Journal of Vocational Rehabilitation - Volume 18, issue 1
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Journal of Vocational Rehabilitation will provide a forum for discussion and dissemination of information about the major areas that constitute vocational rehabilitation.
Periodically, there will be topics that are directed either to specific themes such as long-term care or different disability groups such as those with psychiatric impairment. Often a guest editor who is an expert in the given area will provide leadership on a specific topic issue. However, all articles received directly or submitted for a special issue are welcome for peer review. The emphasis will be on publishing rehabilitation articles that have immediate application for helping rehabilitation counselors, psychologists and other professionals in providing direct services to people with disabilities.
Original research articles, review articles, program descriptions, and case studies will be considered for publication. Ideas for special topical issues are welcomed as well.
Abstract: Objective: This study identifies patterns and correlates of disclosure among professionals and managers with serious psychiatric conditions. Design: A national mail survey of such respondents was conducted. Results: A large proportion (87%) of study participants reported having disclosed their mental illness. About half of the disclosers reported unfavorable circumstances leading to disclosure while one third disclosed when they felt comfortable. Most frequently, respondents disclosed to supervisors; one third…made their disability known when applying for the job. About half of the respondents had no regrets about disclosing. Multivariate analysis showed that correlates with the occurrence, timing, and choice of disclosure converge around constructs related to job confidence, empowerment, and recovery. We also describe those who chose not to disclose. Conclusion: Higher rates than previously reported and better experiences with disclosure were evident and may be related to this population's greater recovery as well as to occupational factors.
Abstract: Objective: Years after the passage of the Americans with Disabilities Act, little empirical information exists about the relationship between the functional limitations experienced by individuals with psychiatric disabilities, and related reasonable accommodations provided on the job. Design: A multi-site, longitudinal study was conducted with 191 employees in 22 supported employment programs across 3 states during a 1-year study period. Data were gathered prospectively in a structured, narrative form designed to describe both the functional…limitations and accommodations of participants. Results: The most frequent functional limitations among this group of employed persons with psychiatric disabilities were cognitive in nature, followed by social, physical, and emotional/other. There was a significant relationship between the type of functional limitation and the number and type of accommodations received. There was a marginally significant relationship between type of functional limitation and a diagnosis of schizophrenia. There were no significant relationships between any other clinical or demographic factors, functional limitations or reasonable accommodations. Conclusion: Functional limitations and their associated accommodations can be defined and categorized. Cognitive limitations were the most prevalent in this sample and the best predictor of the number of accommodations provided. Implications of these findings for accommodations under the ADA, eligibility for Social Security Disability benefits, and vocational assessment and planning are discussed
Keywords: functional limitations, psychiatric disability, reasonable accommodations, work
Abstract: Objective: To examine the one-year employment retention rate and nature of jobs held among clients with severe psychiatric disabilities working in the community at time of closure from the Illinois state vocational rehabilitation (VR) system, as well as factors associated with retention. Design: The sample included clients closed from the VR system while employed in the community during 10/91 through 1/93. A total of 315 individuals were recruited and followed for one year by study researchers, at which time…they completed telephone interviews. Data were analyzed using chi square and multiple logistic regression techniques. Results: One year after closure, 71% of those who were employed in the community at the time of exiting state VR were still employed. Of those who were working, 63% were employed at the same positions held at closure. Conclusions: Findings from post-closure followup studies can be used to enhance long-term vocational outcomes for mental health consumers.
Abstract: Objective: The purpose of this study was to determine whether self-reported course of illness predicts vocational recovery in a representative sample of persons with DSM-III-R diagnosed schizophrenia after adjusting for 13 clinical, and 8 non-clinical predictors chosen on the basis of a recent literature review. Design: Data from the National Survey of Mental Health and Wellbeing in Australia (a survey of people living with psychotic illness) 1997–1998 were analyzed. Participants (n = 380) were characterized…by a diagnosis of schizophrenia, outpatient or short-stay inpatient status, known educational attainment, and an employed or unemployed status at the time of interview. Results: Self-reported course of illness emerged as a practical and low cost predictor of vocational recovery. In contrast to previous controlled studies in the United States, educational attainment and age contributed to predicting vocational recovery in Australia. Conclusions: More severe courses of illness, disrupted education, and age exceeding 44 years, suggest more intensive forms of vocational assistance may be required. Although promising, further work is needed to validate the potential utility of self-reported course of illness in vocational studies.
Keywords: vocational recovery, schizophrenia, employment outcomes, self-reported course of illness
Abstract: Objective: Situational assessments of work performance can be used repeatedly to measure progress in work rehabilitation and used for feedback and goal setting. Design: Sixty-three people with schizophrenia or schizoaffective disorder participating in a 6-month paid work program were randomly assigned to receive a behavioral intervention utilizing work performance feedback and goal setting or to receive usual support services. Results: Results showed that those receiving the behavioral intervention (BI) had significantly greater…improvement on the WBI subscales overall and specifically on Social Skills, Personal Presentation, and Cooperativeness. Those in BI also worked significantly longer, 36% more hours and 22% more weeks. Additionally, those in BI showed a trend toward greater improvements on measures of motivation, sense of purpose, and enjoyment in life. Conclusions: Results indicate that BI can improve work performance, particularly for interpersonal behaviors that are less likely to be addressed by work supervisors, increase job retention, and may enhance feelings of motivation, sense of purpose and enjoyment in life.
Abstract: Objective: For many years, vocational and clinical services for persons with severe mental illness have been separated (i.e., non-integrated) in the United States. Recent research on supported employment shows, however, that combined vocational and clinical services within the same team (i.e., integrated services) produce higher rates of competitive employment than non-integrated services. Design: To understand the advantages of integrating vocational and clinical services, the authors examined quantitative process data, ethnographic…findings, and qualitative interview data from practitioners in three independent studies of supported employment. Results: Integrated services offer four consistent advantages over non-integrated services: (1) more effective engagement and retention, (2) better communication, (3) opportunities for clinicians to understand and focus on employment, and (4) incorporation of clinical information into vocational plans and services. Conclusions: Combining clinical and vocational services within multidisciplinary teams is consistent with the general movement toward developing integrated systems of care. Integrated services are more effective than parallel services because clinicians rather than clients assume the burden of coordination, consistency, and coherence.
Abstract: Objective: Mental health consumers at an urban mental health center were surveyed about their motivations for working and perceived barriers to employment. Design: A survey was developed and administered by a consumer-led research team to 389 persons receiving case management and outpatient services. Results: Most consumers were either working (16%; n=59) or reported a desire to work (46%; n=170). The latter group constituted 55% of the 310 respondents who were not working at the…time of the study. The most common perceived barrier was the fear of losing Social Security benefits. Consumers also reported concerns about receiving low pay and being ashamed of their job histories. Among the 38% of the total sample who expressed a reluctance or unwillingness to work, two-thirds (n=58) indicated that, if they did not have to worry about losing their Social Security benefits while working, they would try to obtain employment. A total of 179 (49%) respondents expressed a preference for receiving vocational services at their clinical sites, versus at a clubhouse location. Conclusions: Most consumers in this study were working or wanted to work. Consumers' motivations for work can be increased, especially if key barriers to work are described as removable. Preferences for types and locations of vocational services need to be considered in planning services.
Keywords: consumers, work, barriers to employment, survey, work motivation