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PubMedDate not supplied

Effects of Snoezelen room, Activities of Daily Living skills training, and Vocational skills training on aggression and self-injury by adults with mental retardation and mental illness.

Multi-sensory stimulation provided in a Snoezelen room is being used increasingly for individuals with mental retardation and mental illness to facilitate relaxation, provide enjoyment, and inhibit behavioral challenges. We observed aggressive and self-injurious behavior in three groups of 15 individuals with severe or profound mental retardation and mental illness before, during, and after being in a Snoezelen room. All participants were receiving psychotropic medication for their mental illness and function-derived behavioral interventions for aggression, self-injury, or both. Using a repeated measures counterbalanced design, each group of participants was rotated through three experimental conditions: Activities of Daily Living (ADL) skills training, Snoezelen, and Vocational skills training. All other treatment and training activities specified in each individual's person-centered plan were continued during the 10-week observational period. Both aggression and self-injury were lowest when the individuals were in a Snoezelen room, followed by Vocational skills training and ADL skills training. The levels in the Snoezelen room were significantly lower than in both the other conditions for aggression but only in ADL skills training for self-injury. The difference in levels before and after Snoezelen were statistically significant with self-injury but not with aggression. The order of conditions showed no significant effect on either behavior. Snoezelen may provide an effective context for reducing the occurrence of self-injury and aggression.

Activities of Daily Living↗
PubMed2002

["REGRATIO" - A vocational reintegration project for psychiatric patients].

OBJECTIVE: Theoretical background and first results of a vocational rehabilitation program for unemployed persons with chronic psychiatric disabilities will be presented. The aim of the program is job-placement in the regular labour market. METHODS: After a 3-month preparatory period the participants were given the possibility of "training on-the-job" in the areas of social services, catering, and care taking activities in 12-months' rehabilitation reintegration courses in co-operation with a social service centre. In addition, a 6-months aftercare period will be included. RESULTS: More than one third of 34 participants (38 %) were placed in a regular employment. CONCLUSIONS: The results support the importance of vocational rehabilitation programs as a supplementary component of the care system of chronic mentally ill patients.

Adult↗
PubMed2003

[Concepts in early planning for vocational rehabilitation in schizophrenia patients during acute care].

The particular relevance of employment for financial independence, acquisition of social skills and, hence, an increase in self-confidence is undeniable, and has for several years now been increasingly considered an essential component of care notably in psychiatric disorders. Vice versa, unemployment is deemed a potential risk factor with regard to poorer therapeutic response and social integration as well as a higher incidence of crises in persons with mental illness. Schizophrenia is among the psychiatric disorders very often resulting in unemployment and subsequent early pensioning. Planning for vocational rehabilitation early-on during acute care therefore is considered of greatest importance especially in this patient group. This article gives a brief overview of the main concepts drawn on in preparing the vocational rehabilitation of patients with Schizophrenia, focussing in particular on their relevance for daily practice and the possibilities for evaluating their effectiveness.

Activities of Daily Living↗
PubMed1985

Resources for vocational planning applied to the job title of PHYSICAL THERAPIST.

Industrial rehabilitation is a rapidly developing area of health care. As a result, physical therapists need to become functionally familiar with common vocational planning processes and resources. Therefore, the purpose of this article is to describe a process called Vocational Diagnosis and Assessment of Residual Employability (VDARE), which is based on the Dictionary of Occupational Titles (DOT) and Classification of Jobs (COJ) resources. We have provided the DOT and COJ classifications for the job title of PHYSICAL THERAPIST as an example of their terminology. A critique of the DOT and COJ, applied to several occupational examples, suggests these resources be used with supplemental task analyses for a given job. The physical therapist, however, can use the VDARE process and the DOT and COJ resources to identify specific and achievable job targets for clients rather than relying solely on traditional trial and error, on-the-job evaluation.

Ergonomics↗
PubMed1987

Common vocational training project for the handicapped (CVTPH).

CVTPH is a special project imparting vocational training to leprosy patients as well as other categories of the handicapped under the same roof, in order to combat the leprosy stigma which is the major obstacle in all leprosy work and to aid rehabilitation by making the trainees economically self-sufficient. The project, which offers training in the industrial sector to leprosy patients, orthopaedically handicapped individuals and able-bodied but socio-economically disadvantaged individuals, began in a small way in 1977, but has grown considerably since then, thus demonstrating the effectiveness of the concept. There have been several problems--chief among which are the leprosy stigma and the reluctance of the trainees themselves to move out from a sheltered environment into the world outside--but these are slowly being overcome by the formation of co-operative societies controlled by the handicapped. This project is hoped to serve as a model for similar vocational training programs.

Combined Modality Therapy↗
PubMedDate not supplied

Supported employment and compensatory strategies for enhancing vocational outcome following traumatic brain injury.

Epidemiological research clearly indicates that traumatic head injury has reached epidemic proportions. Incidence rates for head injury are greater than those for cerebral palsy, multiple sclerosis, and spinal cord injury combined. Many victims suffer from long-term impairments in functional, neurological, medical, neuropsychological and linguistic status. Emotional and behavioural problems are common as well. Additionally, family problems often ensue as a consequence of the victim's dependency and concomitant emotional changes. Investigations of post-injury vocational status indicate that unemployment rates within the first 7 years post-injury range as high as 70% for those with moderate and severe injuries. Researchers have demonstrated that the emotional and neuropsychological changes arising from injury are the greatest contributors to reduced employability. Relatively high unemployment rates strongly suggest that traditional approaches to physical and vocational rehabilitation have been entirely inadequate. To complement existing services and enhance employment outcome, two approaches have been developed and refined for use with victims of head injury. Supported employment is a unique approach which assists the client to select, obtain and maintain suitable employment on the basis of his/her interests and abilities. Compensatory strategies have been developed to help the individual offset intellectual problems which would otherwise interfere with learning job skills and maintaining production levels. Often, compensatory strategies are used in the context of a comprehensive supported employment programme. The greater use of supported employment and compensatory strategies is likely to enhance employment outcomes for those with traumatic head injury. Nevertheless, additional research is needed to more clearly identify the types of techniques which work best for each unique set of problems.

Adult↗
PubMed1999

[Is vocational integration in the competitive labor market a realistic goal for the chronically mentally ill?].

A wide range of sheltered jobs has been created in the second or special labour market with the aim of enabling the chronically mentally ill to participate in working life. However, having a job in the special labour market often precludes the chance of obtain-ing employment in the competitive labour market. To date, vocational integration programs enable only a small number of persons with psychiatric disabilities to attain reintegration into competitive employment. The predictors of successful vocational integration are subsequently discussed. A substantial increase in both sheltered and competitive jobs on the common labour market could be achieved for mentally ill and disabled people by adapting the "supported employment" model, as widely practised in the USA, to European labour market standards and appropriately funding its implementation. The utilisation of this model could serve to reduce the necessity of further expansion in the special labour market.

Employment↗
PubMed1999

[Vocational training for persons with psychiatric illnesses in Gütersloh BTZ. Occupational rehabilitation by training comprehensive key qualifications with concomitant social adjustment services, but without independent training centers--can it be done?].

Gütersloh BTZ has practiced vocational training for the mentally handicapped since August 1995. The main goal is to place the clients into employment in the regular workforce. This is done by intensive vocational training yet without having workshops attached to the institution itself. Gütersloh BTZ is comparable to other training centres in Germany like those in Hamburg, Duisburg, Köln, Dortmund, Paderborn, Straubing, Wiesloch and Schleusingen. They are similar in terms of personnel key, financial support for participants and standards of quality. The main difference between Gütersloh BTZ and other training centres is the absence of attached workshops. In Gütersloh training takes place on the job in the regular labour market like industrial firms, craftsmen establishments and service agencies. The "heart" of Gütersloh BTZ's concept is the reference group. It consists of not more than 8 participants. Two social workers are assigned to each group and provide intensive attention from the participant's first day in BTZ to aftercare on the regular job. The individual rehabilitation aim can only be achieved by establishing a tailor-made concept of support. This calls for a broad range of media, flexible methods and individual aims. In addition to the individual orientated concept, pedagogical group-work with three to five participants plays an important role in the work. Here the emphasis is on close relationship. Incentive, start, duration and contents of internships in agencies and firms are to a high degree individually structured. A flexible graduated plan helps the participants to progress from a trial practicum to a long-term practicum and finally to a regular (and subsidized) job in an agency. The Gütersloh BTZ's quota of successful placement into the regular labour market as well as into subsidized jobs is similar to those in other BTZs in Germany. Participants who can't be placed in a job have to achieve a defined perspective of life and an alternative to regular work. This standard of quality is established in the written concept of BTZ. Gütersloh BTZ compares its work and success with other BTZs through uniform social-scientific BTZ evaluation.

Adult↗
PubMed1975

[Psychotherapy accompanying vocational counselling sessions (author's transl)].

The article reports on psychotherapy accompanying counselling sessions for patients undergoing in-patient psychotherapeutic treatment. With respect to the practical implementation of vocational counselling sessions, the experiences gained within this framework are summarised in three principles: (1) Psychotherapy accompanying vocational counselling sessions are contraindicated if they relate to a partial aspects of problems which so far have not been therapeutically treated. (2) The sessions should take place at the final stage of treatment. (3) The recommendation for a job change should only be given if two conditions are (simultaneously) met: a) the patient can no longer cope with his job and is dissatisfied with it. b) There must be (at least) one alternative job for which the prospects are more favourable. The communicative situation (counsellor, therapist, social worker, employment office, and financially responsible agencies) is discussed as well as the specific behavioural patterns of the patient (acting out, indolence, tremendous demands, wish to have an adjunct therapy, need to safeguard himself.

Germany, West↗
PubMed1988

[Sports in vocational schools in an occupational training center for handicapped patients--prerequisites, responsibilities and organization].

Sports activities in the vocational education centres are viewed as an indispensable rehabilitation measure. Its contents and organizational structure however is to a large extent left to the individual centres. Implementation of effective sports is endangered by the lack of homogeneity in the young trainee population as regards type and severity of the disability, age, maturity. After setting out the present situation and the function of sports in a vocational education centre for physically disabled young people, a school course system is presented that, by achieving a relatively homogenous composition of the sports groups, enables sport-oriented instruction to be realized. In this course system, the young people are allocated to the various courses through sport selection and counselling, based on the criteria of inclination and suitability. The range of sports offered also includes sports for the very severely handicapped, which are described briefly.

Adolescent↗
PubMed1988

Reliability and validity of the vocational assessment and curriculum guide.

Test-retest reliability, internal consistency, and validity of the Vocational Assessment and Curriculum Guide (VACG) with subjects having different employment characteristics was investigated. The VACG, a behavior rating scale comprised of eight vocational and social skill domains, was designed to assist in the development of employment training programs for persons with mental retardation and other disabilities. Test-retest coefficients ranged from - .69 to .96 (mean = .79). Internal consistency, estimated by coefficient alpha, ranged from .59 to .91 (mean = .76) for VACG domain scores. The alpha coefficient for the total test score was .95. Empirical validation results suggest that domain scores differentiated between subjects with mental retardation having only sheltered work experience and those who were employed successfully in the competitive labor force.

Adolescent↗
PubMed1995

[Vocational integration of physically handicapped persons--a regional study in the Regensburg district].

The present study had been aimed at tracing possible reasons for insufficient placement of people with physical disablement in the open labour market in the Regensburg region, at gaining insights on the prerequisites of and potential for improving vocational integration as well as at clarifying the relevance of alternative work and employment opportunities in terms of halfway and sheltered settings. Based on a structured questioning schedule, interviews were carried out with 10 experts, 32 physically disabled individuals and 30 employers concerning their placement notions and experience. Generally speaking, it was in particular found that insufficient placement cannot simply be attributed to economic trends; the groups interviewed, rather, differ in some of their underlying assumptions and expectations, a fact which impacts negatively on the integration process. Interaction of disabled and nondisabled persons hence requires greater attention. For the disabled, along with their educational-occupational qualifications, acquisition of communication and social skills is crucial in vocational integration, whereas the companies, in particular small and medium-sized ones, are in need of better information and counselling as well as appropriate supports to be provided by job or placement assistants when hiring physically disabled persons.

Adolescent↗
PubMed1975

Personality factors influencing vocational rehabilitation.

Fifty male patients with chronic renal conditions and receiving hemodialysis underwent psychiatric examination and repeated followups in a predictive study aimed at elucidating personality factors that influence vocational rehabilitation. Previous level of functioning, satisfaction with work, sick role, and patients' dependency needs were found to influence substantially the level of vocational rehabilitation. All the data collected in the present study indicate that "rehabilitation" should start at a much earlier stage and aim at preventing regression.

Adolescent↗
PubMed1979

Utility of the WAIS in predicting vocational success of psychiatric patients.

Examined the utility of the WAIS OA, BD, PIQ and FSIQ scores in combination with age, apparent degree of emotional severity and psychiatric disability in predicting the vocational success of 180 psychiatric outpatients. Although no significant statistical differences were obtained in a cros-validation procedure indicating that psychiatric disability affected the efficacy of the derived regression equations, substantial differences in predictable variance accounted for were found to be related to the nature of the psychiatric disability. This must be attended to in attempts to predict the vocational success of psychiatric outpatients.

Adult↗
PubMed2000

[Continued training of elderly workers with reference to changes in the organization of continuing vocational training].

In the following contribution the under-proportional participation rate of older workers in vocational training is analyzed. Regarding the changes concerning the organization of vocational training to more job-integrated, self-directed and computer-based learning the consequences for training opportunities, motivation to learn and performance possibilities as well as institutional basic conditions to optimize the participation of elderly workers in further training are discussed.

Aged↗
PubMed2006

The psychology of injured workers: health and cost of vocational rehabilitation.

BACKGROUND: In the vocational rehabilitation of injured workers the influence of the worker's personality has been neglected. This is despite there being substantial evidence that in chronic pain certain personality factors are significantly related to poorer outcomes. This is a preliminary study that has examined the relationship between personality factors, personality psychopathology and rehabilitation outcomes in injured workers. METHOD: Data from structured clinical interviews, self report and rehabilitation outcome (cost) were gathered from 36 injured workers with recognized compensation claims for physical and/or psychological workplace injury. RESULTS: Personality factors were associated with poorer outcome, particularly cost and health. Individuals with extreme personality traits experienced poorer health and vocational rehabilitation outcomes. The combination of high Neuroticism and low Extraversion which is a pattern often characterized as anxious and socially avoidant was found to be consistently related to poor health outcomes. CONCLUSIONS: The results indicate that considering the type of personality characteristics of injured workers may have important theoretical and practical implications.

Adult↗
PubMed2006

Performance-based funding of supported employment for persons with severe mental illness: vocational rehabilitation and employment staff perspectives.

Vocational rehabilitation (VR) supervisors and counselors (n = 35) as well as supported employment (SE) program managers and employment specialists (n = 26) were enrolled in a 12-month evaluation comparing two models of funding services for persons with severe mental illness: fee-for-service and results-based funding (RBF). Quantitative measures of job satisfaction and preference for funding method were obtained prospectively on a quarterly basis, and SE staff activity logs were collected monthly. Qualitative data were collected using a series of focus groups conducted at the conclusion of the study. Despite recording a substantial increase in semi-annualized VR billing charges when using RBF (45-49%), SE staff expressed less satisfaction with RBF over time. Staff raised concerns about increased financial risks and pressures to achieve job placements under RBF. Vocational rehabilitation staff were consistently more satisfied with RBF, expressing particular satisfaction with perceived effectiveness and the payment authorization process. Both VR and SE staff expressed some reservations about RBF, primarily concerning possible pressures for adverse client selection.

Employment, Supported↗
PubMed1983

Vocational adaptation of patients on home dialysis: its relationship to personality, activities and support received.

This analysis identifies, in terms of relative contribution, seven independent variables which appear to be associated with the vocational adaptation of home dialysis patients. The tentative model created by the analysis can be used as a guide for assessing a patient's potential vocational adaptation. It has also identified some conditions associated with adaptation which are amenable to treatment by dialysis staff. Validation of the model, however, requires further testing with other patient groups.

Activities of Daily Living↗