This framework also provides rehabilitation counselors specific interventions for enhancing clients' control over the impact of CIAD.
As opposed to traditional unidimensional measures of adaptation, the multidimensional QOL-framework offers counselors and their clients the opportunity to view the client's life holistically, and understand the impact of CIAD in the context of the complex interactions of personal, social, and environmental domains.
Because the process of adapting to CIAD, as to other changes, is a continuously evolving and cyclical one (Kendall & Buys, 1998; Livneh, 2001), it is likely that all people experience a phase of inertia for some duration before the types of changes described above occur.
Because people seek to maintain a relatively high level of QOL, when CIAD impacts QOL an adaptive response is to be expected.
Domain Control Devins has suggested that the impact of CIAD on QOL occurs through two mechanisms: by reducing satisfaction and by reducing control.
Specifically, in addition to assessing the impact of CIAD in terms of QOL domains, it is also critical to understand the relative importance of each domain to the individual.
In the proposed model, the term centrality refers to the importance an individual attributes to an area of life that is altered by the onset of CIAD.
Based on a linking of these similar constructs, and the inclusion of additional concepts drawn from the QOL literature, the disability centrality model for measuring and understanding the impact of CIAD is proposed.
The MS patients responded to the CIAD as predicted by the DCM tenets.
Increasing perceived control is a response to the impact of CIAD that individuals execute through self-management, treatment, or environmental accommodation (Bishop, Smedema & Lee, 2009).
The onset of CIAD results in a reduction in overall QOL due to the disability, illness, or associated treatments.
According to Bishop (2005), adaptation at the onset of CIAD involves a multidimensional response that is unique to each individual.
