A ten-year follow-up of a supported employment program

Authors: 
Schene, A., Koeter, M., Kikkert, M., Swinkels, J., & Crone, P.
Year Published: 
2004
Publication: 
Psychiatric Services
Volume: 
55
Number: 
3
Pages: 
302-308
Publisher: 
American Psychiatric Association
Background: 

Supported employment is considered to be an evidence-based practice for people with psychiatric disabilities. The rate of competitive employment within supported employment programs is three times higher than those in other programs.

Purpose: 

The purpose of the study was to review the outcomes of supported employment 10 years after an initial demonstration project.

Setting: 

The setting included two rural rehabilitative day centers in New Hampshire that became Individual Placement and Support model centers.

Sample: 

The sample included 20 participants in the 1990 Lebanon group and 24 participants in the 1992 Claremont group; a total of 36 were in the follow-up study 10 years later.

Data Collection: 

A semi-structured interview was developed, which included open-ended questions. Open-ended questions were transferred into structured ratings

Intervention: 

The intervention was the Individual Placement and Support (IPS) model of supported employment.

Control: 

There was no control or comparison condition.

Findings: 

Seventy percent of the participants had had some type of competitive employment. Eighty eight percent (N=17) were employed at the time of the study.

Conclusions: 

The study concluded that supported employment is a viable option for people with psychiatric disorders. Further study is needed to determine is self-sufficiency is a realistic goal given that many people don't consider self-sufficiency as a goal to reach when obtaining competitive employment.

URL: 
http://www.worksupport.com/kter/documents/pdf/A10yearfollowupofSupportedEmployment.pdf
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation

Authors: 
Schneider, J., Slade, J., Secker, J., Rinaldi, M., Boyce, M., Johnson, R., ... & Grove, B.
Year Published: 
2007
Publication: 
Psychological Medicine
Volume: 
37
Number: 
3
Pages: 
351-362
Publisher: 
Cambridge Press
Background: 

Major depression has far-reaching consequences for work functioning and absenteeism. In most cases depression is treated by medication and clinical management. The addition of occupational therapy (OT) might improve outcome.

Purpose: 

The purpose of the study was to determine the cost-effectiveness of the addition of OT to treatment as usual (TAU).

Setting: 

Study was conducted as part of the Programme for Mood Disorders of the Department of Psychiatry on the Academic Medical Centre in Amsterdam.

Sample: 

The study sample included 62 adults. The inclusion criteria were: age above 18 years, major depressive disorder, single episode or recurrent, without psychotic features, no history of psychos, manic, hypo-manic or cyclothymic features, no history of alcohol abuse or dependence, and additional criteria.

Data Collection: 

Treatment effect of OT was tested using the t test for continuous measures and the chi-squared test for categorical variables. For longitudinal analysis, the generalized estimating equations method for dichotomous outcomes and a generalized linear model approach for continuous outcomes was used.

Intervention: 

Sixty-two adults with major depression and a mean absenteeism of 242 days were randomized to TAU (outpatient psychiatric treatment) or TAU plus OT [6 months, including (i) diagnostic phase with occupational history and work reintegration plan, and (ii) therapeutic phase with individual sessions and group sessions]. Main outcome domains were depression, work resumption, work stress and costs. Assessments were at baseline and at 3, 6, 12 and 42 months.

Control: 

Treatment as usual was the standard outpatient treatment for depression. This consisted of clinical management and antidepressants, if indicated and accepted by patients, according to standard treatment algorithm.

Findings: 

The addition of OT to TAU: (i) did not improve depression outcome, (ii) resulted in a reduction in work-loss days during the first 18 months, (iii) did not increase work stress, and (iv) had a 75.5% probability of being more cost-effective than TAU alone.

Conclusions: 

Addition of OT to good clinical practice does not improve depression outcome, improves productivity without increasing work stress and is superior to TAU in terms of cost-effectiveness

URL: 
http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=22007000440
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

SESAMI* study of employment support for people with severe mental health problems: 12-month outcomes

Authors: 
Schoenbaum, M., Unützer, J., McCaffrey, D., Duan N., Sherbourne, C., & Wells, K.
Year Published: 
2009
Publication: 
Health & Social Care in the Community
Volume: 
17
Number: 
2
Pages: 
151-158
Publisher: 
Blackwell Publishing Ltd.
Background: 

Individuals with severe mental illness are underrepresented in the workforce in the United Kingdom. A welfare to work policy was implemented. Guidelines recommend using evidenced based practices, the Individual Placement and Support model, to help people with mental health issues with gaining and maintaining work. It is important to understand what is currently going on to improve existing practices.

Purpose: 

This study was undertaken to learn about factors associated with successful employment and the impact of work on individuals with mental illness.

Setting: 

Six British agencies that specialized in providing services to individuals with mental illness.

Sample: 

One hundred and eighty two individuals with mental health problems participated in the study. Follow up interviews were conducted with 85% of this sample. The majority or 84% were White British or European. Ages ranged from 22 to 67 years with an mean of 42 years. About a third, or 32% reported depression, 25% anxiety, 25% schizophrenia, hallucinations or hearing voices, 14% bipolar and 4% other in response to being asked to describe his or her condition. Fifty five percent of the participants were unemployed, 29% were unemployed, 9% were in work placement and 5% in sheltered work.

Data Collection: 

The study questionnaire included the following measures. The Empowerment Among Users of Mental Health Services Scale; the Herth Hope Index, Perceived obstacles to work; and behaviours indicating nearness to the labour market. This questionnaire was usually completed during an approximately one hour face to face interview. The first was completed at baseline and another at follow up (12 months later).Statistically significant differences were tested. Analysis of variance was also used. SPSS 15.0 was used to analyze all data.

Intervention: 

The intervention was supported employment in the United Kingdom.

Control: 

There was no comparison or control group.

Findings: 

Eighty two percent of those working at baseline were employed one year later. Twenty five percent of those individuals who were unemployed were assisted with gaining work during this time. Financial satisfaction and self esteem increased among those who went to work. In addition, there was a tendency to work part-time.

Conclusions: 

Those who worked reported multiple benefits. The evidence from this study should inform service planning and the Individual Placement and Support model should be implemented in England.

URL: 
https://www.researchonline.org.uk/sds/search/taxonomy.do%3Bjsessionid=948B7FBF03C6A71157E4FD25729AE479?action=document&ref=A20206&pager.offset=140&taxonomy=GIN
Disabilities: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

A comparison of competitive employment outcomes for the clubhouse and PACT models

Authors: 
Secker, J., & Membrey, H.
Year Published: 
2006
Publication: 
Psychiatric services
Volume: 
57
Number: 
10
Pages: 
1416-1420
Publisher: 
Psychiatric Services
Background: 

The unemployment rate among individuals with severe mental illness is high, ranging from 67 to 85 percent. Many studies focus on job placement rates without considering job retention. Supported employment programs vary a lot and no single definition exists. Furthermore, the rapid placement guideline may mean that a lack of job readiness may be impacting an individual's success at work. The clubhouse model to employment may be able to help individuals gain and maintain work at higher rates than other approaches.

Purpose: 

The goal of this study was to determine if a clubhouse model could achieve and maintain employment rates comparable to the Program of Assertive Community Treatment model of supported employment.

Setting: 

The study was conducted in Western Massachusetts Genesis Club.

Sample: 

The study sample included 177 individuals who data was collected over a four year time period. All had a diagnosis of bipolar disorder, depression or schizophrenia and were 18 years of age or older. They were not screened for work readiness and interest in work was not required.

Data Collection: 

After acceptance into the study the Positive and Negative Syndrome Scale was conducted. Interviews were also conducted at baseline and then every 6 months over two and half years. Questions related to symptoms, jobs, hospitalizations and more. Program staff tracked job information. Employment data was also provided by staff or through interviews with participants. Each participant was followed for the study period or until he or she exited services. Time based analyses compared weekly employment and job placement rates for participants in each group. Binary employment outcomes were analyzed with generalized estimating equations of the Genmod procedure in SAS with a logit link function. Another group of job based analyses was also conducted to examine average job duration, hours and wages to compare outcomes from participants in the two groups. Spearman rank-order correlations between job duration, hours and wages were estimated to identify potential covariates in the hours and wages test model.

Intervention: 

The intervention was Supported Employment services delivered through Club Houses.

Control: 

The control was Supported Employment services delivered via Program of Assertive Community Treatment (PACT).

Findings: 

The PACT model had a 14% higher job placement rate than the clubhouse model. Participants in either approach maintained weekly employment levels at or exceeding other published reports. On average participants in more than 2 jobs during the study period and worked 20 hours a week. Clubhouse participants remained employed 2 months longer than individuals in PACT, which resulted in a 66% difference in duration.

Conclusions: 

No difference was found in job placement rates between clubhouse and PACT participants over two and half years. Clubhouse participants remained employed for more weeks and earned slightly higher wages than participants in PACT.

URL: 
http://www.fountainhouse.org/sites/default/files/C.%20Schonebaum%20article.pdf
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Quality of life and supported employment: A case study of three women with developmental disabilities

Authors: 
Staines, G., L., Blankertz, L., Magura, S., Bali, P., Madison, E. M., Spinelli, M.,Horoqitz, E., Guarino, H.,Grandy, A., Fong, C., Gomez, A., Dimun, A., & Friedman, E.
Year Published: 
2004
Publication: 
The American Journal of Occupational Therapy
Volume: 
58
Number: 
4
Pages: 
455-465
Publisher: 
The American Occupational Therapy Association Inc.
Background: 

Programs aimed at enhancing the quality of life for individuals with disabilities are on the rise. This includes work. To understand the impact of new models of vocational training, it may be instructive to look at sheltered work, the long standing model. The job coach model of supported employment helps individuals with disabilities work in the community. The case for a positive relationship between supported employment and quality of life is not well understood. Research aimed at understanding a person's experiences with supported employment and other factors that impact quality of life may identify whether or not the consumers' needs are really being met.

Purpose: 

The purpose of this study was to better understand the experience of supported employment and a wide range of other factors that affect quality of life for people with developmental disabilities.

Setting: 

The setting for the study included various employment settings where each participant worked as a member of an enclave.

Sample: 

The study included nine participants. Three women with developmental disabilities, three job coaches and either a family member or group home manager for each. All women were white, and able to make their own decisions including informed consent. The women had previously worked at a sheltered workshop and were currently working in a enclave of 8 to 10 adults that was supervised by a job coach. The most frequent type of work performed by the enclave included cleaning at various places and entry level food services.

Data Collection: 

Open-ended interviews and on site observations were used to collect data. The interviews were guided by a script and recorded. Afterwards they were transcribed. The women were also observed while working as a member of an enclave. On site field observations lasted about 2 hours. The job coaches and family members were also interviewed. The data was analyzed using a constant comparative method. All interview and observational data were reviewed and coded. Some quotes were also selected to serve as exemplars of each woman's quality of life experience.

Intervention: 

The intervention was supported employment services.

Control: 

There was no control or comparison condition.

Findings: 

The three women preferred enclave work over the workshop setting. The participants indicating satisfaction with work assignments and relationships with others in the enclave. Policies and regulations like social security, impacted quality of life.

Conclusions: 

People with developmental disabilities can and do form their own opinions when give the opportunity. Professionals must be in tune with this fact and find ways to help make sure consumer voices are heard.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/15315252
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Job tips: A transition to employment program for individuals with autism spectrum disorders

Authors: 
Taylor, J. l., McPheeters, M., Sathe, N.A., Dove, D., Veenstra-VanderWeele, J. & Warren, Z.
Year Published: 
2013
Publication: 
The Journal of Autism and Developmental Disorders
Volume: 
43
Number: 
10
Pages: 
2472-2483
Publisher: 
Springer
Background: 

Shattuck et al. (2012) reported that youth with an ASD are uniquely at risk for negative post-school outcomes, as indicated by the fact that while only 55 % of those with an ASD are employed in the 6 years beyond high school, 86 % of those with a speech or language impairment, 94 % of those with a learning disability, and 69 % of those with an intellectual disability have found employment.

Purpose: 

The current study evaluated the effectiveness of a treatment package comprised of a web-based interviewing skills program (JobTIPS) and virtual reality practice on responses to employment interview questions by adolescents with high functioning autism and Asperger‚ Disorder.

Setting: 

The setting was a University Research Center.

Sample: 

The study sample included 22 youth who were between the ages of 16–19 years old.

Data Collection: 

An Interview Skills Rating Instrument was developed by researchers. The first scale was Response Content: A 10 item scale that measures the content of the participant's response to 10 interview questions. The second scale: Response Delivery: 20 items that measure behaviors related to greetings and farewells (handshakes, eye contact, verbal greeting, verbal expression of appreciation at end of interview), as well as the non-verbal behaviors (body positioning, facial expressions) that accompany verbal responses during the actual interview questioning period.

Intervention: 

Internet based transition program

Control: 

Services as usual

Findings: 

The results of the study suggest that youth with ASD who completed the Job TIPS training program showed significant improvement in their job interviewing skills when compared to the control group. The program was more effective in teaching content rather than delivery skills. Participants were able to produce more appropriate verbal responses to interview questions following intervention, but the features that accompany those responses did not improve to the same degree.

Conclusions: 

The findings demonstrate that a web-based training program can be effective as an intervention method to improve employment related interviewing skills for individuals with ASD.

URL: 
http://link.springer.com/article/10.1007%2Fs10803-013-1800-4
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

A systematic review of vocational interventions for young adults with autism spectrum

Authors: 
Test, D.W., Mazzotti, V.L., Mustian, A.L., Fowler, C.H., Kortering, L., & Kohler, P.
Year Published: 
2012
Publication: 
Pediatrics
Volume: 
130
Number: 
3
Pages: 
531-538
Publisher: 
American Academy of Pediatrics
Background: 

Not much is known about effective vocational interventions to assist individuals with ASD. Yet, that population is rapidly growing. Programs and interventions to serve youth are not well understood. The lack of information impacts successful transition to work.

Purpose: 

The purpose of this systematic review of the literature was to assess the effectiveness of vocational interventions for individuals with ASD who are 13 to 30 years old.

Setting: 

The studies that were reviewed were undertaken in various locations and settings in the US, UK, Spain and Germany.

Sample: 

Multiple databases and reference lists were searched to find relevant studies that were published between 1980 and 2011. Afterwards, each study was examined against an inclusion criteria developed by an expert panel. Data about sample, intervention characteristics, assessment techniques, and outcomes, were evaluated and an overall quality and strength of evidence rating was assigned to the included studies according to a specific criteria. The final sample consisted of 5 studies involving young adults with autism.

Data Collection: 

Characteristics of study participants and interventions were summarized. Descriptive statistics were used to report study outcomes. No meta analysis was conducted.

Intervention: 

The studies reviewed looked at a variety of vocational interventions which involved identifying and implementing work supports for young adults with ASD.

Control: 

There were no comparison or control conditions.

Findings: 

Only five studies, related to on the job supports and employment and vocational interventions were found. All of these received a poor quality rating by the reviewers which may be due to the fact that this is a new area of research. The studies included one non randomized trial that looked at the impact of supported employment versus sheltered work settings for 55 young adults with autism. A related study from the same researchers looked at the effect of supported employment versus sheltered work on the cognitive development of 44 young adults with autism. Two cohort studies and one cross sectional study reported on the influence of vocational interventions on independent living outcomes.

Conclusions: 

There is very little evidence about vocational interventions for individuals with ASD. High quality research is needed. Supported employment may be a promising intervention however much more research is needed.

URL: 
http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-0682
Populations: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Supported employment outcomes of a randomized controlled trial of ACT and clubhouse models

Authors: 
Magura, S., Blankertz, L., Madison, E., Friedman, E., & Gomez, A.
Year Published: 
2006
Publication: 
Psychiatric Services
Volume: 
57
Number: 
10
Pages: 
1406-1415
Publisher: 
American Psychiatric Association
Background: 

Supported employment for individuals with mental illness is recognized as an evidenced based practice. One of the highlights of this approach is rapid job placement which does not necessitate a need for job readiness training or sheltered work. Some individuals have used this approach to gain work but do not maintain employment. Some individuals do not need the intensity of services offered in a SE approach, but may benefit from a clubhouse approach.

Purpose: 

This study had two purposes. These included to examine the relationship between the working alliance and the employment outcomes of individuals with severe mental illness who were receiving vocational services. The study also looked at whether working alliance differences existed between client receiving evidenced based supported employment service and those receiving traditional vocational rehabilitation services (DPA). This is a highly regarded team model organized within a day program where individuals get ready to work, then work with a group and overtime progress through a series of placements and eventually move into competitive work. The hypotheses was individuals receiving supported employment services would have a stronger working alliance with their IPS vocational provider than those receiving traditional vocational services (DPA).

Setting: 

The setting included a number of different job sites across 5 states and DC where individuals with mental illness received supported employment services. Services were provided by 5 different experimental programs that adopted the individual placement and support model of supported employment.

Sample: 

The participants included 310 individuals with mental illness who were unemployed, 18 years of age or older and who did not have a diagnosis of severe mental retardation. Each person was randomly assigned to the ACT or the Clubhouse programs. Most participants were white males with a schizophrenia diagnosis.

Data Collection: 

The research measures included participant characteristics and employment. Control variables included: age, severity of psychiatric symptoms, severity of physical health problems and active substance use. Gender was also added.
Psychiatric symptoms were measured using the Positive and Negative Syndrome Scale. Physical health problems were measured through PANSS probes, Medicaid claims, and interviews. Substance abuse was identified through records, reports and interviews. Two motivational control variable were collected related to interest in working at baseline and match of random assignment to participant preference. The programs kept the same service logs and other records.
The data analysis plan included benchmark comparisons of program performance by using published outcome data from exemplary SE programs. A comparison of ACT and clubhouse outcomes was completed using a services of hierarchical regression analyses.

Intervention: 

The intervention was the Individual Placement and Support(IPS)model of supported employment delivered through Assertive Community Treatment programs.

Control: 

There was no control condition as supported employment has already been identified as an evidenced based practice. Comparison services were delivered through Clubhouse programs.

Findings: 

The results included a comparison with benchmark employment outcomes. Club house participants had higher earnings and hours worked as compared to participants in exemplary supported employment programs. Earnings and work hours for ACT participants was greater than two of those programs. A comparison of ACT and clubhouse outcomes found ACT program had better service engagement. There was no difference in time to obtain a first job. Club house participants were employed longer and for more hours and earned more than than ACT participants. Background variables were predictive of receipt of job search services, which predicted higher employment rates. Wage was an incentive for employment success. A few participants in transitional employment, had about the same job tenure as other participants.
ACT participants received services faster than clubhouse participants. The strong integration of vocational and clinical services, provided by ACT, appeared to be especially helpful to participants with co-occurring disorders.

Conclusions: 

The authors concluded that adding supported employment into multiservice programs like ACT and clubhouses, is a way to provide more services to individuals with mental illness, without compromising quality of those services. Although, a cost analysis was not presented, it is suspected that this may also be a cost effective approach to providing supported employment services.

URL: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759891/
Disabilities: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Evaluation of an individual placement and support model system

Authors: 
Luchansky, B., Brown, M., Longhi, D., Stark, K., & Krupski, A.
Year Published: 
2004
Publication: 
Psychiatric Rehabilitation Journal
Volume: 
27
Number: 
3
Pages: 
251-257
Publisher: 
Hogrefe Publishing
Background: 

Individuals with severe mental illness have high rates of unemployment. The Individual Placement and Support(IPS) model of supported employment has demonstrated superior employment outcomes as compared to other conditions (ie. day treatment, sheltered work and counseling)through a number of randomized control trials. It is important to find out if this approach can be effectively implemented with fidelity in the field and yield similar results.

Purpose: 

The purpose of this study was to conduct a retrospective evaluation of the employment outcomes of individuals who were involved in a Services for Employment and Education (SEE) program, based on the IPS model, in Massachusetts over a 4 and half year period of time.

Setting: 

The setting included a number of employment sites in Massachusetts where individuals with mental illness who received supported employment services worked.

Sample: 

Participants were 90 individuals who enrolled in the program from 1995 to 1999. The majority were Caucasian (90%) and male (65.7%). The mean age was 42 years with a range from 21 to 65. The majority (66%) had schizophrenia or another psychotic disorder and were receiving disability benefits. Over three quarters or (77.8%) had never been married.
The mean total score on work readiness was 1.33 and annual clinical contact hours was 23.62; the mean Clinical Evaluation of Risk and Functioning score was 39.62.

Data Collection: 

An independent retrospective evaluation of the SEE employment outcomes was conducted. In addition, the SEE program fidelity was assessed using the IPS Fidelity scale.
Data was selected from three major sources. Demographics, days in program, number of jobs held previously and self rating of "work readiness were collected from the SEE program records. The SEEIS database provided data related to each job obtained (i.e.. start and end date, hours worked, wages etc...) and services received (i.e.. benefits counseling, assistance with job related problems and workplace supports, disclosure of disability etc.... Behavioral health program records provided treatment plan information, clinical contact hours and diagnosis. The case management services client tracking system had information about the person's level of functioning at program exit.

Intervention: 

The intervention was, the Services for Employment and Education program, a modification of the Individual Placement and Support Supported Employment Model.

Control: 

There was no control or comparison group.

Findings: 

SEE participants held 196 jobs. The majority or 35.4% were service jobs. This was followed by 28.6% in marketing or sales, 20.9% were operator, fabricator, or technical jobs and 10.2% were professional, administrative or managerial in nature. The average number of hours worked per week was 16 with a range of 1 to 40 hours. One third of the jobs required 20 or more hours per week.
Wages ranged from $4.75 to $12.00.
Participants frequently received job related supports like benefits counseling, problem solving and on the job support on issues like negotiating changes in schedule, conflicts with coworkers and changes in management.
Support was also offered to assist individuals with disclosing their disability in order to receive reasonable accommodation.
Individuals in non professional jobs quit or were fired from their jobs more often than those who were not.
Eighty two percent of participants held at least one job. The mean was 2.69 positions with a range from 1 to 10. There were no significant differences between those who did and did not obtain work.
On average it took around 3.5 months for participants to secure employment. The average amount of time worked per job was a little more than 11 months.
Employment outcomes were related to education level which was correlated with more highly educated individuals working more total hours across all types of jobs. Participants who had higher self rated work readiness scores remained employed longer than those with lower rates. Also those with more active days in SEE and more employer accommodations remained employed longer. However, those who receive more on the job supports tended to work less hour and earn lower wages. Overall the SEE program had good fidelity to the IPS model.

Conclusions: 

The majority of participants gained and maintained employment. The model had high IPS fidelity and had outcomes similar to and in some areas superior to the Supported employment and IPS model programs. Programs that follow a evidenced based employment model are more likely to have positive outcomes.

URL: 
http://psycnet.apa.org/journals/prj/27/3/251/
Disabilities: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Expanding career options for young women with learning disabilities

Authors: 
Lindstrom, L., Doren, B., & Miesch, J.
Year Published: 
2004
Publication: 
Career Development for Exceptional Individuals
Volume: 
27
Number: 
43
Pages: 
43-63
Publisher: 
Hammill Institute on Disabilities
Background: 

Research indicates poor post school employment outcomes and limited career advancement opportunities for young women with disabilities. Individual and environmental barriers have culminated into limited career choices and post school employment outcomes. There has been very little research on the career decision process or variables that limit or facilitate career choice for this group.

Purpose: 

The study examined barriers restricting career choices and strategies to facilitate or expand career choice for young women with learning disabilities.

Setting: 

The study took place in multiple interview settings.

Sample: 

Participants were six young women with learning disabilities who resided a northwestern state. Three were employed in traditional (female dominated)occupations the other three were not. Earning ranged from $6.50 to $20.00 per hour.

Data Collection: 

Case study methodology was used to analyze variables influencing career choices for young women with learning disabilities. Multiple sources of information were used to confirm, elaborate and verify collected information. This included interviews with all participants and 28 key informants. Additionally, data was collected through on the job observations, field notes, and review of special education and vocational rehabilitation records. A multistep process was used in the first phase of analysis. Descriptive codes were developed based on literature, research questions and initial review of data. Next interview transcripts and field notes were coded following a common scheme. Then coded data and file review information were used to outline the career decision making process for each participant by examining variables that impacted each participant's career choices. In the second phase a explanatory methods were used to explore and confirm findings for each participant. Explanatory matrices were developed that allowed comparison of information on variables across participants. Cross case analysis led to identification and verification of influences on career decision.

Intervention: 

The interventions were career exploration and counseling to improve employment outcomes for young women with learning disabilities.

Control: 

The study did not include control or comparison conditions.

Findings: 

The following variables seemed to influence initial career choices and post school outcomes for participants: gender roles, disability limitations, family and childhood experiences, early work experiences and career exploration and counseling. Gender roles and socialization influenced career choices. Disability limitations restricted career choice. Family and childhood experiences influence career choices. Early work experiences played a role in shaping career options as did career counseling and exploration. Regardless of the participants chosen occupation, the influences on career choices were similar. It was also evident that occupational choices were developed and refined over time.

Conclusions: 

Gender roles and difficulties from disability restricted career choices. Exposure to work through family experiences and employment in high school expanded career aspirations.

URL: 
http://cde.sagepub.com/content/27/1/43.refs
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes