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[Relation of vocational orientation/vocational education and illness status].

A cross-sectional analysis was carried out to examine factors exercising an effect on the sickness rate among trainees. The study comprised 389 boys and 217 girls in their first or second years of apprenticeship. The sickness rate was found to be lower among young people with a high level of motivation and achievement than among those achieving less well. An appropriate practical vocational training helps to decrease the number of apprentices absent due to illness.

Absenteeism↗

Computer vocations for severely physically disabled persons: survey results.

Clients with physical disabilities were assessed for their computer skills and other characteristics related to computer vocations. Then a series of surveys were undertaken to determine availability of computer programming jobs for properly trained students, the best training program to suit these jobs, the equipment to train persons with disabilities, and the numbers of qualified applicants to warrant establishment of such a program. Results indicated that while programming is not a good job prospect, terminal operations appear promising, and occupations related to microcomputers warranted further study. The IBM Personal Computer was recommended, and a sufficient interest was demonstrated to establish the program for one year. Training programs in the United States provided a basis for establishment of the training course for trainees with disabilities.

Canada↗

[Vocational rehabilitation for psychologically handicapped patients: the Mannheim "starting help." On the creation of rehabilitative resources in industry].

A programme for rehabilitation of severely mentally impaired patients (mainly psychotic disorders) in local companies, industrial and municipal, is presented. Introduced in 1970 and extended since 1983, the programme is based on a theoretical model for social work practice, that centers around the concept of resources and interaction. Preliminary experiences with this on-the-job vocational rehabilitation approach are reported.

Germany, West↗

Drugs and youth: an international perspective on vocational and social reintegration.

Despite the negative attitudes of the general public and even of professionals concerning the potential of drug-dependent youth to reintegrate socially and to be employed, there is ample and growing evidence for a more positive outlook. This paper describes the vocational rehabilitation process which can serve as a basic tool for most drug rehabilitation programmes. The author illustrates a number of interesting and innovative approaches, both public and private, which have all demonstrated some measure of positive outcome. Mention is made of the need for and great value of direct involvement of the community in the rehabilitation and reintegration process. Programmes for employed drug-dependent persons are also cited as a preventive and highly effective approach.

Adolescent↗

[Occupational and vocational rehabilitation of psychiatric patients: a control and attribution theory approach to examining the effect of working conditions].

In recent years, work and occupational activity have come to assume a therapeutic orientation in the rehabilitation of persons with mental illness. The study presented addressed the specific ways in which work activities during rehabilitation programme participation may act in a manner conducive to rehabilitation. The findings point to a positive relationship between the opportunities objectively available in the work setting for rehabilitees to influence aversive conditions or occurrences and their work-related subjective well-being. A second step enabled us to show that subjective well-being is determined less by the situation objectively at hand but primarily by the mentally ill rehabilitees' perceptions of influenceability and, hence, the experience of controllability. Further, examination of the rehabilitees' attributional patterns concerning the various control experiences revealed that the extent to which their subjective well-being is affected is mediated cognitively. The findings are discussed in view of their implications for the vocational rehabilitation of persons with mental illness.

Adaptation, Psychological↗

[Vocational rehabilitation of psychiatric patients].

135 former clients of the "Arbeitstrainingszentrum (ATZ)" in Upper Austria, a facility for vocational rehabilitation, participated in a comprehensive follow-up study 1 to 9 years (mean 3,8 years) after termination of the ATZ. 60% of them finished the ATZ regularly, meaning either that they completed the full training or that they left for another job. Occupational situation of the former clients at follow-up was as follows: 24% were competitively employed, 17% held a sheltered working place, 3% underwent training, 6% did not-economic work, 6% worked in a household. 13% were unemployed and in search for a job, 30% received a disability pension. 41% of all clients had held no job at all since termination of the ATZ.

Adult↗

Long-term vocational adjustment of cancer patients diagnosed during adolescence.

Long-term vocational achievements of 40 survivors of cancer diagnosed during adolescence were examined and compared with 40 healthy sex-matched and age-matched controls. Patients' ages at diagnosis ranged from 13 to 19 years (mean, 16.15). Study subjects had survived cancer for over 5 years and were on no cancer therapy. Assessment measures included the Rand General Well-Being Scale, the Rand Functional Limitations and Physical Abilities Batteries, and a semistructured interview. The relation of physical disability and limitations caused by cancer to patients' achievements also was evaluated. Although cancer patients, on the average, were more concerned about their health and reported lower general spirits than controls, no differences were found between control and study groups with regard to overall general well-being. More cancer patients than controls reported that their health limited their ability to engage in vigorous activities. A greater functional deficit was found among unemployed than employed cancer patients. Employers and co-workers often were aware of the patient's diagnosis (85% and 67%, respectively). Cancer patients reported disease-related discrimination in hiring (7.4%), induction into the military (66.7%), and obtaining health, life, and disability insurance (31.5%). There was no significant relationship between health status and employment. Nevertheless, cancer patients had a higher average income than controls. Sixty-four percent of patients believed that changes in certain physical features of the workplace were necessary to facilitate readjustment to the job. Despite the disabilities experienced by cancer patients and generally negative public attitudes, long-term survivors have a good outlook on life and are competitive members of the workplace and society.

Adolescent↗

Factor structure of the Edwards personal preference schedule in a vocational rehabilitation sample.

The 15 scales of the Edwards Personal Preference Schedule were factor analyzed for 450 male and 89 female vocational rehabilitation clients in order to compare results by gender as well as combining them to compare with the college norming data in the EPPS manual. Correlations and factors were similar in many ways when the combined sample and norm samples were compared, but larger and consistent differences between the study scores suggest that separate norms are justified and that norm tables need to be revised.

Adult↗

Vocational guidance during the Depression: phrenology versus applied psychology.

The paper describes the design and use of a machine, the "Psychograph," which automatically measured the size and shape of the skull and provided evaluations of mental traits according to phrenological principles. Developed in 1930, the psychograph was billed as a diagnostic tool capable of providing suitable vocational guidance to the thousands of unemployed as a result of the Depression. Its appearance prompted a vigorous opposition from the Psychology Department at the University of Minnesota, especially in the person of Donald L. Paterson. Subsequently, the psychograph was merely exploited for its entertainment value and disappeared after the 1933 World's Fair in Chicago.

Aptitude↗

Randomized comparison of a multidisciplinary job-retention vocational rehabilitation program with usual outpatient care in patients with chronic arthritis at risk for job loss.

OBJECTIVE: Work disability is a major consequence of inflammatory rheumatic conditions. Evidence regarding the effectiveness of interventions aimed at the prevention or reduction of work disability in rheumatic diseases is limited. We conducted a randomized controlled trial to investigate the effectiveness of a multidisciplinary job-retention vocational rehabilitation (VR) program in patients with a rheumatic condition who were at risk for job loss. METHODS: A total of 140 patients with a chronic rheumatic condition were randomly assigned to either a multidisciplinary job-retention VR program (n = 74) or usual outpatient care (UC) (n = 66). Patients in the VR group were assessed and guided by a multidisciplinary team, whereas patients in the UC group received care as initiated by their rheumatologist, supplemented with written information. The main outcome measure was the occurrence of job loss (complete work disability or unemployment); additional outcome measures included job satisfaction, pain, functional status, emotional status, and quality of life. RESULTS: There was no difference between the 2 groups regarding the proportion of patients having lost their job at any time point, with 24% and 23% of the patients in the VR and UC groups, respectively, having lost their job after 24 months. Over the total period of 24 months, patients in the VR group had a significantly greater improvement of the fatigue visual analog scale and of emotional status (all P values < 0.05). CONCLUSION: A job-retention VR program did not reduce the risk of job loss but improved fatigue and mental health in patients with chronic rheumatic diseases at risk for job loss.

Adolescent↗

Individual Placement and Support: a community mental health center approach to vocational rehabilitation.

Individual Placement and Support (IPS) is a vocational rehabilitation intervention for people with severe mental disabilities. IPS draws from components and philosophies of several other models. Employment specialists, who are part of the community mental health center team, provide services in the community. IPS emphasizes client preferences, rapid job finding, continuous assessment, competitive employment, integrated work settings, and follow-along supports. Initial research on IPS shows favorable results.

Community Mental Health Centers↗

Person-related predictors of employment outcomes after participation in psychiatric vocational rehabilitation programmes--a systematic review.

BACKGROUND: There is increasing recognition of the importance of psychiatric vocational rehabilitation (PVR) programmes in helping individuals with severe mental illnesses to find and secure jobs. However, little is known concerning the factors related to PVR outcomes. OBJECTIVE: This review identifies those person-related factors which most strongly influence employment outcomes after participation in PVR programmes. METHOD: Medline, Psychinfo, Pubmed and CINAHL were searched for studies using multivariate analysis of longitudinal data, which analysed employment outcomes after at least 6 months of programme participation, and which analysed at least three predictor domains. RESULTS: Eight studies presented in 16 publications met all the criteria. Better employment outcomes were most strongly related to better work performance measured during PVR participation and to higher work-related self-efficacy. Better social functioning during PVR participation was also significantly related to positive employment outcomes, but this relationship was generally weaker than those of the two aforementioned factors. In most studies, employment outcomes after PVR were not related to past functioning, including work history and diagnosis. Findings on the severity of psychiatric symptoms measured during PVR were mixed. In terms of contribution to outcome, severity of symptoms usually ranked below work performance, when measured concurrently. CONCLUSION: Contrary to previous reviews, this study suggests that the influence of past functioning, including work history, diagnosis and psychiatric history, is outweighed by work performance in PVR. Further prospective and controlled studies are needed to reach more definite conclusions about the individual contributions of person-related factors.

Disability Evaluation↗

Vocational rehabilitation program for persons with occupational deafness.

INTRODUCTION: A pilot return-to-work program based on the concept of work readiness and three-month job placement with support was developed to enable people with occupational deafness to return to the workforce. METHODS: A convenient sample of six male persons with occupational deafness completed the program. A Pretest-Posttest Single Group Design was utilized to measure the program outcome. Two instruments: the Chinese version of SF-36 Health Assessment Questionnaire and the Chinese version of Lam's Assessment of Stage of employment readiness were used to measure the participants' health status and their work readiness respectively. RESULTS: The preliminary findings indicated that the six participants showed improvement in their general health and work readiness. The employment outcome indicated that three of the participants had secured a job and another two participants had attained job offers. CONCLUSION: This pilot study suggested that a systematic vocational rehabilitation program can facilitate persons with occupational deafness to return to the workforce. Further research using a controlled investigation with larger sample size is recommended for evidence-based practice even though the results of this return-to-work program appear promising.

Adult↗

"What did you say?" Using review of tape-recorded interactions to increase social acknowledgments by trainees in a community-based vocational program.

Dana and Rick, two adults with developmental disabilities enrolled in a restaurant training program, had poor prospects for long-term employment because of inappropriate social behavior. They often made no response, mumbled inaudibly, or made a negative remark when spoken to by their supervisors or other employees. Each trainee's Individual Vocational Plan (IVP) included goals of prompt and polite acknowledgement of coworker initiations. Previous efforts to improve Dana and Rick's acknowledging behavior had been unsuccessful. Throughout the study, each trainee's responses to 20 verbal initiations by coworkers (i.e., requests, questions, corrective feedback, praise, and social comments) were recorded during each of two observation periods per workshift. Throughout one of the observation periods during the intervention phases, the trainees carried in their work aprons a small, audio cassette recorder that recorded their interactions with coworkers. The primary intervention consisted of a preworkshift meeting in which the trainee and experimenter reviewed five randomly selected interactions recorded during the previous day's shift. The review included self-evaluation, praise, corrective feedback, and role-play. A multiple baseline across subjects design showed each trainee acknowledged a greater number of coworker initiations as a function of the intervention. Each trainee also acknowledged more coworker initiations during the second observation period when the tape recorder was never worn. In a subsequent intervention phase, Dana reviewed her tape-recorded interactions prior to randomly selected shifts. Rick's acknowledgments increased to a socially valid level when the review procedure was supplemented with graphic feedback. Both trainees continued to acknowledge their coworkers' initiations at levels equal to nondisabled restaurant employees when they no longer wore the tape recorder during a final phase and during follow-up observations 4 to 8 weeks later.

Adult↗

The Program Without Walls: innovative approach to state agency vocational rehabilitation of persons with traumatic brain injury.

OBJECTIVE: To describe the Program Without Walls (PWW), a person-centered, community-based approach for state rehabilitation counselors to provide vocational rehabilitation (VR) services to people with traumatic brain injury (TBI). DESIGN: Nonrandomized posttest only matched control group design using existing state VR data. SETTING: Community-based within 2 district offices of the state-federal VR program in New York State. PARTICIPANTS: VR consumers with TBI (N=42); 21 received PWW services, and 21 matched controls received traditional VR services. INTERVENTION: All participants experienced the initial VR process: eligibility determination and the development of an individualized employment plan. Participants receiving the traditional approach were referred to various organizations for services and monitored by their state VR counselor. Those receiving PWW services were never "handed off" to outside agencies. Instead, they received person-centered, community-based services from a team of freelance consultants who were recruited, trained, and supervised by the state VR counselor overseeing the PWW team. MAIN OUTCOME MEASURES: Data were gathered from VR central files for all consumers with a primary or secondary disability of TBI. Outcome variables were case status at closure, weekly earnings at closure, hours working at closure, and cost of case services. RESULTS: The PWW successfully placed more consumers who worked a greater number of hours per week and earned more per week than those who received traditional VR services without increasing the cost of case services. CONCLUSIONS: The PWW showed promise as a systems change effort to improve VR services for people with TBI.

Adult↗

Patterns of employment and independent living of adult graduates with learning disabilities and mental retardation of an inclusionary high school vocational program.

Vocational/employment and independent living for individuals with disabilities has been a major area of interest for those interested in transition from school to work and adulthood. Recent statistics for such individuals continue to be poor and problematic. The present study investigated a group of adults with either specific learning disabilities or mild mental retardation who had graduated or exited an inclusionary high school which emphasized vocational technology training and independent living skills. The results indicated higher than the national average for employment and rate of pay as well as stronger than expected indicators of independent living in terms of mobility. The largest group of individuals, however, were still residing with their parents. Respondents with learning disabilities were doing better than their mentally retarded counterparts in terms of many of the indicators but individuals with mental retardation were still doing strongly when compared against figures reported in other studies. Results are discussed in terms of recommendations for generalization as well as the educational model used for these students.

Activities of Daily Living↗

Factors associated with awareness of vocational rehabilitation services after traumatic brain injury.

OBJECTIVES: To determine the characteristics of persons with traumatic brain injury (TBI) who were aware of vocational rehabilitation (VR) services 1 year after hospital discharge. DESIGN: Medical record and longitudinal survey data on persons with TBI were analyzed using logistic regression and bivariate analyses. SETTING: The study sample was drawn from a population-based sample of persons hospitalized in 1 of 8 hospitals in north-central Alabama. PARTICIPANTS: Criteria for inclusion were: (1) being at least 18 years of age or older when injured; (2) having sustained a TBI; (3) being discharged alive after a hospital stay of at least 3 days; (4) residing and having been injured in the state of Alabama; (5) participation in a 12-month follow-up interview. MAIN OUTCOME MEASURE: Patients' awareness of VR service programs and benefits. RESULTS: Awareness of VR service programs was associated with: (1) being Caucasian; (2) being more often employed at the time of injury; (3) being more often severely injured; and (4) more frequently receiving outpatient rehabilitation. CONCLUSION: Interventions should target non-Caucasians, those who were unemployed when injured, those less severely injured, and those not receiving outpatient rehabilitation services after hospital discharge. Periodic review of VR benefits with patients and their families should be undertaken by health care and VR professionals.

Adult↗