Affiliations: New York Institute of Technology, Occupational Therapy
Department, School of Health Professions, Northern Boulevard, P.O. Box 8000,
Old Westbury, NY 11568-8000, USA. Tel.: +1 516 686 3863; E-mail: [email protected]
Abstract: Governmental expectations of placement outcomes were often high
given the severity of work barriers that were present in disabled welfare
recipients in the United States [11]. The purpose of this article is to
identify challenges that were inherent in welfare-to-work programs and
solutions to these challenges. Although rich with opportunity, welfare-to-work
programs presented the challenge of employing large numbers of
difficult-to-employ individuals before their public assistance benefits
expired\cite{5}. Many clients also had symptoms of Posttraumatic Stress
Disorder (PTSD) secondary to childhood physical or sexual abuse (59%) or
severe domestic violence (55%) [8]. Few funds were available for work
training and education. Instead, the employment-first model was expected even
though most consumers did not have a high school diploma, had not worked in
years, and were fearful and resistant about returning to work [3].
Performance based payment systems presented a challenge because the program's
future depended on the compliance of its consumers. There was an impetus for
substance abusers to return to work even if they were still using drugs, which
contradicted the teachings of many recovery models. This paper presents
possible solutions to each of these problems and reports outcomes of one
particular welfare-to-work program. By examining the challenges of
welfare-to-work programs, by identifying solutions, and by realizing that these
solutions are inherent in the basic principles of rehabilitation, this article
provides therapists with tools and motivation to make unique contributions to
this area of practice.
