Supported Employment Initiative Research Articles

Impact of the COVID-19 Pandemic on a Statewide Individual Placement and Support Employment Initiative.

The COVID-19 pandemic has had an enormous impact on the provision of behavioral health care services across the United States. This column examines this impact within the context of New York State's supported employment initiative, which involved 89 implementation sites before the start of the pandemic. The pandemic caused changes to the training and implementation supports provided, the number of sites providing these services, and the ways in which sites provided supported employment services. Although mean self-assessed implementation fidelity decreased modestly, employment outcomes that dipped early in the pandemic rebounded quickly to prepandemic levels.

Minds@Work: A New Manualized Intervention to Improve Job Tenure in Psychosis Based on Scoping Review and Logic Model.

Introduction A significant proportion of people experiencing psychosis are unemployed, despite a strong desire to work. Current supported employment programs appear effective in helping them obtain employment, yet job tenure remains an arduous challenge. The objective of this study was to review the literature and model the results to inform the development of a new manualized group psychosocial intervention-'Minds@Work'-aimed specifically at improving job tenure in psychosis. Methods The study was registered on the Open Science Framework platform ( https://osf.io/he68z ). The literature was searched in Medline, Embase, PsycInfo and Cochrane Library databases for studies examining predictors of job tenure in psychosis and existing occupational psychosocial interventions. Data were extracted using a pre-established form and synthesized using logic models. Results A total of 94 studies were included and their findings were modeled using different categories: intervention typologies, mechanisms of action, predictors of job tenure, outcomes and contextual factors. The 'Minds@Work' program was built based on these modeled findings and aimed to target specific predictors of job tenure while addressing some of the limitations of existing interventions. The program uses evidence-based techniques and is divided into 9 modules covering 4 themes: positive psychology (motivation, character strengths, self-compassion), neurocognitive remediation (attention, memory, problem-solving), cognitive biases training (jumping to conclusions, defeatists beliefs, theory of mind, attributional styles) and socioemotional coping skills (emotion regulation, communication). Conclusions Once validated, this new program is meant to be used either as a stand-alone intervention or integrated in supported employment initiatives, by employment specialists or healthcare workers.

Evaluation and follow up of Supported Employment initiatives in Spain from 1995 to 2008

This paper is the last in a series of quantitative studies about Supported Employment in Spain, looking at how the situation has changed since the previous studies. The study is based on an Internet survey of all organizations participating in the national ECA Caja Madrid program. The results show a significant increase in the number of organizations that provide Supported Employment programs, in total 202, delivering services to 23,342 users in Spain. This paper analyses the characteristics of the services provided, the users, the professionals and the funding.

Disability Management, Return to Work and Treatment

Individuals with severely disabling mental illness receive more benefit from supported employment initiatives than from other vocational services, but these initiatives show variable job tenure and low implementation by governments. For those with less severely disabling mental illnesses, such as depression, evidence-based treatment results in substantial restoration of job function, and restored work function occurs in synchrony with reduced symptomatology. However, there is a substantial degree of residual impairment despite receiving standard treatment. Major research trends include an increasing focus on occupational recovery in less severe forms of mental illness and potential application of integrated disability management models to occupational recovery from disabling mental disorders. Promising research directions include effectiveness of standard mental healthcare in restoring work function; effectiveness of actively managing co-morbid mental health problems for disabling physical disorders; population factors affecting return to work in those with disabling mental disorders; identification of policies fostering occupational recovery for disabling mental disorders; effectiveness of innovative mental healthcare focused on occupational recovery; and organizational interventions to foster occupational recovery in employees with disabling mental disorders.

Employment Aspirations of People with Learning Disabilities Attending Day Centres

A small but growing number of people with learning disabilities are obtaining paid work through supported employment initiatives. A survey of 275 persons attending three day centres in Belfast suggests that upwards of one-third aspired to having a job and their key workers thought that one in five would be able to hold down a job. These proportions were higher among those who had work experience placements. Key workers viewed poor concentration, communication skills and motivation as the most common obstacles to obtaining paid work, with the main benefits to the individuals being increased self-esteem, independence and confidence. These findings confirm that new forms of day services are required for this client group in order to meet their aspirations. These should provide work experience opportunities alongside vocational and social skills training, job finding assistance and support in the workplace.

What sort of ‘support’ in employment?

Despite a growing amount of literature concerning the success of supported employment initiatives in enabling people with mental health problems to work successfully in open employment (Bond et al, 1997), less attention has been paid to the type of support people might require. Rachel Perkins and her colleagues explore this issue from the perspective of the Pathfinder User Employment project. (See An act to follow, in: A life in the day 2 (1) 1998.)

Improving supported employment outcomes through cross-agency training: local solutions to local problems

Improving supported employment outcomes through cross-agency training: local solutions to local problems Tom Fisha,*, Margo Vreeburg Izzoa , Katina Karoulisb, Bruce Growicka Ohio State University, Nisonger Center, 1581 Dodd Drive-McCampbell Hall, Columbus, OH 43210-1296, USA bOhio Department of Mental Retardation and Developmental Disabilities, Office of Adult Services, 30 East Broad St., Suite 1265, Columbus, OH 43266-0415, USA This paper describes a university sponsored training program for supported employment specialists called Get Supported Employment Training (GET-SET). The purpose of GET-SET was to increase the supply of qualified supported employment personnel through a nine-credit continuing education program. Because many supported employment initiatives require interagency COllaboration, this training program focused on recruiting cross-agency teams as trainees. These teams consisted of representatives from education, rehabilitation, mental retardation and mental health agencies and family members. Each team participated in 2 full weeks of course material and collaborated on practical experience in which they jointly coordinated supported employment services for consumers in their local communities. These cross-agency teams addressed many systemic issues such as: family and consumer empowerment; community-based work experiences for youth in transition; integrated planning; and cross-training for parents, consumers and service providers at the local level. Outcome data on the impact these teams have had on consumers, as well as continued efforts at the local level are documented. © 1997 Elsevier Science Ireland Ltd.

Supported Employment from 1986 to 1993

Since its inception in the mid-1980s, supported employment has evolved into a major component of the nation's service delivery network for individuals with mental retardation and other significant disabilities. Increasingly, however, human service programs are being scrutinized to determine whether they are achieving their intended purpose. The present study summarizes the major achievements of the supported employment initiative during the period between 1986 and 1993. Particular emphasis is placed on the number of program participants, consumer characteristics, the program's ability to reduce dependence on the Social Security income maintenance programs, participant earnings, and program expenditures.

At the Crossroads: Supported Employment a Decade Later

Supported employment has grown rapidly within the past decade, fueled by the consumer empowerment and inclusion movements. The program has resulted in thousands of people with severe disabilities entering the labor force for the first time. Many consumers have expanded their vocational expectations, and employers have developed a new appreciation of the potential contribution individuals with disabilities can make to the workforce. Unfortunately, despite these dramatic gains, the supported employment movement appears to have lost much of its early momentum and is increasingly at a crossroads. This article addresses major challenges that consumers and professionals alike must face. Conversion of day programs to integrated work options, expansion of program capacity, the need to insure consumer choice and self-determination, and the achievement of meaningful employment outcomes in a highly competitive economy are among the challenges that those dedicated to the supported employment movement must solve in the years ahead. Specific recommendations are offered to meet each challenge. Ultimately, the way to expand and reenergize the supported employment initiative will be to educate and empower more consumers and families.

Attitudes toward supported employment of parents and primary caregivers of individuals with severe intellectual disabilities

During the past decade, the delivery of vocational services for people with severe disabilities has shifted dramatically from work activities in segregated settings to real work in community settings. The services being utilised to achieve community-based employment are known as supported employment services. While a significant body of research has described the effects of the supported employment initiative on the lives of people with severe disabilities, little research is available that documents the perceptions and expectations of parents and/or primary caregivers to this approach to service delivery. In the present study, parents and primary caregivers of individuals with severe intellectual disabilities were interviewed to determine their attitudes toward supported employment in relation to their child/ward. Findings suggested that the respondents were generally satisfied and accepting of their child's/ward's participation in supported employment. They felt that the supported employment programs of...

The Underachievement of Supported Employment

A review of the status of the national supported employment initiative shows that thousands of individuals are benefiting from the initiative and that supported employment is offered by community programs in every state in the nation. Yet despite these successes, access to supported employment is severely limited, the quality of the outcomes is challenged, and the investment in change appears to be dwindling. If supported employment for persons with severe disabilities is to expand and improve to meet the growing demand, then communities and government alike must analyze both the successes and the problems of the supported employment initiative and create a new path to change. The purpose of this paper is to review the status of the supported employment initiative, explore the perception of its underachievement, and provide recommendations for recapturing the momentum of the initiative.

Meeting the Challenge in Clwyd: The Intensive Support Team

The current pattern of services for people with severe or profound learning disabilities is radically different from that of just twenty years ago. For many people, ordinary housing now provides a real alternative to the long stay hospital, attempts to replace day centres with supported employment initiatives are gaining momentum and some progress is being made toward a more integrated system of education. Aided over recent years by funding improvements and policy guidance under the All Wales Strategy (Welsh Office, 1983) Clwyd is one County where considerable headway has been made. The transition, however, has not been easy — change brings its own challenges. One of the major challenges facing service providers in Clwyd has been the provision of good quality community services for people with learning disabilities who display very challenging behaviour.This paper describes one service initiative which has formed part of Clwyd's overall response to challenging behaviour — the Clwyd Intensive Support Team (IST). In this paper, we explain our working definition of challenging behaviour before going on to describe the development of the Team, how it has operated and what the pattern of referrals has been like over the first three years. In a second paper, we will report on how the Team used its time, maintenance of outcomes to date, consumer satisfaction and what the Team has cost. We will conclude by delineating what we believe to be the essential elements of a specialist challenging‐behaviour peripatetic support team.

Achievements and Challenges I: A Five-Year Report on Consumer and System Outcomes from the Supported Employment Initiative

This article presents results from the 1990 fiscal year survey of state supported employment implementation conducted by the Rehabilitation Research and Training Center on Supported Employment at Virginia Commonwealth University, and a longitudinal analysis of findings from the 5-year course of this investigation. State vocational rehabilitation agencies reported a total of 74,657 supported employment participants and 2,647 provider agencies for 1990. Persons with mental retardation continue to be the primary service group, but there has been a dramatic increase in the proportion of supported employment participants with mental illness. Among participants with mental retardation, those with mild retardation continue to be the primary recipients of services. Use of the individual placement model has also increased substantially, with a corresponding decrease in the use of most group options. The availability of extended services funding was found to be limited across a number of disability groups. Findings are discussed in relation to the achievements of the states in implementing supported employment, and challenges to the states for improving service access and delivery for individuals with severe disabilities.

Review of Emerging Trends in the National Supported Employment Initiative: A Preliminary Analysis of Twenty-Seven States and Achieving Outcomes: A Guide to Interagency Training in Transitional and Supported Employment.

Review of Emerging Trends in the National Supported Employment Initiative: A Preliminary Analysis of Twenty-Seven States and Achieving Outcomes: A Guide to Interagency Training in Transitional and Supported Employment.

The National Supported Employment Initiative

The National Supported Employment Initiative

Supported Employment: Promises Deferred for Persons with Severe Disabilities

The extent of supported employment participation by individuals with severe or profound disabilities was investigated through an analysis of the employment histories and functional characteristics of 1,411 individuals involved in supported employment programs in eight states. Results indicated that individuals currently participating in supported employment possessed very limited previous employment experience, yet did not possess functional characteristics indicative of individuals with severe or profound disabilities. Persons with severe or profound disabilities were found to be minimally represented in current supported employment efforts, representing less than 8% of all individuals investigated. Based upon the results of the study, recommendations are offered to enhance the opportunities of individuals with severe or profound disabilities to benefit from the national supported employment initiative, including the need for further research and demonstration activities and the necessity of immediate modification of federal and state supported employment policies.

Natural Supports in the Workplace: A Reexamination of Supported Employment

The purpose of this article is to examine some of the basic premises of supported employment initiatives. In particular, the role of agency-sponsored job coaches in supporting employees with severe disabilities in integrated work environments is discussed. A broader concept of supported employment is proposed, based on studies of the supports and informal interactions characteristic of natural work environments. Alternative support options, entitled the Mentor Option, the Training Consultant Option, the Job Sharing Option, and the Attendant Option, which involve the active participation of supervisors and co-workers, are presented with suggestions for implementation.

Quality and Equality in Employment Services for Adults with Severe Disabilities

This paper responds to Brown et al. (1984), who propose an extended training program involving work without pay in integrated settings for adults with severe intellectual handicaps. While agreeing about the capability of persons with disabilities, the importance of integration, and the failings of typical services, we believe that their extended training proposal represents an unnecessary retreat from values that have guided development of exemplary school and community services for persons with severe handicaps. As an extended outcome of services, the proposed program needlessly sacrifices wages and other employment benefits, distorts the benefits of integration by looking only at the workplace, and tolerates unequal treatment of citizens with severe handicaps. Relying on unpaid work as a strategy for time-limited employment preparation creates the risk of overuse and of perpetual readiness programming, suggesting that professional effort could be better spent in development of supported employment opportunities. Current federally supported employment initiatives provide a framework for combining wages and integration and offer support for local program development.