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Vocational assessment and intervention for people with epilepsy.

Employment restrictions have been experienced by many people with epilepsy. In many cases, the restrictions are unjustified and based on stigma or a stereotypical image of the person with epilepsy. Unjustifiable restrictions are a form of discrimination and lead to unemployment and underemployment. Unfortunately, much of the research in this area has been difficult to interpret because of differences in the definition of "people with epilepsy" and differences in the definition of "employment restrictions or problems." I report on an attempt to develop a classification structure and examine some survey results collected by the IBE Employment Commission from professionals and people with epilepsy concerning the sources of employment restrictions and possible methods to overcome these restrictions.

Attitude to Health↗

Portfolio-based learning and general practice vocational training.

This action research project developed a portfolio-based learning system, based around a 'log dairy,' with the trainers and general practitioner registrars of one training region in the UK. For those that found benefit from the system, the diary became an important way of holding all the events of a training year together; a way of looking back, in order to view the progress made, and looking forward, to view potential learning needs. Such portfolios were not found to be effective formal assessment mechanisms because the threat of assessment influenced the type of material collected. The enthusiasm of trainers was crucial in encouraging use of the model. The action research process was fundamental in stimulating explorations of ideas on reflective learning. There remains some resistance to the idea of reflective writing, and in this context, portfolios may be one educational tool for use by some, but which may not be universally applicable. Their development and implementation requires considerable local support through facilitation.

Family Practice↗

Negative symptoms and vocational impairment in schizophrenia: repeated measurements of work performance over six months.

Interest in negative symptoms as a dimension of schizophrenia has grown dramatically in the last decade. One hypothesized correlate of negative symptoms that has received less attention is deteriorated work function. To address this issue, this study compared biweekly measurements of work performance for 21 patients with prominent negative symptom and 29 patients without prominent negative symptoms enrolled in a 26-week supported work program. Nonparametric analysis indicated that subjects with prominent negative symptoms demonstrated poorer performance than other subjects on task orientation, social skills and personal presentation. No evidence was found that the work performance of either group improved or worsened over time, although a trend suggested that social skills may have improved slightly for both groups across the 26 weeks. These results support hypotheses linking negative symptoms with deteriorated work function.

Adult↗

Fifteen years after treatment: a follow-up study of comprehensive vocationally-oriented psychotherapy.

The fourth follow-up study of adolescent delinquent boys treated in a community-based program that combined job placement, remedial education, and psychotherapy indicates that the better overall adjustment of the treated group, compared to untreated controls, is maintained well into adulthood. It reaffirms the importance of developing sound, innovative means of reaching adolescents in crisis, and suggests the value of a full-scale replication of the original program.

Adolescent↗