ABSTRACT
This chapter describes two contrasting organizational systems and structures in vocational rehabilitation settings in Israel and in the United States. A common outlook exists in the two countries on a conceptual definition, criteria of client success, and stages of the rehabilitation process. The notion that the rehabilitation process is not unidirectional is accepted by both countries. The organization and structure of the rehabilitation system is no less crucial for the success of the service. Vocational rehabilitation services are provided within human service organizations which may lack a clear concept of organizational effectiveness, more specifically, a consensus as to what constitutes successful client outcomes. The formal structure of the organization of the rehabilitation system is not always determined by demands emanating from assessed client needs or from current rehabilitation practices, but by policy makers who are generally removed from these needs and practices. The National Insurance Institute (Nil) provides social security payments to special groups in the population.
