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[A report on the effect of sheltered workshop activities on the social living activity of the mentally ill--analysis of research on workshop clients].

The effect of sheltered workshop activities on the social living activity of the mentally ill was studied in order to evaluate the role and level of function of workshop activities as a self support and employment system for clients, and to determine the future tasks of the workshop and rehabilitative services in the community. The following results were observed: 1) Clients' social living ability appears to be poor, especially in questions related to personal relationships and time distribution, where less than 50% of the clients answered "Possible without assistance". This appears to be characteristics of the living behaviors of mentally ill individuals. 2) Most of the families of the clients evaluated the sheltered workshop activities positively in terms of increasing the clients' social living ability. 3) A survey of families showed that by utilizing the workshop much progress has been made toward improving those living behaviors which are easily made into habits and lifestyle pattern. On the other hand, personal relationships and living behaviors which require coping flexibility, are much more refactory. Based on those results, the future task of sheltered workshops and the supportive role of the public health center need to be examined further.

Adult

Reality orientation versus sheltered workshops as treatment for the institutionalized aging.

The effects of two psychosocial treatments, Reality Orientation and Sheltered Workshops, were evaluated against an assessment-only control. Thirty nursing home residents (mean age, 64.4 years) were randomly assigned to one of two groups in one of the three experimental conditions. Residents assigned to therapy conditions met for 15 group sessions led by trained nursing home personnel. Program effects were assessed before and after treatment using three variables: the Life Satisfaction Index-A, nurses' ratings, and behavior observations. The Sheltered Workshop treatment produced significant gains in Life Satisfaction Index-A scores and staff perceived social interest; Reality Orientation resulted in nonsignificant decrements in Life Satisfaction Index-A scores. Neither treatment produced effects on observer-rated on-ward behavior. The results underscore the importance of empirically evaluating therapy effects with the institutionalized aging and suggest that Sheltered Workshops may be more beneficial for this population than has previously been recognized.

Adult

Sheltered workshops: financial and philosophical liabilities.

Some of the economic and philosophical reasons why sheltered workshops remain liabilities within the field of special education were discussed. Low wage rates, the unavailability of work, changing industrial forecasts for blue collar employment, financial dependence, tax returns, segregation, and normalization issues, along with other factors, were examined to provide support for the assertion that sheltered workshops are not providing clients with appropriate work experiences.

Adult

A follow-up study of psychiatric patients in a sheltered workshop program.

Participants in a long-term sheltered workshop program were followed up to determine their present status, their degree of symptom impairment, and their assessment of the program. The author found the rate of clients' return to work greatly exceeded the rate of rehospitalization. The study also indicated that symptom impairment was not a valid predictor of success in the workshop or adjustment in the community and that satisfaction with the program was closely associated with improved self-esteem.

Adult

Enterprise-based sheltered workshops in Nanjing. A new model for the community rehabilitation of mentally ill workers.

This paper describes the development of community mental health services in Nanjing and reports on a retrospective study that compared the two-year outcome for 78 schizophrenic patients who attended four enterprise-based sheltered workshops (experimental group) with that of 78 schizophrenic patients who attended an out-patient clinic (control group). Despite having a longer course of illness and more prior hospital admissions than patients in the control group, at the end of the two years patients treated in enterprise-based sheltered workshops had significantly less psychosocial dysfunction (mean Social Dysfunction Screening Schedule score 3.4 (s.d. 0.2) v. 7.4 (s.d. 0.7), t = 49.2, d.f. 154, P < 0.001) and less severe psychiatric symptomatology (mean Brief Psychiatric Rating Scale score 33.1 (s.d. 2.7) v. 54.1 (s.d. 2.9), t = 47.0, d.f. 154, P < 0.001). Moreover, compared with the control group, over the two year period a smaller proportion of the experimental group experienced a clinical relapse (14.1% v. 38.5%, chi 2 = 5.10, d.f. 1, P < 0.05) or hospital readmission (7.7% v. 21.8%, chi 2 = 10.7, d.f. 1, P < 0.01). We conclude that the organisation of on-site sheltered workshops for mentally ill factory workers is an effective model for promoting community mental health that merits widespread application in China.

Adult

Concurrent feelings of power and dependency in a sheltered workshop for chronic neuropsychiatrics.

The present study investigated the reported feelings of power and dependency of chronic neuropsychiatric patients in a sheltered workshop. Self-evaluations of dependency were assessed in relation to one real-life role (i.e. disabled welfare recipient), and evaluations of power feelings were assessed in relation to another real life role (i.e. worker in a sheltered workshop), with a complementary work-related performance measure. While dependency and power feelings were independent of each other, it was also found that: 1) dependency feelings positively predicted the number of mental hospital admissions; and 2) feelings of power in the workshop negatively predicted work performance. These results provide direct evidence that feelings of dependency and power can be role specific and not indicative of generalized behaviours. They also provide indirect evidence of a role theory interpretation of learned helplessnesslike phenomena.

Achievement

Clinical use of the Quick Test with sheltered workshop clients.

The purpose of this note is to provide clinical reference data on the Quick Test responses of 48 adult sheltered workshop clients. The mean IQs for Forms 1, 2, and 3 were 66.3, 67.6, and 69.7, respectively. The mean IQ for combined Form 1 + 2 + 3 was 68.4. Standard deviations of IQs for the three forms were 13.68, 13.99, and 15.31, respectively, and for Form 1 + 2 + 3 was 13.65. There were 17 females and 31 males ranging in age from 18-2 to 61-1. These data provide tentative local norms for psychologists to use when the Quick Test is given to evaluate mentally subnormal clients of these sheltered workshops for placement or to predict their success in work programs. Future norms should be checked and updated for workshop clients.

Adolescent

A supervisory strategy to improve work performance for lower functioning retarded clients in a sheltered workshop.

A multiple component strategy was investigated for aiding staff responsible for supervising production of lower functioning retarded clients on contract tasks in an institution-based sheltered workshop. The strategy was assessed in a combined multi-element, multiple baseline across groups design with a reversal component. Production performance increased during the production supervisory strategy with all 16 clients, with the range of increase varying from a few percentage points to 150% of baseline production. Both the clients and staff (responsible for conducting the research) preferred working under experimental conditions rather than under baseline conditions which approximated those found in "typical" sheltered workshops.

Achievement

Effects of price manipulations on consumer behavior in sheltered workshop token economy.

The consumer behavior of institutionalized retarded clients in a sheltered workshop token economy were evaluated by changing prices in the workshop store. In the first experiment we found that clients displayed elasticity of demand in that raising the prices of frequently purchased goods reduced the frequency and amount spent on more expendable items. Results from the second experiment showed that this change in spending pattern was not due to the relative modal unit price of item classes. The regulation of demand for consumer goods is a potentially useful way to maintain economic balance and effectiveness of a token economy.

Adolescent

The case for a flexible, long-term sheltered workshop for psychiatric patients.

In making his case for a flexible, long-term sheltered workshop, the author presents seven propositions that he supports with reviews of outcome studies in psychiatric treatment and rehabilitation. He submits that it is unrealistic to expect a lasting cure for many psychiatric patients; that despite rehospitilizations, many patients spend most of their lives in the community, where their vocational performance is poor; that total vocational rehabilitation is an unrealistic goal for many of the patients but that in our culture employment is essential to self-respect; and that hospital patients can and will work in hospital workshops and in community workshops after discharge. In addition, he describes a work-for-pay program affiliated with a psychiatric day hospital.

Day Care, Medical

The physical, psycho-social and vocational effectiveness of a sheltered workshop for brain-damaged war veterans.

This two-year investigation of the rehabilitation effectiveness of a sheltered workshop for severely brain-damaged war veterans who had been deemed non-feasible for the Ministry of Defense's usual rehabilitation services, included: (a) a multi-disciplinary staff, (b) adapted jobs, (c) client involvement in workshop management and maintenance, (d) client earnings and (e) social activities. Brain-damaged war veterans from the Tel Aviv area constituted the experimental group. Persons with similar neurological impairment, cognitive, emotional disabilities and social handicaps constituted the control group. In interviews at the beginning and end of the research period, the rehabilitation workshop members and the families expressed a significantly greater increase in satisfaction with a variety of major life activities than did members of the control group and their families. It would appear that sheltered work can increase the brain-damaged persons' satisfaction with major life activities by ameliorating the personal, social and vocational dysfunction that accompanies and aggravates the consequence of brain damage.

Adolescent

Social ecology of supervised communal facilities for mentally disabled adults: VII. Productivity and turnover rate in sheltered workshops.

Turnover, reasons for termination, productivity, and number of hours worked as a function of demographic data, workshop settings, and measures of sociability for mentally disabled adults at six sheltered workshop settings were examined. An annual turnover rate of 48 percent was found, but only residence type and workshop setting were related to length of time in the workshop before termination. Physical attractiveness and sociability (as observed during free periods at the workshops) were positively related to productivity, but only workshop settings predicted number of hours worked. Clients who terminated from the agency for positive reasons were highest in sociability and desire for affiliation, whereas clients who terminated for negative reasons were lowest in sociability and desire for affiliation. Sex, age, IQ, diagnosis, and history of institutionalization were unrelated to vocational variables.

Adolescent

Validity of the Vocational Adaptation Rating Scale: prediction of mentally retarded workers' placement in sheltered workshops.

The validity of the Vocational Adaptation Rating Scale (VARS) for predicting placement of mentally retarded workers in sheltered-workshop settings was investigated. The VARS was administered by workshop supervisors to noninstitutionalized adolescents and adults, ranging from severely to mildly retarded. Frequency and severity of maladaptive behavior in six domains predicted the concurrent placement of retarded workers in workshops and their placement one year later. Results indicated low to moderate significant partial correlations with concurrent placement and one-year follow-up placement (controlling IQ, age, and sex). Multiple-correlation analyses indicated that the VARS provided significant increments in predictable variance in workshop placements (13.8 to 16.1 percent) relative to predictions based on IQ, age, and sex. Results support the instrument's incremental validity as a measure of maladaptive behavior in vocational settings.

Adaptation, Psychological

Retarded adult's discrete work performance in a sheltered workshop as a function of overall productivity and motivation.

Production times of high and low retarded adults in a sheltered workshop were analyzed in terms of actual time working as opposed to actual time not working and under conditions of standard and high motivation. Under standard conditions, low productivity was primarily the result of more time spent not working. High motivation attenuated this effect. The results were discussed in terms of cognitive vs. motivational interpretations of individual differences in work performance.

Adult

Training developmentally handicapped persons as supervisors in sheltered workshops.

Developmentally handicapped persons were taught to apply a behavioral supervisory strategy to maintain work rates of other developmentally handicapped clients in a sheltered workshop. In two experiments, each with two subjects, training procedures were examined in a multiple baseline across supervisory components within subjects. Results clearly demonstrated that the subjects learned to apply the supervisory components as a function of the training procedures. The subjects were approximately as effective as were regular staff for maintaining production rates of the workshop clients. Potential benefits of the supervisory training for the subjects as well as for the staff were discussed. The results suggest that the teaching of developmentally handicapped persons to perform more complex supervisory activities in sheltered work settings deserves greater attention than it has received in the past.

Adolescent

Purpose in life and occupational interest in a gerontological sheltered workshop.

Measured the concept of purpose-in-life and underlying occupational interests and aspirations of older men (N = 25) and women (N = 29) in a gerontological sheltered workshop. The relationship among the Purpose-in-Life Test, Vocational Preference Inventory, Will-to-Live scale, and demographic information, is explored. Findings, which include that the construct of purpose in life and vocational aspirations are poorly related for workshop participants, are discussed in terms of previous research.

Aged

A streamlined weight loss program for moderately retarded adults in a sheltered workshop setting.

An abbreviated version of a behavioral weight loss program for obese retarded adults was provided for two groups of eight moderately retarded, obese adults working in a sheltered workshop. The program involved ten weeks of treatment, five weeks of maintenance and included a one-year follow-up check. Pictured materials were developed to facilitate the subject's comprehension and practice of the behavioral weight loss strategies. subjects in one treatment group were also paired to assess the impact of a buddy reinforcement program on their weight loss. Following ten weeks of treatment, significant weight loss was observed (mean percent weight loss = 6.2); weight loss continued during five weeks of maintenance (additional mean percent weight loss = 1.8). No differences in weight loss or percent weight loss were found between the buddy reinforcement group and the other treatment group at the end of treatment of maintenance and during follow-up. At one year follow-up, 37.5% of the sample maintained a weight loss. Discussion centers around the issues of developing efficient weight loss strategies for obese retarded adults, high inter-individual variability observed in weight loss during treatment, and relatively low long-term maintenance of weight loss after treatment terminated.

Behavior Therapy