In the United States, VR refers to training and supports for persons to obtain work, return to work, or stay at work. There are different types of rehabilitation programs (for example, medical and vocational) and various organizations and funding sources that support rehabilitation services, including federal, state, and private entities. Although the organizations and funding sources for rehabilitation can overlap, the central focus of this section is on VR interventions offered through financing mechanisms of the U.S. Department of Education's Rehabilitation Services Administration (RSA). The RSA-sponsored state-federal program is by far the largest VR program offering employment-support interventions to help individuals with disabilities obtain employment. Title I of the Rehabilitation Act of 1973 authorizes a VR program to provide services to persons with disabilities so they can prepare for and engage in gainful employment. Each state and territory designates a single VR agency to administer the VR program, except where state law authorizes a separate agency to administer VR services for blind individuals.
VR counselors are professionals who work with individuals with disabilities to develop a rehabilitation plan for employment. VR interventions are tailored for each client, and may include a broad array of services, such as counseling; assistive technology; vocational training; or funding for higher education, job search, or job-placement assistance and SE.12
Numerous studies have been conducted on the federal-state VR program, and most indicate that intensive job readiness, job placement, and SE are associated with competitive employment outcomes at a statistically significant level (Pruett et al. 2008; Ownsworth & McKenna 2004; Saunders et al. 2006). However, many VR studies do not sufficiently control for outside factors, and there is seldom a satisfactory control-group, making it difficult to determine the relative employment outcomes for people with disabilities in the absence of VR services (Livermore & Goodman 2009).