluestein, D.L., Phillips, S.D., Jobin-Davis, K., Finkelberg, S. & Roarke, A. (1997). The school to-work transition: A theory building investigation. The Counseling Psychologist, 25, 364-402.

Bolton, B., & Brookings, J. (1996). Development of a multifaceted definition of empowerment. Rehabilitation Counseling Bulletin, 39, 256-264.

Brown, D. (2002). Introduction to theories of career development and choice. In D. Brown & Associates (Eds.), Career choice and development (4th ed.), (pp.3-23). CA: Jossey-Bass.

Chan, F., Shaw, L. R., McMahon, B. T., Koch, L., & Strauser, D. (1997). A model for enhancing rehabilitation counselor-consumer working relationships. Rehabilitation Counseling Bulletin, 41, 122-137.

Chandra M. Donnell, Daniel C. Lustig, David R. Strauser (2004). The Working Alliance: Rehabilitation Outcomes for Persons with Severe Mental Illness. Journal of Rehabilitation, 70, (2),

Camille, N., Coricelli, G., Sallet, J., Pradat-Diehl, P., Duhamel, J. R., & Sirigu, A. (2004). The involvement of the orbitofrontal cortex in the experience of regret. Science, 304, 1167-1170.

Cormier, S. & Cormier, B (1998). Interviewing strategies for helpers. Pacific Grove, CA: Brooks/Cole.

Curl, R. & Sheldon, J. (1992). Achieving reasonable choices: Balancing the rights and responsibilities of consumers with those of rehabilitation counselors. Rehabilitation Education, 6, 195-206.

Dawes, R. M., (1998). Behavioral decision making, judgment, and inference. In D. Gilbert, S. Fiske, & G. Lindzey (Eds.), The Handbook of Social Psychology (pp.589-597), Boston, MA: McGraw-Hill.

Emener, W. G. (1991). An empowerment philosophy for rehabilitation in the 20th century. Journal of Rehabilitation, 57(4), 7-12.

Festinger, L. & Carlsmith, J. (1959) Cognitive consequences of forced compliance. Journal of Abnormal and Social Psychology, 58, 203-210. Retrieved 4/21/05 at http://psych

Gati, I. (1990). Interpreting and applying career decision making models; Comment on Carson and Mowesian. Journal of Counseling and Psychology, 3 7(4), 50/8-514.

Gigerenzer, G. (2001). Decision making: Non-rational theories. International Encyclopedia of the Social and Behavioral Sciences, 5, 3304-3309.

Gigerenzer, G. & Goldstein, D. G. (1996). Reasoning the fast and frugal way: Models of bounded rationality. Psychological Review, 103, 650-669.

Gilovich, T., & Medvec, V. (1995). The experience of regret: What, when and why. Psychological Review, 102(2), 379-395.

Gilovich, Medvec, V. & Kahneman, D. (1998). Varieties of regret: A debate and partial resolution. Psychological review, 105(3), 602-605.

Gilovich, T., Medvec, V. & Chen, S. (1995). Commission, omission, and dissonance reduction: Coping with regret in the "Monty Hall" problem. Personality and Social Psychology Bulletin, 21(2), 182-190.

Hartung, P. & Bluestein, D. (2002). Reason, intuition, and social justice: Elaborating on Parson's career decision-making model. Journal of Counseling and Development, 80(1), 41-47.

Horan, J. (1979). Counseling for effective decision making: A cognitive behavioral perspective. MA: Brooks Cole.

Izquierdo, L. Gotts, N. Polhill, J. (2004). Case based reasoning, social dilemmas and a new equilibrium concept. Journal of Artificial Societies and Social Stimulation, 7(3), 1-9.

Janis, I. & Mann, L. (1977). Decision making: A psychological analysis of conflict, and commitment. Detroit: Free Press. Johnson -Laird, P. N. (1983). Mental Models. MA.: Harvard University Press.

Josephs, R., Larrick, R., Steele, C., & Nisbett, R. (1992). Protecting the self from the negative consequences of risky decisions. Journal of Personality & Social Psychology, 62, 26-37.

Kahneman, D. (2002). Maps of bounded rationality: A perspective in intuitive judgment. Nobel Prize lecture, December 8, 2002, at Aula Magna, Stockholm University. Retrieved May 14, 2004 from kahnemann-lecture.pdf

Kahneman, D. (1995). Variants of counterfactual thinking. In N.J. Roese & J.M. Olson (Eds.), What might have been: The social psychology of counterfactual thinking (509-519). N.J.: Erlbaum.

Kahneman, D. & Riepe, M. (1998). Aspects of investor psychology. Journal of Portfolio Management, 24(4), 52-65.

Kahneman, D., & Tversky, A. (1982). Variants of uncertainty. Cognition, 11, 143-157.

Kahneman, D., Slovic, P. & Tversky, A. (1982). Judgment under uncertainty. New York: Cambridge University Press.

Kirkpatrick, M., Johnson, J. & Mortimer, J.T. (2002). Sociological Perspective to Career choice and development. In D. Brown & Associates (Eds.), Career choice and development (4th ed.), San Francisco: Jossey-Bass.

Kleeberg, J., Bruggimann, L. , Annoni, J.M. , van Melle, G., Bogousslavsky, J., Schluep, M. (2004). Altered decisionmaking in multiple sclerosis: a sign of impaired emotional reactivity? Annals of Neurology, 56(6), 787-95.

Klein, G. & Calderwood, R. (1988). How do people use analogues to make decisions? In Kolodner, J.L., (Ed.) Proceedings of the DARPA Case-Based Reasoning Workshop, Morgan Kaufmann, Calif., US.

Kosciulek, J. (2004). Empowering people with disabilities through vocational rehabilitation counseling. American Rehabilitation, 28 (1), 40-48.

Kosciulek, J. (2004). Theory of informed consumer choice. Rehabilitation Education, 18(1), 3-11.

Kosciulek, J. (1999). Consumer Direction in Disability Policy Formulation and Rehabilitation Service Delivery, Journal of Rehabilitation 65 (2), 4-9.

Krieshok, T. S. (1998). An anti-introspectivist view of career decision making. Career Development Quarterly, 46, 210-230.

Krumboltz, J.D. & Hamel, D.A. (1977). Guide to career decision making skills. New York College Entrance Examination Board.

Landman, J. (1987). Regret: A theoretical and conceptual analysis. Journal for the Theory of Social Behavior, 17, 135-160.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

Lent, R. (2004). Toward a unifying theoretical and practical perspective on well being and psychosocial adjustment. Journal of Counseling Psychology, 51(4), 482-509.

Livneh, H. & Antonak, R. (2005). Psychosocial adaptation to chronic illness and disability: A primer for counselors. Journal of Counseling and Development, 83, 12-20.

Malle, B. F., Moses, L. J., & Baldwin, D. A. (Eds.) (2001). Intentions and intentionality: Foundations of social cognition. Cambridge, MA: MIT Press.

Parsons, F. (1909). Choosing a vocation. Boston: Houghton Mifflin.

Peterson, G, Sampson, J., Lentz, J. & Reardon, R. (2002). A cognitive information processing approach to career problems solving and decision making. In D. Brown & Associates (Eds.), Career choice and development (4th ed.)(312-369). San Francisco, CA: Jossey-Bass.

Phillips, S.D. (1997). Toward and expanded definition of adaptive decision-making. Career Development Quarterly, 45(3), 275-288.

Phillips, S.D., Christopher-Sisk, E.K., Gravino, K.L. (2001). Making career decision in a relational context. The counseling psychologist, 29(2), 193-213.

Rappoport, L. & Summers, D. (1973). Human judgment and social interaction. New York: Holt Rinehart & Winston. Rubin, S & Roessler, R. (2001). Foundations of the vocational process, (5th ed.), Austin: Pro-Ed.

Savickas, M.L. (1993). Career counseling in the post modern era, Journal of Cognitive Psychotherapy, 7, 205-215.

Schank, R. & Abelson, R. P. (1977). Scripts, plans, goals and understanding, New Jersey: Lawrence Erlbaum Associates.

Schank, R. (1982). Dynamic Memory: a Theory of Reminding and Learning in Computers and People. Cambridge: Cambridge University Press.

Schriner, K. (1995). Improving rehabilitation education. A case for teaching disability policy to our rehabilitation students. Rehabilitation Education. 9, 323-338.

Scotch, R. K., & Schriner, K. (1997). Disability as human variation: Implications for policy. Annals of the American Academy of Political and Social Science, 549, 148-159.

Shafir, E., & Tversky, A. (1992). Thinking through uncertainty: Non-consequential reasoning and choice. Cognitive Psychology, 24, 449-474.

Shafir, E. & Tversky, A. (1995). Decision making. In E.E. Smith & D.N. Osherson (Eds.) Thinking: An Invitation to Cognitive Science, (77-100). Cambridge MA: MIT Press.

Simon, H. (1983). Reason in human affairs. Stanford, CA: Stanford University Press.

Smart, J. (2001). Disability, Society and the Individual. Gaithersburg, MD: Aspen.

Stanovich, K. & West, R. (2000). Individual differences in reasoning: Implications for the rationality debate. Behavioral and Brain Sciences, 23, 645-726.

Swanson, J. L. (1996). The theory is the practice: Trait factor/person-environment fit for counseling. In M. Savickas & W.

Walsh (Eds.), Handbook of career counseling theory and practice (93-108). Palo Alto, CA: Davies-Black.

Syzmanski, E. M. & Parker, R. M. (eds.) (1996). Work and disability. Austin, TX: Proed.

Syzmanski, E. & Hershenson, D. (2005). An ecological approach to vocational behavior and career development of people with disabilities. In R. Parker, E. Syzmanski, & J Patterson (Eds.), Rehabilitation counseling basic and beyond (4th ed.). Austin: Texas: Proed.

Todd, P. & Gigerenzer, G. (2000). Precis of simple heuristics that make us smart. Behavioral and Brain Sciences, 23, 727-780.

Tversky, A. & Kahneman, D. (1974). Judgment under uncertainty: Heuristics and biases. Science, 185, 1124-1131.

Tykocinski, O. & Pittman, T. (1998). The consequences of doing nothing: Inaction inertia as avoidance of anticipated counterfactual regret. Journal of Personality and Social Psychology, 75(3), 607-616.

Zeelenberg, M. (1999). Anticipated regret, expected feedback and behavioral decision-making. Journal of Behavioral Decision Making, 12, 93-106.

Young, R. A., Valach, L., Collin, A. (1996). A contextual explanation of career. In D. Brown & L. Brooks (Eds.), Career choice and development (3rd ed.)(477-512). San Francisco, CA: Jossey-Bass.

Zunker, V. (2002). Career Counseling (6th ed.), Pacific Grove, CA: Brooks Cole.

Jane L. Nichols

Michigan State University

Jane L. Nichols, MS, CRC, Michigan State University, East MI 48824.
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Author:Nichols, Jane L.
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Date:Oct 1, 2006
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