Review of Vocational rehabilitation and supported employment.

Reviews the book, Vocational rehabilitation and supported employment edited by Paul Wehman and Sherril Moon (1988). As the preface to this sourcebook notes, this collection of 23 articles from 39 contributors "represents only a beginning" to the formulation and critical assessment of supported employment (SE). Rehabilitation professionals should become familiar with this monograph because of the pivotal role of the contributors in the SE movement. Organizationally, this text is well conceived, consisting of five wide-ranging sections. The topic selection demonstrates a sensitivity to the kinds of questions rehabilitation workers are asking about SE. The first section provides the philosophical underpinnings of SE, a recent history of vocational rehabilitation, and a cost-benefit analysis. The three middle sections address a range of implementation issues. Topics include community consensus building, curricula for training rehabilitation staff, job development, and performance indicators. The fifth section consists of applications to specific populations: mental retardation, autism, traumatic brain injury, chronic mental illness, and physical disabilities. This book is an intelligent, up-to-date introduction that will find a wide audience among state planners, program administrators, employment specialists, and researchers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Return to work for patients with traumatic brain injury. Analysis of costs

This brief report describes staff time commitment and program cost outcomes for a return to work program of supported employment for persons with brain injuries. The mean cost of providing services was $10,198 for the first year of service (median, $6,942). Clients achieved job stabilization after an average of 18 wk of time-limited job coaching services, during which they received mean intervention time of 245.7 h (median, 219) at a cost of $7,789. A mean of 2.24 h/wk of extended services intervention was required to maintain clients in employment for the remainder of the first year of service, at a mean weekly cost of $71.01. Results are compared with findings reported in a previous study using a smaller sample.     

Standards of comparison and job satisfaction.

On the basis of discrepancy theories of satisfaction, it was hypothesized that satisfaction with specific job facets is uniquely related to discrepancies between current job facet experiences and desired levels of those same job facet experiences (i.e., between what employees now get from their jobs and what they want from their jobs). Seventy-eight employed college students provided questionnaire data to test this hypothesis for each of 13 separate job facets (e.g., hourly pay, customer/client contact, promotion opportunities). Results based on 2 methods of operationalizing the discrepancy concept generally supported the unique predictive capacity hypothesis. A second sample of 47 master's of business administration students provided similar results. Discussion focused on the value of the discrepancy concept in efforts to predict and explain satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CLIENT 1: A computer program which simulates client behavior in an initial interview.

Presents details of CLIENT 1 in which, through interaction with the counselor, a programed client progresses toward the goal of verbalizing a specific problem statement. Client movement is a function of the simulated variables: threat value of counselor and client statements, strength of the relationship, and an index of counselor competence. The simulation project is valuable as a means of training and evaluation in counselor education and in studying counselor cognitive processes. The program, written in FORTRAN IV, also provides an opportunity to test the sufficiency of an explicit set of theoretical constructs for explaining client behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving Success in a Veterans Homeless Domiciliary Vocational Program: Model Development and Evaluation.

Objective: Determine predictors of success in a vocational rehabilitation component of a Veterans Affairs Rehabilitation Program. Design: The 1st of 2 experiments evaluated risk factors for failure to find competitive employment. The 2nd assessed attainment of employment following program changes based on identified risk factors. Participants: Eighty-four and 82 homeless veterans in Experiments 1 and 2, respectively. Results/Experiment 1: Eight factors were found to be significant and were combined into a Risk Factor Scale. Results/Experiment 2: The authors assigned patients to a competitive job-search-only track or a hybrid program combining competitive job search and the potential for supported employment. Overall employment rates increased, and success rates for those seeking only competitive employment rose. Employment rates of those unlikely to find competitive employment increased. Conclusion: Findings demonstrated the effect of developing systematic data on risk factors for failing to find employment, implementing changes based on the data, and applying the benefit of these changes to program functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal outcomes in supported employment: A survival analysis.

Studied 90 consecutive job placements (46% minority) in a supported employment program for individuals with severe mental illness to examine employment longevity. Results indicate significant differences for long-term employment retention between minorities and nonminorities and among psychiatric diagnostic categories (i.e., schizophrenia and schizoaffective disorders, affective disorders, other personality disorders). The advantages of survival analysis methodology for studying employment retention data are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supported work: An innovative approach to the vocational rehabilitation of persons who are psychiatrically disabled.

Presents a model for the vocational rehabilitation of persons with severe psychiatric disability (SPD) that helps clients find private-sector jobs and provides support to both client and employer. Preliminary data on a supported work program in which 152 Ss with SPD participated suggest that the model is effective in returning individuals with SPD to competitive employment. Close monitoring of a subset of 34 Ss during the 1st yr of the program revealed that Ss whose disabilities were identified in adolescence (age 19 yrs or younger) were almost twice as likely to be employed as those with an adult onset. Clinical stability and level of motivation also appeared to affect program outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Crisis intervention training program: Influence on staff attitudes in a postacute residential brain injury rehabilitation setting.

Purpose/Objective: Acquired brain injury produces a host of behavioral changes, and specialized training in proper management of these behaviors is essential to resolve crises and calm aggressive clients. This study was conducted to determine whether crisis intervention training was effective in increasing staff comfort with difficult client behaviors in a residential rehabilitation program for individuals with postacute acquired brain injury and whether changes would be maintained over time. Research Method/ Design: Twenty-five rehabilitation staff members participated in Nonviolent Crisis Intervention training and completed the Rehabilitation Situations Inventory before training, immediately following completion of the program, and 1 month later. Results: Immediately following completion of the program, participants reported increased comfort when faced with client behaviors related to motivation and adherence, sexuality, and aggression and when interacting with other staff and client families. Changes in comfort level with sexual situations, aggression, and staff/staff interactions were maintained 1 month post training. Conclusions/Implications: These results suggest that crisis intervention training is effective in increasing levels of staff comfort with difficult situations commonly experienced in the rehabilitation setting and the changes are maintained following training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental illness stigma and the fundamental components of supported employment.

Purpose/Objective: The success of supported employment programs will partly depend on the endorsement of stigma in communities in which the programs operate. In this article, the authors examine 2 models of stigma--responsibility attribution and dangerousness--and their relationships to components of supported employment-help getting a job and help keeping a job. Research Method/Design: A stratified and randomly recruited sample (N=815) completed responses to a vignette about "Chris," a person alternately described with mental illness, with drug addiction, or in a wheelchair. Research participants completed items that represented responsibility and dangerousness models. They also completed items representing 2 fundamental aspects of supported employment: help getting a job or help keeping a job. Results: When participants viewed Chris as responsible for his condition (e.g., mental illness), they reacted to him in an angry manner, which in turn led to lesser endorsement of the 2 aspects of supported employment. In addition, people who viewed Chris as dangerous feared him and wanted to stay away from him, even in settings where people with mental illness might work. Conclusions/ Implications: Implications for understanding supported employment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The policy & procedure manual: development of a computer-assisted process for review

This article documents the successful development of a computer-assisted process for systematic review of nursing policies and procedures at The Queen Elizabeth Hospital, Toronto, Ontario. Through broad staff input, policies and procedures are research-based yet grounded in the reality of the facility's nursing practice. Client-related standards are written as measurable, realistic statements of desired client outcomes, and as such are standards for client care. Policies and procedures have been rated according to the Canadian Council on Health Facilities Accreditation criteria (client centered, high risk, high volume, problem prone, interservice, outcome-related), so that important policies are easily identified to provide focus for quality assurance activities. The review process is structured so that over the course of a year, all policies are circulated for review by all levels of nursing staff.     

Supported employment for adults with psychiatric disability: Results of an innovative demonstration project.

Describes an innovative 3-yr research and demonstration project evaluating a supported employment program on a university campus designed specifically for persons with psychiatric disability. The vocational status, job satisfaction, work integration, symptomatology, and social supports of 20 Ss were assessed during the project, and a 2-yr follow-up of employment status was conducted. While a university setting was ideal for providing supported employment services for persons with psychiatric disabilities, the university itself was not a particularly receptive or compatible employer. The 2-yr follow-up showed that 10 Ss were employed an average of 17.5 hrs per week with mean earnings of $156 per week, representing a modest increase in percentage of Ss employed, and a substantial increase in average hours worked and average wages earned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Supported employment: Models, methods, and issues.

Reviews the book, Supported employment: Models, methods, and issues, edited by Frank R. Rusch (see record 1991-97391-000) as consisting of 25 chapters by 49 contributors, including many well-known supported employment researchers, educators and administrators. Of the book's four sections, the first is an update on the spread of SE, with three chapters presenting survey data on program implementation in Virginia, Illinois, and Pennsylvania. Although informative, such data are now widely available and, unfortunately, quickly dated. The second section consists of nine "how-to" papers describing how integration can be in fact actualized. The third section addresses a range of issues affecting the future of SE, including conversion of sheltered workshops, employment opportunities of the future, and national strategies in implementation. The book's final section includes four chapters on the transition from school to work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance in occupational therapy as a predictor of successful prevocational training

Scores on three subtests of the Minnesota Follow-up Scale (MFS) were related to client outcomes in a prevocational training program in a study of 26 clients who were referred from an adult psychiatric day treatment unit. The results of the study agreed with a prediction that successful performance in occupational therapy in the day treatment unit, as measured by subtest 1, would be significantly related to successful client outcomes. the results regarding predictions for two other subtests were less conclusive because clients received high scores. Age and sex distributions showed that the younger male clients were most likely to be referred for prevocational training. The staff of the prevocational training program accepted the results of the study and also agreed that performance in occupational therapy (in the day treatment unit) should receive greater recognition by staff members as an important indicator of work potential when evaluating clients for referral to a vocational training program. It is planned to continue the use of the MFS in the day treatment unit as an aid for evaluating clients for referral purposes. Scores will continue to be related to client outcomes in the prevocational training program. Further study is also planned concerning the relationship of age and sex and sources to which clients are discharged or referred from the day treatment unit.     

A survey of master's-level staffing patterns and clinical roles.

1,157 mental health agencies were surveyed concerning the employment of master's-level clinical psychologists, and usable data were provided by 637. Numbers and proportions of staff positions, salaries, job functions performed, and training models preferred for master's-level clinicians are reported for 9 types of mental health agencies. Community mental health centers and state hospitals provided the best sources of employment. The optimal training program should prepare the student to perform group and individual therapy, psychological testing, and community mental health functions. Research skills were more important in state hospitals than in community mental health centers. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal versus professional evaluations of self-disclosing and self-involving counselors.

The concept of counselor disclosure was separated into 2 types of counselor responses: self-disclosing statements and self-involving statements. These types were also varied along a positive–negative dimension. 80 female undergraduates listened to taped segments and rated the counselor using self-involving statements as more professional than the counselor using self-disclosing statements. Positive vs negative disclosures produced no significant differences. Self-disclosing statements directed Ss' attention toward the counselor, whereas self-involving statements kept the focus of counseling on the client. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

De-mystifying employment test validation: A process to get high validity coefficients.

Presents a model of test validation which yielded high validity and reliability coefficients. The study was conducted for a mid-level secretary position at a state university. An employment selection test was developed around 25 tasks of work identified in the job analysis. A research performance appraisal was developed with behavioral statements, which matched each of the test sections. The appraisal contained 80 task statements and was mailed to 1,488 incumbents and their supervisors at 20 institutions. Questionnaires were returned by 883 incumbents and 659 supervisors for a total return of 1,542 completed questionnaires. Ss evaluated each of the 80 task statements as to relative importance, frequency, and knowledge needed at time of hire. Results substantiate the importance of job analysis in the test validation process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing the effects of an affective and a behavioral counselor style on client interview behavior.

Examined the effects of affective and behavioral interview styles on client environmental contingency; goal-related, action-step-related, and self-reference affect; and time-oriented statements. 24 female student teachers were assigned to 2 treatment conditions for 2 25-min interviews scheduled 1 wk apart. Only half of the Ss experienced the counselor style they had preferred during an earlier sampling study. The 7 verbal dependent variables were subjected to an analysis of variance for a 2 (Styles) * 2 (Preference) * 2 (experimenters) factorial design. The behavioral style significantly increased client environmental contingency, goal-related, and action-step-related statements. Results show that counselor interview styles differentially prepare clients to describe their behavior in specific behavioral terms and engage in goal-setting and action-step-planning phases of counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)