Journal of Vocational Rehabilitation - Volume 5, 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: This paper presents a framework for examining the costs and benefits of psychiatric rehabilitation and illustrates the framework with case examples. Data are presented for three program models: supported employment, psychosocial rehabilitation centers, and training for consumers to work in the human service field. The per diem and annual per diem costs varied widely, as did benefits to consumers. Of these approaches, only the supported employment approach had evidence for a cost offset in the form of reduced mental health service utilization.
Keywords: Cost evaluation, Psychiatric rehabilitation, Case examples, Program models, Supported employment, Psychosocial rehabilitation centers
Abstract: To contribute to the techniques available to psychiatric rehabilitation, an implementation analysis was conducted of WINS—a research demonstration project exemplifying the hybrid case management/supported employment model. An implementation evaluation framework was used to assess the internal and external environments of the program, based on data collected from WINS' management information system and from two focus group sessions with project staff. Operationally, WINS appeared to meet expectations in terms of the quantity of services, heterogeneity of service recipients, and the numbers who obtained jobs. Examination of information on the external environment of the program revealed difficulties in impacting vocational rehabilitation services…for persons with severe mental illness, as well as in the community systems which needed to be in place for a project like WINS to be fully effective. Information on who received services and what services were provided raised challenging questions about whether or not zero exclusion in vocational programming is a feasible or even desirable goal, about the usefulness of the choose-get-keep linear model, and about staff difficulties in balancing the emphasis between client responsibilities and provision of appropriate supports.
Abstract: The results of survival analyses are reported as indicators of a supported employment program for persons with mental illnesses. Separate sets of analyses were conducted to assess three critical dimensions of survival. First, length of time between program registration and placement into employment was used to assess the program's rapidity in job placement. Second, length of time employed was used to assess the program's durability in job placement. Third, the duration of program enrollment was used to assess the program's longevity in support provision. Post-hoc analyses were conducted to identify consumer characteristics. These results are discussed with regard to their…implications for future research as well as programmatic considerations in providing supported employment services to individuals with long-term mental illnesses.
Abstract: This survey of 12 exemplary Supported Employment (SE) programs identified through NIDRR examines the salient issues in developing and implementing SE for persons with psychiatric disabilities. Although SE was originally designed for persons with developmental disabilities, approximately one-quarter of the individuals currently served by SE are persons with psychiatric disabilities. The survey findings suggest that the original SE model requires some modifications for programs serving persons with psychiatric disabilities. Therefore, the mental health field needs to establish its own set of standards and/or guidelines for implementing and administering SE programs for persons with psychiatric disabilities. The extraordinarily high performance rates…(e.g., drop-out and placement rates) reported by survey respondents are encouraging but need to be viewed within the limitations of the current study. Controlled research is required prior to the establishment of performance guidelines for SE programs. Nonetheless, this survey suggests that SE holds great promise for persons with psychiatric disabilities.
Abstract: This study of a two-site urban psychosocial rehabilitation center's transitional employment program examines the vocational histories of 602 consecutive clients to identify features that distinguish between those who do and do not achieve competitive employment. Discriminant function analysis revealed a number of significant influences including: number and type of job placements; program participation features; local economy of the program sites; and client characteristics. Implications of these findings for service development and design are discussed.
Keywords: Discriminant function analysis, Competitive employment, Transitional employment program, Severe mental illness, Psychosocial rehabilitation
Abstract: In the traditional brokered model of vocational rehabilitation for persons with psychiatric disabilities, mental health and vocational services are provided in separate agencies. Problems in this model have frequently been described in the literature but without client-level data. In a controlled clinical trial, clients assigned to a ‘best practice’ exemplar of the brokered model achieved vocational outcomes that were inferior to those of clients assigned to a model that integrated mental health and vocational services within the same program. In this paper, process data are examined to clarify the relatively poor performance of the broke red model. A large proportion…of the clients who were assigned to the brokered model (38%) either failed to engage with the vendor or to complete the preemployment skills training phase. For clients who had difficulty engaging and for those who did engage and complete the preemployment phase, problems related to coordination between the mental health program and the vocational vendor were common and negatively affected outcomes. This analysis supports a more fundamental integration of mental health and vocational services than is characteristic of the brokered model.
Abstract: The present study is a record-based evaluative description of Transitional Employment (TE) in Fountain House, New York. The study sample (n=295) consisted of members entering Fountain House between 1988 and 1993 who participated in TE. Of the 720 TEPs worked during this period, 420 (58%) were held by a single member for over 3 months and 253 (35%) were held by a single member for over 6 months. Seventy-four percent of the sample had 3-month tenure on at least one TEP, and 54% of the sample had 6-month tenure on at least one TEP during the study period. Length of…tenure in TE was significantly related to time spent in Fountain House programs, primarily the Work-Ordered Day, prior to employment: an analysis of member attendance records at Fountain House programs revealed that those members who spent more time in Fountain House before beginning a TEP worked more days on their first TEP. This finding conflicts with research suggesting that unpaid prevocational work is a poor predictor of paid work performance.
Abstract: This article describes the problems that make it difficult to develop comprehensive vocational services for youth with serious emotional disabilities, discusses the problems of identification, and describes relevant characteristics of the youth related to employment. Current legislation is described that could effect the provision of vocational services by secondary and post secondary educational institutions and mental health and vocational providers. Effective vocational service programs are briefly described and recommendations made.