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The state-federal vocational rehabilitation system is tasked to demonstrate accountability for employment outcomes of persons with disabilities. State VR agencies have sought to evaluate existing practices, and in areas that existing practices leave room for improvement, create the conditions for innovation to occur. The purpose of this article is to identify promising organizational and cultural factors that appear to promote best practices in the public vocational rehabilitation program. A multi-stage study utilizing the Consensual Qualitative Research (CQR) was conducted involving four high performing state VR agencies to discover emerging and promising organizational practices leading to improvements in employment outcomes of people with disabilities. The comprehensive examination revealed specific organizational practices, culture and structural elements that encourage and support the development of innovative, effective service delivery practices. Given the complexity of service provision and the increasing demand for successful outcomes, VR agencies must develop organizational cultures that facilitate transformational learning by employing evidence-based practices that lead to successful outcomes for agency consumers.

As an epilogue to this special issue, this article provides a brief overview of the research undertaken by the Rehabilitation Research and Training Center on Evidence-Based Practice in Vocational Rehabilitation (RRTC-EBP VR) in Phase II of their studies, and what was learned from the comprehensive review of the literature (e.g., Fleming, Del Valle, Kim & Leahy, 2013) and multi-state case studies in terms of promising practices in state VR agencies (Leahy et al., 2013). Gaps identified in EBP research that hinders the implementation of efficacious, effective, and efficient services based on the best scientific evidence are discussed, and finally, recommendations for future research directions and knowledge translation initiatives that will improve the effectiveness of VR service delivery practices are provided.

The state-federal vocational rehabilitation (VR) program has been challenged to demonstrate the effectiveness of VR services provided to eligible consumers. State-federal VR agencies are under pressure to develop a foundation of evidence-based practices that lead to competitive employment outcomes for people with disabilities. This article provides a qualitative analysis of the organization structural elements and service delivery practices related to the provision of effective best practices that enhance employment outcomes for individuals with disabilities. Using a Consensual Qualitative Research (CQR) approach, a multi-stage qualitative analysis of four high performing state VR agencies was conducted to identify promising organizational and service delivery practices that facilitate employment outcomes. Twenty-nine practices were identified as being supportive of the successful outcomes of persons with disabilities being served by these agencies. The identified practices reflect unique and similar service patterns across the four VR agencies studied. Practices were divided into Promising Organizational Practices and Promising Service Delivery Practices. The culture of an organization is an important factor in the development and sustainability of innovative practices. Best practices reconsider traditional rehabilitation counselor roles and offer new methods for delivering services. Rigorous research and program evaluation are required to identify which practices will ultimately constitute evidence-based practices.

Rehabilitation counselors and practitioners are under increased pressure to adopt and pursue evidenced-based practices, and the rehabilitation counseling literature has been criticized for a lack of empirical work providing support for individual-level interventions. The purpose of this literature review was to examine the last 25 years of rehabilitation research with specific attention to empirical studies related to active employment-focused interventions and present models of best practices that already exist within the literature. Findings indicated that 35 empirical studies met the search criteria of presenting services or models with initial evidence of supporting employment outcomes. In the review process, studies were classified into seven categories based on topic, including interagency collaboration, counselor education and customer outcomes, services to a targeted group, supported employment and evidence-based practice (EBP), empowerment and customer self-concept, essential elements of service delivery, and miscellaneous vocational rehabilitation services and outcomes. A review and synthesis of studies within these topical areas are presented, along with implications within the context of the critical need for EBPs in rehabilitation counseling.