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PubMed2006

Social/communication skills, cognition, and vocational functioning in schizophrenia.

Deficits in social/communications skills have been documented in schizophrenia, but it is unclear how these deficits relate to cognitive deficits and to everyday functioning. In the current study, social/communication skills performance was measured in 29 schizophrenia patients with a history of good vocational functioning (GVF) and 26 with a history of poor vocational functioning (PVF) using a role-play-based social skills assessment, the Maryland Assessment of Social Competence (MASC). A battery of standard cognitive tasks was also administered. MASC-indexed social skills were significantly impaired in PVF relative to GVF patients (odds ratio = 3.61, P < .001). Although MASC social skills performance was significantly associated with cognitive performance in domains of verbal ability, processing speed, and memory, the MASC nevertheless remained an independent predictor of vocational functioning even after controlling for cognitive performance. Social/communications skills predict vocational functioning history independently of cognitive performance, and social skills measures should be considered for inclusion in test batteries designed to predict everyday functioning in schizophrenia.

Activities of Daily Living↗
PubMed1997

The acceptability of personal learning plans in vocational training.

Personal learning plans have been advocated as a means of introducing the principles of adult learning into general practice vocational training. The aim of this study was to investigate attitudes amongst general practice trainers and registrars to the introduction and use of personal learning plans. A questionnaire was sent to general practice trainers and registrars in one vocational training scheme prior to the introduction of personal learning plans. Overall, doctors in the training scheme were positive to the idea of personal learning plans. Trainers were significantly more positive towards introducing learning plans than their registrars. Registrars in their final general practice posts were significantly more positive towards the idea of learning plans than their hospital counterparts. Doctors who had completed membership of the Royal College of General Practitioners, usually trainers or final year registrars, were also more positive in their attitude. This pilot study suggests that most trainers and registrars were positive in their attitude towards personal learning plans prior to their introduction in the Lincoln vocational training scheme. The study cautiously suggests a wider use and evaluation of personal learning plans in vocational training.

Adult↗
PubMed2006

Assessment in dental vocational training: where are we now?

In this paper the author gives his opinion on the existing arrangements for assessment of vocational dental practitioners (VDPs) (outside Scotland), during dental vocational training. He critically evaluates the arrangements in relation to the aims and objectives for dental vocational training. Potential improvements to the existing system are then proposed and new assessment techniques suggested that may help to provide a more robust and relevant educational assessment strategy for dental vocational training in the future.

Education, Dental, Graduate↗
PubMed1996

Perceived problem-solving and vocational identity: implication for nontraditional premedical students.

The purpose of this study was to examine the relationship between vocational identity and self-appraised problem solving. A total of 86 students enrolled in a special program took the Vocational Identity subscale of My Vocational Situation and the Problem Solving Inventory one week apart. Pearson product-moment correlations indicated a relationship between personal problem-solving appraisal and vocational identity, suggesting the inventories assess one construct. Implications for intervention strategies for the present population are discussed.

Adult↗
PubMed1997

The relationship between length of vocational disability, psychiatric illness, life stressors and sociodemographic variables.

OBJECTIVE: The primary objective of this study was to examine the relationship between vocational disability, psychiatric illness, life stressors and sociodemographic factors. METHOD: Information on a variety of variables was obtained from insurance files of 147 subjects who had submitted claims for monetary compensation on grounds of psychiatric symptoms. RESULTS: The majority of subjects received a diagnosis of mood disorder or anxiety disorder. Extended vocational disability was associated with longer duration of psychiatric illness, rating of poorer prognosis by the treating physician, and lower income and occupational levels. Individuals with recent onset of disability reported more stressors than those experiencing extended disability. CONCLUSION: Although longer duration of psychiatric illness was associated with vocational disability, other variables play an important role in accounting for extended vocational disability.

Adult↗
PubMed1998

The career outcomes for doctors completing general practice vocational training 1990-1995.

BACKGROUND: While much has been published about the career outcomes of doctors who completed general practice vocational training prior to 1990, no evidence is currently available about those who have qualified since that time. AIM: To obtain information about the career paths of doctors who had completed general practice vocational training since 1990, and to compare the results with previously published data. METHOD: Postal questionnaire survey of all doctors completing vocational training during the period 1990-1995 in three regions of the United Kingdom. The study examined current work status, career path since completion of training, desire for and experience of part-time training, degree of difficulty in choosing and following a career, and the degree to which certain factors impeded career choice. RESULTS: The overall response rate was 64.8%, although there was a significant difference between the response rates for men and women. While virtually all responders were employed, with the majority working in general practice, women were significantly less likely than men to be working as principals in general practice, for all cohorts. These results were very similar to those cohorts described in earlier studies. The career paths of doctors only became stable after about four years. Of those working in general practice, about 20% found it difficult to choose their career, and about 10% found it difficult to follow their career. Out-of-hours work was the major factor impeding career choice. CONCLUSION: Although they are taking longer to reach, the final career destinations of doctors completing vocational training since 1990 are no different from those of earlier cohorts.

Career Choice↗
PubMed1984

[Group psychotherapy with epileptic adolescents during initial vocational training].

When the therapeutic alliance between physician or psychotherapist, and epileptic patient is seriously disrupted (non-compliance) group psychotherapy is capable of bringing about marked changes in coping with the epileptic condition. Even a brief therapy of 20 sessions with epileptic young people undergoing initial vocational training contributes to their learning to perceive problems present in their vocational-social development, as well as various disease phenomena and therapeutic possibilities. Eight young adults aged 18-20 years who had been referred to the Annedore Leber Vocational Training Centre for psychological and neurological examination suffered from frequent seizures, which had in each case been attributable to non-compliance. On completion of therapy, serum levels of anti-epileptic drugs had reached the therapeutic range. None of them failed to complete their vocational training.

Adolescent↗
PubMed1986

Effects of psychotropic drugs and psychiatric illness on vocational aptitude and interest assessment.

This study examined the vocational aptitude and interest scores of 326 inpatients at a large urban psychiatric hospital. The inpatient group performed significantly below the adult normative mean on eight of nine General Aptitude Test Battery (GATB) aptitude measures; the single exception was Verbal Aptitude. Further, GATB aptitude scores (adjusted for age and education) were significantly lower for patients who were receiving (N = 210) psychotropic medication than for patients who were not receiving (N = 114) psychotropic medication, again with the exception of Verbal Aptitude. Differentiation of patients into subsamples who were receiving particular drugs or drug combinations indicated that phenothiazines in combination with Anti-Parkinsonians were associated with the poorest GATB performances. Interestingly, self-reported vocational interests were not related in any systematic fashion to receiving medication. A variety of explanations that may account for these findings, including drug side-effects and severity or type of psychiatric disorder, were investigated. Implications for vocational counselors were discussed.

Adult↗
PubMed1998

[The course of illness and rehabilitation of schizophrenic patients in ambulatory vocational therapy. A prospective study over 3 years].

Within the framework of a study on vocational rehabilitation of the mentally ill, we examined 83 schizophrenic outpatients enrolled in a work therapy program. The course of illness and rehabilitation was documented over a 3-year period by means of annual follow-up examinations. The sample comprised 44 men and 39 women with an average age of 35 years (SD +/- 8.5). The majority were chronically ill patients with a history of frequent and long psychiatric hospitalization. After 3 years, 22% of the patients were integrated into the general labor market, 26% had sheltered employment, 23% were still in work therapy, and 29% were unemployed. Besides the patients' subjective expectations, early introduction of rehabilitative measures and a favourable course of illness were found to be predictors of a successful rehabilitation leading to vocational integration. Outpatient work therapy is a contemporary, effective organizational form of sociotherapy. It may contribute to improved vocational competence and integration, reduced psychiatric hospitalization and stabilized psychopathology.

Adult↗
PubMed2000

Assessing human-robotic performance for vocational placement.

This paper describes the results of an exploratory study of the use of standard occupational therapy assessment tests to measure the effective manipulation ability of individuals with disabilities using a robotic aid. Robotic manipulators have been explored for use as a vocational accommodation to support the job placement of individuals with severe manipulation disabilities. One of the factors that has impeded the transfer of this work is the lack of practical information that is relevant to the vocational placement process. The preliminary performance data presented in this paper provides an indication of robot-assisted manipulation skill that rehabilitation professionals may use to better understand the potential for use of this technology in providing greater job opportunities for people with severe manipulation impairment. Three different assessment tests were administered to nine different subjects with severe physical disabilities using a computer-controlled robotic workstation to perform the manipulation requirements of the tests. In all cases, the subjects, who were otherwise unable to physically perform the tasks without the robot, were able to perform manipulation tasks a factor of 20-700 times less than that of the performance indicated in published norms. Although these performance levels are modest in terms of nondisabled populations, supporting data is also provided that suggests that individuals with severe manipulation deficits could have access to a much wider range of vocational opportunities with an appropriate implementation of robot technology.

Activities of Daily Living↗
PubMed1989

Vocational education and students with learning disabilities.

This inquiry focuses on the status of nearly 500 students with learning disabilities in 17 state-operated regional vocational-technical schools in a northeastern state. The inquiry addressed four primary concerns: patterns of assessment, career choice, school marks, and attendance. The data indicate that a variety of instruments were used in the assessment process and that the overall grade equivalent levels of attainment ranged between fifth- and seventh-grade levels. Children defined as learning disabled participated in a large number of vocational trade specialties and some 50% or more had school marks indicating that they were passing in these areas. Attendance was high. Many children with learning disabilities successfully perform in competitive vocational education programs designed to produce proficiency at the level of journey person.

Adolescent↗
PubMed1993

International perspective of vocational options for people with mental retardation: the promise and the reality.

Developments in research into the vocational needs and preparation of people with mental retardation were briefly traced over recent decades. The premise was made that the study of vocational programs for this population should be examined in the context of the labor market developments of individual countries. Areas for future research were identified, with specific reference to community-based vocational programs.

Employment↗
PubMed1976

[Catamnestic studies of the value of vocational prognoses for persons with infantile brain-damage (author's transl)].

The basis of this study is the examination of 100 people who suffered from severe neurological and psychic defect syndromes. Of this group 49 were re-examined eight years later- age-range then 20 to 34. The vocational prognoses which were given at the first examination were determined according to the degree of severity of the disability and proved to be correct in 39 cases. In five cases each, the level of productivity was assessed either too high or too low. Only eleven of the sample group had an income exceeding DM 500,-45 were living either with their families or in institutions, and of the remaining four, who rented rooms, two were married. The course of life of this category of people, who suffers from such a wide range of disabilities, can be facilitated if attention is paid to the vocational prognosis before the individual starts vocational training.

Adult↗
PubMed1992

Factors associated with successful vocational rehabilitation in persons with arthritis.

OBJECTIVE: The objective of this study was to analyze factors associated with successful vocational rehabilitation (return to work) among persons receiving state-federal vocational rehabilitation services because of work disability from arthritis. METHODS: Multivariate analyses were used to determine the association of sociodemographic, disease-related, and agency factors with work outcome among a group of 456 persons with arthritis receiving state-federal vocational rehabilitation services during 1985-1988. RESULTS: Agency-sponsored physical restoration services (P less than 0.0001) and retraining (P less than 0.0001) were the variables most strongly correlated with return to work. Age, sex, race, disease severity, financial status, and educational level assessed at intake were not significantly associated with work rehabilitation outcome. CONCLUSION: Factors potentially amenable to agency intervention were more strongly associated with work rehabilitation outcome than were sociodemographic or disease-related variables.

Adult↗
PubMed1980

The effects of vocational services provided to the mentally disabled.

The purpose of this study was to evaluate the effects of vocational services provided to mentally disabled clients of the Fresno County Department of Health by the California State Department of Vocational Rehabilitation located in Fresno, California. The findings were (a) 46% were discharged as employed; (b) cost per client was $1,590: (c) cost per success was $3,448; (d) the employed persons entered a variety of competitive jobs; (e) average annual income for persons employed at discharge was $5,539; (f) persons who were employed were less psychiatrically disabled and had a better work history; (g) only 26% of the severely disabled were employed, compared to 50% of the persons who were mildly or moderately disabled; (h) the main benefit of the program appeared to be that of returning less disabled clients with better work histories to work at normative levels shown prior to vocational services; and (i) cost-benefit analysis showed that annual earned income exceeded program cost.

Adult↗
PubMed1994

Project WINS: integrating vocational services on mental health case management teams.

In an effort to expand employment opportunities available to psychiatric consumers, a research demonstration project was developed to incorporate vocational services into case management teams. Following psychiatric rehabilitation principles, Project WINS employs professionals as Vocational Specialists and consumers as Peer Support Specialists to work with clients and their case managers. This report describes the characteristics of clients eligible for WINS services, the implementation of the program, and the impact of WINS on clients and on the mental health and vocational systems. It also describes the challenges and barriers this innovative service is confronting.

Adult↗
PubMed1982

Assessing the problematic interpersonal skills of mentally retarded individuals in a vocational setting.

The present paper reports on two studies which were designed to assess specific interpersonal situations and behaviors which interfere with a mentally retarded individual's adjustment to a vocational setting. In the first study, lists of problematic interpersonal situations and problematic behaviors were generated based on (a) interviews with prevocational teachers, school personnel, and work supervisors in a sheltered workshop setting, and (b) behavioral observations of workers in prevocational classes and a workshop setting. The list of problematic behaviors was further evaluated by work supervisors to determine the frequency and seriousness of each behavior. This information provided a basis for establishing training priorities in an interpersonal skills training program for mentally retarded individuals. In a second study, problem behavior ratings were obtained from prevocational teachers and residential supervisors for 40 mentally retarded individuals. Teachers additionally rated each individual using several standardized assessment scales (Behavior Problem Checklist, AAMD Adaptive Behavior Scale, Vocational Competency Scale). After placement in a sheltered workshop setting, problem behavior ratings were obtained from work supervisors for each individual, and the length of successful employment was assessed. Intercorrelations among measures and across raters provided initial support for the validity and reliability of the problem behavior list. Implications for future researching and training on interpersonal-vocational skills are discussed.

Aggression↗
PubMed2004

Does social cognition influence the relation between neurocognitive deficits and vocational functioning in schizophrenia?

Research on barriers to treatment and rehabilitation readiness in people with schizophrenia, especially focusing on risk factors of poor outcome in social and vocational functioning, has focused on the role of social cognition and neurocognition. Others have hypothesized that social cognition (i.e., encoding and understanding of social cues guided by social schemas or scripts) may be one mediator between basic neurocognition and functional outcome. Our study analyzes data from 133 DSM-IV schizophrenic inpatients on a rehabilitation ward using structural equation modeling (SEM) to test whether social cognition has a stronger and more direct influence on vocational functioning than nonsocial cognition. The results supported the hypothesized model; that is, 25% of work-related social skills could be explained by social cognition and nonsocial cognition. The direct impact of nonsocial cognition on vocational functioning was smaller than the impact of social cognition on work-related social skills. Nevertheless, an overwhelming proportion of social cognition (83%) could be explained by nonsocial cognition.

Adult↗