Black / African American

Transition-age youth (14 - 24)

Outcomes:

Increase in hours worked

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Competitive employment for youth with autism spectrum disorders: Early results from a randomized clinical trial.

Authors:

Wehman, P., Targett, P., Yasuda, S., & Brown, T.

Year Published:

2014

Publication:

Journal of Autism and Developmental Disabilities.

Volume:

Number:

Pages:

487-500

Publisher:

Springer US

Background:

Unemployment rates for individuals with autism after existing secondary education are high. Rates for individuals with ASD are between 4 to 12 percent. They also have low rates of participation in vocational or technical education, and post secondary education as compared to individuals with speech and language impairments, learning and intellectual disabilities. Furthermore, state vocational rehabilitation programs are experiencing difficulties responding to the employment service needs of transition aged youth with ASD. The employment outcome rate reported by VR for individuals with ASD has declined much in recent years. Research is limited on intervention to assist adults with ASD with gaining and maintaining employment. Project Search is an intensive internship program that has been replicated with modifications and has shown some degree of success with assisting transition aged youth with gaining and maintaining real work for real pay in their communities.

Purpose:

This study had two hypotheses. First, higher number of individuals who participate in an employer based employment training and placement program will be employed than those in the control condition at a)completion of intervention and b) 3 months post completion of the intervention.Second, those who participate in the program will require less work support as measured by the Support Intensity Scale Employment Activities Subscale than those in the control condition at a) completion of the intervention and b) 3 months post completion of the intervention. The study was continuing at this writing and this analysis presents results from the first 3 years of cohorts who have completed one school year in Project SEARCH plus ASD Supports.

Setting:

The students worked in a variety of internships in two suburban hospitals.

Sample:

A total of 40 students participated in the study. 16 were assigned to the control group and 24 were in the treatment group. The two groups were equivalent on a number of demographic variables including gender, race, medical diagnosis, and Individualized Education Plan category. There was a significant difference between the ages of the treatment and control groups. The age range for both was between 18 and 21.5 years old.

Data Collection:

Information was collected from the application process and a brief interviews at scheduled times to gain insight into the person's employment status, wage earned, hours worked, and employer paid benefits. The Supports Intensity Scale was also used to assess adaptive behavior and intensity of support needs. The six subscales used were: home living, community living, lifelong learning, employment, health and safety, and social. The SIS allowed the examiners to identify the types of work supports individuals required and provided a measure of the overall adaptive behavioral support needs of participants at baseline. Data collectors were trained in the administration of the instrument and inter-rater reliability was high 92.5%.Preliminary analysis included frequencies, means, standard deviations and distribution of scores.

Intervention:

The intervention was Project SEARCH.

Control:

The control condition was traditional transition service.

Findings:

The treatment group attained employment at a rate of 87.5% after completing Project SEARCH internship and the ASD program compared to the control group at 6.25%. The treatment group also experienced an increase in weekly hours worked and wages.Three months later there was a significant difference between the treatment and control group mean standard scores on the Employment Activities Subscale of the SIS.

Conclusions:

This study provided preliminary results.Twenty one out of 24 or 87.5 percent of the treatment group acquired employment. While only one in 16 or 6.25 percent of the control group went to work.Employment after graduating from high school is an attainable goal for youth with ASD who display challenging behavior and who have a comorbid medical diagnoses.

URL:

http://researchautism.net/publications/5492/competitive-employment-for-youth-with-autism-spectrum-disorders:-early-results-from-a-randomized-clinical-trial.

Disabilities:

Autism Spectrum Disorder

Populations:

Asian

Outcomes:

Randomized Controlled Trials (RCTs)

Increase in hours worked

Increase in tenure

Wages

NIDILRR Funded:

Yes

Research Design:

Peer Reviewed:

Yes

Influence of least restrictive environment and community based training on integrated employment outcomes for transitioning students with severe disabilities.

Authors:

Wickizer, T. M., Campbell, K., Krupski, A., & Stark, K.

Year Published:

2004

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

149-156

Publisher:

IOS Press

Background:

In light of the data supporting the education of individuals with severe disabilities in natural contexts, it stands to reason that programs would no longer provide training in contexts other than those that result insurable employment opportunities. However, this continue to occur. Even with mandated transition planning integrated employment outcomes are not improving for students with severe disabilities. Many of these students will then enter the public welfare system and/or segregated adult programs.

Purpose:

The purpose of this study was to identify variables that are correlated with successful integrated employment outcomes for transitioning students with severe disabilities.

Setting:

The setting included 20 different schools sites within 12 school districts in a county in California.

Sample:

The sample included 104 students with severe disabilities, ages 18-22, who had exited school without diploma. Close to half (48%) of the participants had an IQ that placed them in the profound (25%) or severe (23%) category. The majority of the participants were white (53%), followed by Hispanic (28%), Asian (13%),African American (4%) and Pacific (2%). Around 53% of the students were males. Around 80% of the participants lived at home; the others lived in group homes.

Data Collection:

The specific variables measured in this study included: the influence of duration of community-based training (CBT) that included on-the-job training, on the-job training as a subset of CBT, the least restrictive environment (LRE), or the degree of integration with non-disabled peers during the school day, demographics(gender, ethnicity, home setting, behavior problems, physical disability and mental ability) as measured by
intelligence quotient (I.Q.).Data was collected by structured interview with teachers and administrators, record review and on site observations. Correlations were used to examine predictive relationships between the independent variables and the dependent variable of post-school integrated employment. Cross tabulations and chi-square analysis of correlated variables were then used to identify significance of specific variables on employment outcome.

Intervention:

The intervention was community based training. This included on the job training and physical integration with non disabled peers.

Control:

There was no comparison or control group

Findings:

These data indicate significant interactions between community based training (r = 0.387, p < 0.001), degree of integration with typical peers (r = 0.360, p < 0.001), andon-the-job training (r = 0.305, p = 0.001) and employment outcome. There were also strong intercorrelations among the three variables of CBT, degree of integration or LRE and on-the-job training.Transitioning students who received CBT and on the job training had a 69% integrated employment rate after leaving school.

Conclusions:

The combinations of least restrictive environments,CBT/on-the-job training, and innovative teacher advocacy are potent predictors of post school employment for students with severe disabilities, regardless of intellectual functioning.

URL:

http://www.kcdsg.org/files/content/Cheryl%20Jorgensen_Influence%20of%20LRE%20on%20Outcomes.pdf

Disabilities:

Intellectual disabilities

Populations:

Transition-age youth (14 - 24)

Asian

Native Hawaiian / other Pacific Islander

Outcomes:

NIDILRR Funded:

Not Reported

Research Design:

Single group

Qualitative

Peer Reviewed:

Yes

Predictors of engagement in vocational counseling for methadone treatment patients

Authors:

Kemp, K., Savitz, B., Thompson, W., & Zanis, D. A.

Year Published:

2000

Publication:

Substance Use and Misuse

Volume:

Number:

Pages:

1125-1138

Publisher:

Informa Healthcare

Background:

Employment enhances the outcomes of substance dependency treatment. Although unemployed methadone treatment patients frequently state they are interested in a job, many fail to participate in vocational services when available. Unless patients become engaged, vocational services do not have an opportunity to be effective.

Purpose:

The purpose of this study is to examine a broad array of variables that may be associated with differential engagement in vocational services among methadone patients, including the availability of a special vocational program that emphasized outreach to ambivalent patients. The ?ndings are intended to inform recommendations to improve engagement of methadone patients in vocational services.

Setting:

The setting was two methadone maintenance clinics in Manhattan in New York City.

Sample:

The study sample consisted of 211 patients of the two clinics. The criteria for inclusion were unemployed or underemployed at study entry, stabilized on methadone dose, negative urine toxicology for both opiates and cocaine for the patient‚ last four weekly urine tests, and no physical or mental condition or caretaker responsibilities that would absolutely preclude employment Nearly three of the study participants were male, and a majority (75%) was non-white, with an average age of 45 years.

Data Collection:

Participants were interviewed at study entry using a computer-assisted personal interview constructed with the Questionnaire Development System. In addition to the interview data, a vocational activities log that included information on vocational services provided and patients vocational outcomes during the period of service was recorded by the vocational counselors. Chi-square tests, t-tests, and logistic regression analyses were used for bivariate analyses. Multiple logistic regression was used for multivariate analysis.

Intervention:

The experimental vocational program, Customized Employment Supports (CES), offered more individualized counseling than traditional services. Patients were expected to participate in up to three sessions per week at the start, which was made possible by limiting CES counselors caseloads to 15 active cases. The emphasis was on establishing a therapeutic alliance, overcoming both vocational and non-vocational barriers to employment, and enhancing patients' self-efficacy and motivation to work.

Control:

The control group received the clinics standard vocational programs. In both clinics this consisted of individual and group vocational counseling depending on the needs and desires of the patients. These activities included initial assessment, helping with resume preparation, and workshops on topics such as job readiness and interviewing skills.

Findings:

Thirty percent of the sample was de?ned as engaged, that is, had 5 or more in-person sessions with their counselors during the ?rst 6 months after study induction. Those who became engaged with vocational services were more likely to be non-Hispanic, with high school education or beyond, had ever injected drugs, had ever used crack, experienced a drug overdose, had reported emotional chronic problems and scored relatively high on depression and psychological distress, had ever attended Anonymous groups, had previously enrolled in
methadone two or more times, had been exposed to hepatitis B or C, and had positive attitudes toward employment. Relative to the intervention more engagement was found among CES than standard vocational program participants. The CES intervention was also the strongest predictor of engagement in the multivariate analysis.

Conclusions:

Methadone treatment is a challenging environment for vocational counseling. The CES model suggests a new approach to increasing active participation of unemployed patients in vocational services, without which no service can be effective. In addition, the acceptance rate of the model was high among patients.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/16798680

Populations:

Outcomes:

NIDILRR Funded:

Research Design:

Mixed methods

Peer Reviewed:

Yes

Predictors of employment outcomes for state-federal vocational rehabilitation consumers with HIV/AIDS

Authors:

Kang, S., Magura, S., Blankertz, L., Madison, E., & Spinelli, M.

Year Published:

2010

Publication:

Rehabilitation Counseling Bulletin

Volume:

Number:

Pages:

175-185

Publisher:

Sage

Background:

As the widespread use of potent combination antiretroviral therapy has improved their health and longevity, people with HIV/AIDS have increasingly focused on entering or reentering the workforce. Despite their growing interest in and need for employment, however, many persons living with HIV/AIDS have faced barriers to employment, remained unemployed, in need for vocational rehabilitation (VR) services. Little research is available regarding individuals with HIV/AIDS service by the VR system.

Purpose:

The purpose of this study was to investigate the effect of demographic, medical, and service variables on employment outcomes for persons with HIV/AIDS who received State-Federal VR services.

Setting:

This study included individuals with HIV/AIDS served by multiple vocational rehabilitation agencies in various settings.

Sample:

The study sample consisted of 1,178 individuals with a primary diagnosis of HIV/AIDS who were clients of the State-Federal VR services in 2006, and who were closed either successfully or unsuccessfully.

Data Collection:

The RSA-911 database includes client demographic and historical information, case service information, case expenditures, and service outcomes. Data are submitted to the RSA-911 database at case closure. A logistic regression model was employed to estimate the contribution of each predictor variable while simultaneously taking other predictor variables into account and was tested across the two random groups of participants to assess the generalizability of the model.

Intervention:

The study included client demographic variables, disability variables, and intervention variables. The intervention variables consisted of the 10 VR service codes contained in the RSA-911 database. In addition, a variable was created for training service, which would include participation in any training activity, including higher education, vocational/technical training, etc.

Control:

This study did not include a control or comparison group. Comparisons were made between those who were successfully rehabilitated and those who were unsuccessful.

Findings:

Four service-related variables were found to be predictive of successful rehabilitation: Job placement assistance, on-the-job supports, months in VR program (12‚Äì23 months, 24‚Äì35 months, and 36‚Äì162 months), and service expenditures ($2,001‚Äì$4,500 and $4,501‚Äì$65,000). Of the four predictive variables, on-the-job supports was one of the most important variables that contributed to the prediction of a successful employment outcome. Provision of job placement assistance and on-the-job supports increased the probability of achieving employment by 2 to 4 times.

Conclusions:

This study underscores the importance of job placement assistance and on-the-job supports (e.g., job coaching, follow-along, job retention services) in employment success of VR clients with HIV/AIDS. The authors note that these individuals may have been unemployed for a long period since they left their job after an HIV/AIDS diagnosis. Thus, they might be unsure of their readiness for a job, what types of jobs match with their skills and preferences, and how to find job information and job leads. Rehabilitation counselors can assist individuals with HIV/AIDS who need to discuss work-related issues and make more informed decisions about accommodation needs and requests that can enhance job retention.

URL:

http://rcb.sagepub.com/content/53/3/175.short

Populations:

Outcomes:

NIDILRR Funded:

Yes

Research Design:

Observational

Peer Reviewed:

Yes

Predicting work outcomes and service use in supported employment services for persons with psychiatric disabilities

Authors:

Jung, Y., Schaller, J., & Bellini, J.

Year Published:

2001

Publication:

Psychiatric Rehabilitation Journal

Volume:

Number:

Pages:

Publisher:

American Psychological Association

Background:

Individuals with mental illness have problems finding work on their own. To help promote employment for these individuals the federal government fund supported employment services. Research shows that supported employment services have been able to increase work outcomes for this population. Sometimes services may be reimbursed based on the attainment of outcomes rather than hours need to deliver services. Therefore, identifying factors that impact success of supported employment programs may prove beneficial.

Purpose:

The purpose of this study is to identify correlates of effectiveness and efficiency in supported employment. They hypotheses were are individuals with more severe impairments less successful at obtaining employment and if they go to work are more hours of services required as compared to individuals who are less impaired.

Setting:

The setting included a number of different employment sites in a midwestern state where individuals with psychiatric disabilities worked.

Sample:

The statewide sample included 1,861 individuals with mental illness who were enrolled in a supported employment program between 1993 and 1997. The majority were males (507). Most had a primary diagnosis of schizophrenia (437). The minority were non white (114). Among this sample 210 had incomplete employment data. The final analysis was based on information from 1,861 participants.

Data Collection:

The study used program evaluation data from 21 agencies that provided supported employment services to individuals with mental illness using the Indiana supported employment model which was based on the Individual Placement and Support Model. Different samples were used for different analyses. An intake form provided information on demographics. The Global Assessment of Functioning scale provided information about a person's current skills. Other information was obtained from monthly records about staff services that an agency had to keep for reimbursement. Because the study related to obtaining work, only services related to this were measured. The study did not look at services that were provided after placement. Notably part of the specific services included an evaluation of a person's employment potential...which is NOT in alignment with best practices in supported employment services. Related to predicting work outcomes and services hours the first discriminant function looked at persons who worked and those who did not as the criterion categories. The second discriminant function looked at a different set of variables measured at intake. For individuals who worked, multiple regression analysis were conducted using the same individual characteristics to predict the total hours of SE services required prior to becoming employed. Related to supported employment services a discriminant function analysis was used to determine the characteristics of services associated with obtaining work.

Intervention:

The intervention was the measurement of the quality and quantity of supported employment services.

Control:

There was no control or comparison condition.

Findings:

None of the clinical or demographic variable were significant predictors of work outcome or the amount of supported employment services required. Travel was the category most associated with future work. This included travel to a job site, to a person's home or transporting the individual anywhere. Advocacy unrelated to work and training related to days ot day activities (ie. money handling, grooming, transportation or management of symptoms) also had importance.

Conclusions:

Supported employment agencies should provide individualized, person centered services to individuals with mental illness. More high quality research about supported employment is needed.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/11529453

Disabilities:

Emotional disturbance

Populations:

Traumatic brain injury (TBI)

Outcomes:

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

"Rural/urban differences in vocational outcomes for state vocational rehabilitation clients with TBI"

Authors:

Johnstone, B., Vessell, R. Bounds, T., Hoskins, S., & Sherman, A.

Year Published:

2003

Publication:

NeuroRehabilitation

Volume:

Number:

Pages:

197-203

Publisher:

IOS Press

Background:

After TBI many individuals experience difficulties with returning to work and if financially eligible turn to federally funded state vocational rehabilitation (VR) programs for services. Although billions of taxpayer dollars are spent on VR services each year, little is known about their effectiveness. Few studies have been published on the vocational outcomes of persons with TBI who utilize
state VR programs. More research is needed about individuals with TBI who receive state VR services in order to identify problems, develop appropriate services, and improve vocational outcomes. There are few published studies regarding persons with TBI in rural areas. Furthermore, the published research specifically on the vocational outcomes of persons with TBI in rural areas is essentially non existent with only one study identified on this topic.

Purpose:

The purpose of the study was to evaluate differences in demographics, injury severity, and vocational outcomes for individuals with TBI based on whether that resided in a rural vs. urban environment. It was hypothesized that individuals from rural and urban areas would not differ in demographics, that rural individuals would have greater injury severity based on previous studies, and that rural individuals would receive fewer VR services and have a lower rate of successful employment.

Setting:

The setting for the study was vocational rehabilitation agencies in Missouri.

Sample:

The study included 78 individuals with TBI who had completed services from the Missouri Division of Vocational
Rehabilitation (VR). The majority or 71% were male. Eighty percent were Caucasian.
Demographic and injury severity data was reported by rural (N=28) and urban status (N=50). For the rural group, the mean age was 37; mean years of education was 12, and mean years post injury was 8 for the rural group. Mean number of hours in coma was 241 hours, mean days of post traumatic amnesia was 53 and mean days of hospitalization was 53 days. For the urban group, the mean age was 36; mean years of education was 12, and mean years post injury was 11 for the rural group. Mean number of hours in coma was 96 hours, mean days of post traumatic amnesia was 25 and mean days of hospitalization was 33 days.

Data Collection:

Each participant was administered a standard neuropsychological evaluation used as part of a statewide VR protocol. Information about demographic and psychosocial variables was obtained by the evaluating psychologist. Self-report information regarding duration of loss of consciousness (LOC), posttraumatic amnesia (PTA), and hospitalization was obtained from most clients because medical records were not routinely available for review.

Information from Missouri DVR was obtained on each participant, including the specific services provided, the vocational status of the participant at case closure, and the financial cost of the case to DVR. Vocational outcome was determined using standard DVR categories, including: 1) successfully closed, 2) closed, no services provided, 3) closed, services interrupted, and 4) unsuccessfully closed. Rural and urban status was determined by definitions used by the US Office of Management and Budget (OMB). Data analysis included Chi-squares, Fisher‚ Exact tests, Wilcoxon Rank Sums test, and MANOVAs.

Intervention:

The intervention was vocational rehabilitation services.

Control:

A comparison was made between two groups of individuals with TBI; those living in rural versus urban settings.

Findings:

There were no remarkable differences between the groups in terms of demographics. People residing in urban areas received significantly more maintenance funds, transportation services, and on-the-job training, than those living in rural settings. Additionally these individuals had more case service dollars expended on them. Finally, although statistically non-significant, individuals from urban areas were successfully employed at VR case closure, compared to those from rural areas.

Conclusions:

The results suggest that rehabilitation professionals and vocational counselors should focus on possible environmental factors that limit the successful vocational outcomes of individuals with TBI in rural areas. VR counselors need to focus on environment factors that limit vocational outcomes for those living in rural areas. They need to find creative ways to address difficulties associated with limited resources in rural environments like transportation , locating vocational training settings, and developing job opportunities. VR counselors also need to better determine why many of their rural clients with TBI discontinue services after they are deemed eligible to receive them. This information can help them develop strategies to increase their client retention.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/14530584

Disabilities:

Populations:

Rural

Urban

Outcomes:

Return to work

NIDILRR Funded:

Yes

Research Design:

Observational

Peer Reviewed:

Yes

Supported employment: Randomized controlled trial

Authors:

Ipsen, C., Seekins, T., & Arnold, N.

Year Published:

2010

Publication:

British Journal of Psychiatry

Volume:

196

Number:

Pages:

401-410

Publisher:

Royal College of Psychiatrists.

Background:

There is evidence from North American trials that supported employment using the Individual Placement and Support (IPS) model is effective in helping individuals with severe mental illness gain competitive employment. There have been few trials in other parts of the world.

Purpose:

The purpose of the study was to investigate the effectiveness and cost-effectiveness of Individual Placement and Support in the United Kingdom.

Setting:

Individuals with severe mental illness in South London were randomized to IPS or local traditional vocational services.

Sample:

Participants were recruited from community mental health teams in two boroughs of South London. Inclusion criteria were that participants should be receiving outpatient or community psychiatric care from local mental health services, have severe mental illness (duration of illness over 2 years, global assessment of functioning (GAF)8 score of 60 or less, and a diagnosis of a psychotic or chronic affective disorder), aged 18‚Äì65, able to read and speak English to a high enough standard to give informed written consent, to have been unemployed for at least 3 months.

Data Collection:

All data were analyzed using SPSS for Windows (version 15.0). The primary and secondary hypotheses were tested on the whole group. For comparing groups, t-tests and ?2-tests were used to compare means and proportions respectively, unless the data were highly skewed, in which case non-parametric tests were used. Logistic and linear regression models were also fitted including potential confounding variables: (grouped) age, gender, ethnic group, educational level, symptomatology and diagnosis. All data were analyzed in groups as randomized, whether or not receiving an intervention (i.e. intention-to-treat). Data were compared for those followed up with those not followed up, overall and by each treatment arm.

Intervention:

Individual Placement and Support (IPS) is a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice.

Control:

The control condition (treatment as usual) involved existing psychosocial rehabilitation and day care programmes available in the local area. Each service employed, on average, 7 vocational staff, had a median of 58 places available to clients (range 6‚Äì3000) and 79% of services received referrals from clinical teams. A range of courses were offered, most commonly pre-employment preparation (e.g. interview skills, curriculum vitae coaching and application form practice), computers/information technology and confidence building/motivation.

Findings:

Two hundred and nineteen participants were randomized, and 90% assessed 1 year later. There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment (13% in the intervention group and 7% in controls; risk ratio 1.35, 95% CI 0.95‚Äì1.93, P = 0.15), nor in secondary outcomes.

Conclusions:

There was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up, which may reflect suboptimal implementation. Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services, and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals.

URL:

http://www.ncbi.nlm.nih.gov/pubmed/20435968

Disabilities:

Emotional disturbance

Populations:

Male

Outcomes:

Randomized Controlled Trials (RCTs)

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Randomized trial of supported employment integrated with assertive community treatment for rural adults with severe mental illness

Authors:

Graham, C., Inge, K., Wehman, P., Murphy, K., Revell, W. G., & West, M.

Year Published:

2006

Publication:

Schizophrenia Bulletin

Volume:

Number:

Pages:

378-395

Publisher:

Oxford University Press

Background:

Urban Based randomized clinical trials of integrated supported employment and mental health services in the United States on average have doubled the employment rates for adults with severe mental illness compared to traditional vocational rehabilitation. However, studies have not explored if the service integrative functions of supported employment will be effective in coordinating rural based services.

Purpose:

Study designed and implemented a program blending Assertive Community Treatment (ACT) with a supported employment model using Individual Placement and Support (IPS) in a rural setting. In a 24 month randomized controlled trial, the ACT_IPS approach was compared to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults for serious mental illness.

Setting:

Sumter County South Carolina catchment area of the South Carolina Department of Mental Health served by the Santee-Wateree Community Mental Health Center. Population = 102,000; African American (47%), White (49%)

Sample:

Study sample met the federal Center for Mental Health Services criteria for severe and persistent mental illness. All were age 18 or older and unemployed at time of study entry. All had been a client of the Santee-Wateree Community Mental Health Center (SWCMHC) for at least 6 months.

Data Collection:

Data collection and analysis addressed five key questions: (1) What obstacles would a rural South Carolina setting posed to implementing and sustaining ACT-IVR and IPS model? (2) How do the competitive work outcomes of the ACT-IVR and IPS programs compare to a traditional program providing parallel services in a rural economy? (3) How are overall work outcomes affected by differing strategies for obtaining employment? (4) How do rates of income earned from competitive employment change over time by program? (5) How do the programs' work outcomes compare after controlling for the number of participants' service contacts?

Intervention:

Intervention was a fully integrated combination of Assertive Community Treatment with Integrated Vocational Rehabilitation (ACT-IVR)and Individual Placement and Support (IPS). ACT-IVR tightly integrated vocational with mental health services within a self contained provider team. IPS integrated its vocational services with its host agency or another agency's mental health services.

Control:

Comparison program was a formal partnership between a local vocational rehabilitation agency and the SWCMHC. Program provided parallel traditional vocational rehabilitation and mental health services, respectively. The rehabilitation agency's employment specialists prepare participants for competitive jobs by taking a gradual, stepwise approach that focused on developing skills to manage workplace demands in staff supervised jobs set aside for adults with work disabilities.

Findings:

More ACT-IPWS participants held competitive jobs and earned more income than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs.

Conclusions:

The ACT-IPS program aided persons with serious mental illness-related work impairments, limited job experience, and tremendous educational and economic disadvantage to attain competitive work outcomes on a par with the urban supported employment programs cited in the literature. the ACT-IPS service-coordinating functions and immediate attention to competitive work may have been key processes that overcame rural-area obstacles to receipt of appropriate services and to labor market participation. However, the earnings generated fall far short of economic independence. It is recommended that barriers to accessing higher education for adults with SMI in rural areas must be reduced, with more of a focus placed on career-oriented job opportunities providing a means to develop highly marketable technical skills.

URL:

http://schizophreniabulletin.oxfordjournals.org/content/32/2/378.full.pdf+html

Disabilities:

Emotional disturbance

Populations:

Rural

Outcomes:

Randomized Controlled Trials (RCTs)

Increase in hours worked

Part-time employment

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

The relation between VR services and employment outcomes of individuals with traumatic brain injury

Authors:

Garcia-Villamisar D., & Hughes C.

Year Published:

2003

Publication:

Journal of Rehabilitation

Volume:

Number:

Pages:

31-38

Publisher:

National Rehabilitation Association

Background:

Individuals with severe traumatic brain injury (TBI) have poor vocational outcomes. Post injury employment rates have ranged between 22% to 55%. Many studies have looked at predictors for employment outcomes for this group. Other studies have looked at neuropsychological functioning, severity of injury, demographic characteristics, length of time from injury and return to work, assistive technology and rehabilitation outcomes. However, there are no studies about vocational rehabilitation services impact on employment outcomes for individuals with TBI.

Purpose:

The purpose of this study was to examine the relationships between the provision of six rehabilitation services and vocational outcomes for individuals with TBI. The research questions included: How many participants received assessment, college, counseling and guidance, job placement, restoration and work adjustment services? Are assessment, college, counseling and guidance, job placement, restoration and work adjustment services significantly related to closure status? Are there significant differences in weekly earnings based on the provision of assessment, college, counseling and guidance, job placement, restoration and work adjustment services?

Setting:

This study included individuals with TBI served by multiple vocational rehabilitation agencies in various settings.

Sample:

The study sample included 1,073 individuals with TBI who received state vocational rehabilitation services from a southeastern state and whose cases were closed in either competitive employment or non-rehabilitated from 1992 to 2000. Forty nine percent of the participants were competitively employed when there case was closed by state vocational rehabilitation (VR) and 51% were not. The majority (89%) reportedly had a severe disability. Most were single (79%), Caucasian (78%), and male (70%). The ages ranged from 16 to 71 years. The majority had 11 years of education or better. At the times of services 91% reported no prior work experience.

Data Collection:

A number of variables were examined in the study. This included: successful employment outcome, hours worked and wages and the cost of services. Data was pulled for all of the United States. Washington DC and US territories were excluded. Data from each state and year was reported for each study question. In order to identify trends data from 2002 to 2006 was compared to 2007 to 2011 and regression analysis was used to evaluate the data. Mean data for the total transition population served by VR was compared to the ASD group and t test statistics were used to compare outcomes between the two groups.

Intervention:

The interventions included six vocational rehabilitation services. This included: assessment, college, counseling and guidance, job placement, restoration, and work adjustment services.

Control:

There was not control or comparison condition.

Findings:

Counseling/guidance was the most frequently provided services (89%). VR services identified as positive predictors of closure status were: college, counseling/guidance, and job placement services. The odds of obtaining competitive employment after receiving college services was 5.21 times the odd for those not receiving services. The odds of obtaining competitive employment for those receiving counseling/guidance services was 3.03 times greater than those who did not receive the services and the odds of competitive employment among those who received job placement services was 20.77 times greater than those who did not. Notably, work adjustment was a significant negative predictor of closure status. Individuals who did not receive assessment or college services had higher earnings than those who receive college services alone. When job placement services were not provided the effect of college training on mean weekly earnings was different at each level of assessment.

Conclusions:

College, counseling/guidance and job placement services were significantly and positively related to closure status.
Work adjustment services were inversely related to weekly earnings for competitively employed individuals and assessment, college, and job placements services interacted significantly on weekly earnings of those competitively employed. Job placement is the most important positive predictor of closure. Rehabilitation counselor education and training should focus on job placement services. College training benefited an small number of individuals in the sample. Additional research is needed to investigate the relationship between VR services and employment outcomes for individuals with TBI.

URL:

https://www.questia.com/library/journal/1G1-106646165/the-relation-between-vr-services-and-employment-outcomes

Disabilities:

Traumatic brain injury (TBI)

Populations:

Asian

Outcomes: