Journal of Vocational Rehabilitation - Volume 27, 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: To compare fidelity of implementation of supported employment in different types of provider organizations. Methods: Using opportunity sampling, a multi-state survey yielded a sample of 106 supported employment programs, including 33 located in community mental health centers (CMHCs), 18 located in psychosocial rehabilitation centers, 31 located in comprehensive rehabilitation centers, and 24 housed in other social service agencies. Program directors completed a telephone interview on the Quality of Supported Employment Implementation Scale (QSEIS),…a 33-item supported employment fidelity scale. Results: CMHC-based programs rated significantly higher on fidelity than programs housed in psychosocial rehabilitation or comprehensive rehabilitation centers. Integration with mental health treatment was the key factor differentiating the types of provider organizations. Conclusions: Type of provider organization is an important factor in facilitating implementation of evidence-based principles of supported employment.
Abstract: Objective: This paper provides a review of experiences by six states and the District of Columbia in disseminating an evidence-based practice, supported employment (SE). Each jurisdiction had unique strengths and barriers to overcome to effectively implement supported employment services for people with severe mental illness. Methods: Using a case study approach seven jurisdictions report special aspects surrounding the implementation of evidence-based supported employment. Results: Diverse strategies were used to augment implementation of…supported employment services: a) Instituting state-level administrative procedures and reconfiguration of local staffing to enhance collaboration between mental health and vocational rehabilitation; b) Promoting SE services through the media, on-line training, and training by early adopters; c) Hiring benefits specialists; d) Teaching outcome-based supervision; and e) Building capacity for supported employment fidelity reviews. Conclusions: Dissemination of evidenced-based supported employment was enhanced when six states and the District of Columbia addressed special aspects. Supported employment implementation included different pathways to good employment outcomes.
Abstract: Vocational rehabilitation for people with severe mental health problems is poorly developed in the UK. Although a high proportion state they would like to work, few actually do. This paper reports a pre and post design comparing the outcomes of two vocational services in the UK: an Individual Placement and Support (IPS) service and a non-integrated pre-vocational service in addition to employment outcomes, we report fidelity ratings, service costs and findings from a survey of user…experiences of mental health services two years after implementing IPS. The study shows that high fidelity IPS was significantly more effective in enabling people with severe mental health problems to gain and retain open employment. After two years of full IPS implementation a significantly greater proportion of service users reported that they received help with vocational needs with decreased unmet vocational need in comparison to the non-integrated pre-vocational service. In addition, service user expectations to gain open employment appeared to increase in comparison to the non-integrated pre-vocational service. The IPS service was 6.7 times financially more efficient in terms of delivering open employment outcomes than the non-integrated vocational service.
Abstract: Labor force non-participation, unemployment, disrupted education and disrupted career pathways exacerbate the social and economic marginalization of people with severe mental illness. One way to address this problem is to introduce evidence-based supported employment. One key ingredient, integrating vocational services into publicly-funded mental health services, is recognized as the missing component of evidence-based practices in Australia. During 2006, seven sites independently attempted to implement evidence-based supported employment. Early stage implementation challenges to…the introduction of evidence-based practices were identified for this descriptive summary. While the establishment of evidence-based supported employment appears feasible, when actually attempted, multiple and sometimes unique practical challenges emerged at each site. The major difficulties were related to service integration and utilizing the existing Federal disability employment system. Establishing sustainable partnerships between the mental health and disability employment sectors, through co-location of employment specialists within mental health teams, remains a promising way forward. The early implementation experiences of these Australian sites add to international knowledge on how best to implement evidence-based employment services for people with psychiatric disabilities.
Keywords: Supported employment, mental illness, psychiatric disability, evidence-based practice
Abstract: Although supported employment (SE) helps most individuals with mental illness find employment, many continue to face significant barriers to achieving their vocational goals. In this 12-month prospective study, consumer perceptions of illness-related (e.g., medication side effects) and common (e.g., transportation) barriers to employment were assessed in relation to work and rehabilitation outcomes. At the time of SE enrollment, endorsement of illness-related barriers correlated negatively with hopefulness and quality of life, whereas…endorsement of common barriers correlated negatively with clinician ratings of independent functioning. Both total barriers and common barriers correlated negatively with later employment attainment.
Abstract: Background: One widely-used approach in the vocational rehabilitation field is the situational work assessment, in which staff rate general worker behaviors relevant to any employment setting. The Work Behavioral Inventory (WBI) is a standardized situational assessment developed specifically for individuals with severe mental illness (SMI). Originally developed in a sheltered workshop environment, its application in community settings has not been studied. We examined the predictive validity for the WBI in a range…of community and agency settings. Methods: Using a prospective longitudinal study, we assessed 52 clients with schizophrenia spectrum disorders newly enrolled in a vocational program at a psychiatric rehabilitation agency. Participants were followed for nine months and assessed every two months on the WBI. Findings: WBI ratings were unrelated to employment outcomes in the full sample at nine months. However, among participants who obtained paid employment at some time during follow-up, WBI ratings were positively associated with total wages earned, weeks worked, and paid hours worked. Conclusions: Situational assessment is a useful method for predicting employment outcomes for individuals with schizophrenia who obtain work. However, its utility in predicting initial job acquisition is uncertain. In addition, the limitations in the use of situation assessments in community employment settings raise questions about how it would be best adapted in programs implementing evidence-based supported employment.
Keywords: Prediction of employment, severe mental illness, situational assessment
Abstract: This paper presents a review of the literature of articles that examined determinants of return to work, among persons who experience spinal cord injury. Results of the review highlight the low rate of employment among persons with spinal cord injury. A total of fourteen common factors that influence professional reintegration were identified. These factors include: education, type of employment, severity of the lesion, age, time since injury, gender, marital status and social support, vocational counselling, medical…problems, employer's attitudes, race, psychological state, and environment. While a number of variables associated with return to work were identified, there exists great variability across studies. Consequently, no clear conclusion on return to work can be drawn from the literature. This article highlights factors that facilitate professional reintegration, identifies gaps in the literature and suggest paths for future research.