Journal of Vocational Rehabilitation - Volume 49, issue 2
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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 examine factors associated with employment outcomes of Individual Placement and Support (IPS) Supported Employment (SE) among participants with spinal cord injury (SCI). METHOD: A secondary analysis of data from a 24-month study of IPS participants with SCI was conducted. Factors from three broad domains of sociodemographic, clinical, and supports were examined for potential impact on employment outcomes. Regression analysis was used to model the probability of obtaining employment. RESULTS: Univariate models showed significant predictors by domain as follows: Sociodemographic – college education, employment at time of SCI, and post-SCI work experience; Clinical – tetraplegia,…number of inpatient days, and traumatic brain injury history; Supports – transportation and motor function/mobility. In the multivariate model, only number of inpatient hospital days during IPS and post-SCI work experience remained significant. CONCLUSION: Longer hospital admissions were associated with a reduced likelihood for IPS participants to obtain employment. Full participation in IPS leading to job acquisition is most likely to occur when health is optimized and prolonged hospitalization is minimized. To understand how past experience working with a SCI influences participation in IPS services and employment outcomes, including job sustainability, further examination is needed.
Keywords: Disability, individual placement and support (IPS), outcomes, predictors, spinal cord injury, supported employment, veterans, vocational rehabilitation
Abstract: BACKGROUND: Current trends in vocational rehabilitation value demand-side “dual customer” approaches that serve both businesses and job seekers with disabilities, as well as approaches that use rapid engagement in work-based experiences. OBJECTIVE: This conceptual paper describes the evolution of Progressive Employment (PE) in Vermont and aims to define the key features and critical components of PE as a distinct model of dual customer service delivery. CONCLUSION: The PE approach has promise as an effective dual customer model with high potential for replicability in employment systems, especially for job seekers with little or no successful work experience.…Salient elements of the model and replication considerations are discussed.
Keywords: Progressive Employment, vocational rehabilitation, transition programs, transition youth, supported employment, dual customer, high risk job seeker, demand side rehabilitation, work experience
Abstract: BACKGROUND: People with intellectual disability and high or very high support needs face systemic economic and social exclusion. Small business enterprise (SBE) models of employment focusing on adults with intellectual disability have emerged relatively recently, predominantly developed by parents. These are highly individualised, person-centred, and are built around the skills, strengths, and interests of the focal person. SBEs draw on a range of funding sources and paid and unpaid supports are instrumental in their development and continuation. OBJECTIVE: To explore the utility of SBE as an emerging employment pathway to economic and social inclusion for adults with intellectual…disability. RESULTS: Four case studies describe a range of strategies to develop and maintain SBEs to create meaningful economic and social inclusion. They illustrate different supports used in establishing and continuing these arrangements, and issues related to safeguarding and sustainability. CONCLUSION: There is a dearth of empirical studies of SBE for people with intellectual disability who have high or very high support needs. Further work to develop and operationalise an SBE quality framework needs to account for the differences between the start-up and continuation stages, emphasising sustainability.
Keywords: Australia, employment, family leadership, high support needs, individualised approaches, intellectual disability, person-centred
Abstract: BACKGROUND: Over the past decade, knowledge translation (KT) has emerged as a framework for turning research findings into actions which will improve outcomes for individuals with disabilities. OBJECTIVE: This article examines how the origins of KT in healthcare have shaped (and perhaps limited) how it has been conceptualized in the realm of disability and, more specifically, disability and employment. CONCLUSION: We focus on three questions. First, how have the origins of KT shaped the epistemological commitments informing its use in the realms of healthcare and disability? What features do these commitments draw attention to? What features…do they render invisible? Second, the realm of disability is characterized by a more complex and disparate landscape of stakeholders than is the case in healthcare. Stakeholder groups are not simply neutral knowledge users. Each stakeholder group has a unique culture, discourse, epistemology and view of “success.” What does this mean for KT in the realm of disability? Third, the Knowledge-to-Action (K2A) Framework (Graham et al., 2006 ) has been widely adopted in several realms: Healthcare, education, international development and disability. Given the unique challenges of KT in the realm of disability, how might the K2A Framework need to be adapted to strengthen its effectiveness?
Abstract: BACKGROUND: Adults with a history of opioid dependence may find it difficult to gain or maintain employment. Barriers to employment include a lack of education and skills, and relapse to drug use. OBJECTIVE: To compare the rate of employment before, during, and after participation of detoxified opioid-dependent adults (n = 117) enrolled in a therapeutic workplace intervention and to identify predictors of post-intervention employment. METHODS: Analyses were conducted on self-reported employment information collected using the Addiction Severity Index-Lite and direct observation while enrolled in a model workplace intervention called the therapeutic workplace. RESULTS: Participants were…more likely to work during the intervention (67% of days available) than before (1% of days available) or after (26% of days available) the intervention. Participants also reported working more after the intervention than before. Participants who reported working 6 months after the intervention had stronger work experience and attended the therapeutic workplace more frequently during the intervention. CONCLUSIONS: Given the opportunity in a model workplace, unemployed detoxified opioid-dependent adults are more likely to attend a model workplace than to work in a community job.
Keywords: Drug misuse, employment, therapeutic workplace, vocational training
Abstract: BACKGROUND: Resource Facilitation (RF) is an intervention developed to improve return to work (RTW) following brain injury. RF is an individualized treatment specializing in connecting patients and caregivers with community-based resources and services to mitigate barriers to return to work. OBJECTIVES: Examine the effectiveness of the RHI RF program for a clinical prospective cohort of participants referred to this program from the State Vocational Rehabilitation agency. METHODS: Participants were 243 participants with data drawn from the two sources: 33 from previous randomized controlled trial (RCT) control groups who did not receive RF and 210 from clinical…patients discharged from the RHI RF program. RESULTS: At discharge from RF, a greater proportion of the treatment group obtained employment than the control group [X2 (1) = 5.39, p = 0.018]. When controlling for baseline level of disability, treatment group significantly predicted employment outcome (Wald = 4.52, p = 0.033) and participants in the treatment group were 2.3 times more likely to return to work than controls. CONCLUSIONS: Previous RCTs have studied the RHI RF model and demonstrated significant efficacy. The findings from the present study are consistent with the employment rates found in the previous RCT’s following RF, and also provide initial support for the clinical effectiveness of RF.
Keywords: Brain injuries, return to work, employment, rehabilitation, vocational
Abstract: BACKGROUND: Federal legislation has called for the phasing out of sheltered workshops and the transition to integrated employment, causing providers to struggle with how to adapt their model towards providing community integration services. OBJECTIVE: Our purpose was to identify the essential characteristics of successful organizational transformation for providers serving individuals with intellectual and developmental disabilities. METHODS: A Delphi panel consisting of 36 experts in the field of organizational transformation underwent an iterative process to respond to previously identified characteristics of successful organizational transformation, develop new characteristics, and then rank the final characteristics in order of importance.…RESULTS: The identified essential characteristics to successful organizational transformation in ranked order were: clear and consistent goals; an agency culture that values inclusion; an active, person-centered job placement process; a strong internal and external communication plan; reallocated and restructured resources; an ongoing investment in professional staff development; a focus on customer engagement; effective employment performance measurement, quality assurance, and program oversight; a holistic approach; and multiple and diverse community partnerships. CONCLUSIONS: The Delphi panel confirmed the six characteristics identified in previous research, and added four new characteristics that reflected recent changes in the field of employment and the understanding of what creates lasting organizational change.
Keywords: Organizational transformation, intellectual and developmental disabilities, Delphi, integrated employment
Abstract: BACKGROUND: Stigma and discrimination against people with mental illness have a negative impact on their vocational integration. The rates of their labor force participation worldwide are still low. The reason for this, from the perspective of employers, is their reluctance to employ them due to a number of fears and concerns. OBJECTIVE: This review examines the literature of the last 25 years on the employment of people with mental illness to identify employers’ benefits from their employment and to provide recommendations for occupational therapists. FINDINGS: The importance of employing individuals with mental illness is emphasized. This…review identifies a research gap on the benefits of their employment from the perspective of employers, and presents the findings of studies that explore the benefits of employing individuals with disabilities. CONCLUSIONS: Information and greater awareness are pointed out to be the major ways of improving the employment rates of people with mental illness. The proposed challenge for occupational therapists is to demonstrate the effectiveness of their employment to all interested parties. Future research should focus on the economic impact of mental illnesses and on the outcomes of employing individuals with mental illness from the perspective of employers.
Abstract: BACKGROUND: Paid and unpaid work experiences are in-school predictors of post-school employment success for students with disabilities. Unfortunately, students who engage in work-related problem behaviors are at an increased risk of having these experiences terminated. To decrease problem behaviors on the job to help ensure students maintain employment, transition personnel should work in collaboration with high school teams implementing Tier III systems of support to address social-behavior problems in the workplace. OBJECTIVE: The purpose of this article was to describe (a) how collaborative partnerships could be developed between high school teams implementing Tier III systems and secondary transition…personnel supporting students in work environments, and (b) provide a conceptual model outlining the collaborative partnership. Future considerations for research and practice are discussed.
Keywords: Work-based learning, WBLE, function-based, FBA, problem behaviors, Tier III systems, school-wide positive behavior interventions and supports, SWPBIS
Abstract: OBJECTIVE: The purpose of this article is to provide information about tinnitus to rehabilitation counselors and rehabilitation professionals and to discuss the possible impact of tinnitus on employment. CONCLUSION: While the research on psychological aspects of tinnitus and on psychological interventions is expanding rapidly, little research has been publication about the kinds of accommodations that may be useful for tinnitus. This article will focus on the vocational implications of tinnitus and will provide suggestions to help rehabilitation counselors and allied-health professionals assist individuals with tinnitus in the context of work settings.
Abstract: OBJECTIVE: Early retirement caused by invalidity is a major topic of research on teacher’s health. The identification of influencing factors is important to implement appropriate prevention strategies. This study analyzes influencing factors on the subjective prognosis of long-term vocational disability in German teaching staff. METHODS: In this cross-sectional study we analyzed medical records of N = 515 teachers and educational staff who had attended an occupational medical/psychological consultation between 2011 and 2016. The majority were women (73.0% ; n = 375), the mean age was 49.6 (SD = 9.1) years. We used a comprehensive set of measures:…work-related demands (Wuerzburg Screening) to identify occupational problems, vocational disability (SPE) and depression/anxiety (PHQ-9, GAD-7). RESULTS: Subjective prognosis of long-term vocational disability was significantly related to age, years of service, several work related strains as well as mental health symptoms. Significant predictors in a multiple logistic regression model were age (OR: 1.06), ‘limited vocational capability‘ (OR: 1.65) and ‘being loaded by work‘ (OR: 1.56). CONCLUSION: Professionals who are concerned with occupational health management should consider those factors in order to prevent or delay early retirement. Persons who are at high risk for early retirement should receive specific trainings or brief psychotherapeutic interventions.
Keywords: Education sector, work load, mental health, early retirement
Abstract: BACKGROUND: Despite ample research about empowerment or supported employment in the mental health field, research about people with psychiatric disabilities in competitive employment and its impact on personal empowerment using standardized measurements needs to be expanded. OBJECTIVE: This study examined if competitive employment contributes to a positive impact on personal empowerment among 55 people with psychiatric disabilities who participate in community based mental health organizations. METHODS: The current sample was created from a larger study with the purpose of obtaining a homogenous set of participants based on the employment status criteria. Participants filled out the Portuguese…version of the empowerment scale and hierarchical regression analysis was used to study if participants’ employment status was a predictor of personal empowerment. RESULTS: The conducted analyses demonstrated that competitive employment was related to higher levels of empowerment, and that the empowerment dimension of power-based interpersonal relationships was significantly associated with being at work. CONCLUSIONS: Our results suggest that addressing consumers’ working needs through supported employment services has the potential to enhance consumers’ personal empowerment and improve community life.
Abstract: OBJECTIVE: The aim of this study was to evaluate the measurement structure of the Abbreviated Disability Inclusion Scale . METHODS: Exploratory factor analysis results indicated a two-factor measurement structure (disability inclusion climate and disability inclusion preparedness). CONCLUSION: Higher levels of disability inclusion were found to be associated with lower levels of employer stigma. The Abbreviated Disability Inclusion Scale can be used as part of an assessment battery in demand-side employment research for model testing, as well as an outcome measure in intervention research.
Keywords: Demand-side employment, disability inclusion and diversity, employer stigma