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The SE program involves extended individualized supported employment for clients through a Mobile Job Support Worker MJSW who maintains contact with the client after job placement and supports the client in a variety of ways.
The resulting cases were randomly assigned to either the SE condition treatment group or the usual protocol control group which consisted of life skills training and employment in an in-house sheltered workshop setting.
Significant treatment effects were found on all four measures, but they were in the opposite direction from what was hypothesized. Instead of functioning better and having more self esteem, persons in SE had lower functioning levels and lower self esteem. The most likely explanation is that people who work in low-paying service jobs in real world settings generally do not like them and experience significant job stress, whether they have severe mental illness or not.
The implications for theory in psychosocial rehabilitation are considered. The Effects of a Supported Employment Program on Psychosocial Indicators for Persons with Severe Mental Illness Over the past quarter century a shift has occurred from traditional institution-based models of care for persons with severe mental illness SMI to more individualized community-based treatments.
Along with this, there has been a significant shift in thought about the potential for persons with SMI to be "rehabilitated" toward lifestyles that more closely approximate those of persons without such illness.
A central issue is the ability of a person to hold a regular full-time job for a sustained period of time.
There have been several attempts to develop novel and radical models for program interventions designed to assist persons with SMI to sustain full-time employment while living in the community.
The most promising of these have emerged from the tradition of psychiatric rehabilitation with its emphases on individual consumer goal setting, skills training, job preparation and employment support Cook, Jonikas and Solomon, These are relatively new and field evaluations are rare or have only recently been initiated Cook and Razzano, ; Cook, Most of the early attempts to evaluate such programs have naturally focused almost exclusively on employment outcomes.
However, theory suggests that sustained employment and living in the community may have important therapeutic benefits in addition to the obvious economic ones. To date, there have been no formal studies of the effects of psychiatric rehabilitation programs on key illness-related outcomes.
To address this issue, this study seeks to examine the effects of a new program of supported employment on psychosocial outcomes for persons with SMI. Over the past several decades, the theory of vocational rehabilitation has experienced two major stages of evolution.
Original models of vocational rehabilitation were based on the idea of sheltered workshop employment. Clients were paid a piece rate and worked only with other individuals who were disabled.
Controlled studies of sheltered workshop performance of persons with mental illness suggested only minimal success Griffiths, and other research indicated that persons with mental illness earned lower wages, presented more behavior problems, and showed poorer workshop attendance than workers with other disabilities Whitehead, ; Ciardiello, In the s, a new model of services called Supported Employment SE was proposed as less expensive and more normalizing for persons undergoing rehabilitation Wehman, The SE model emphasizes first locating a job in an integrated setting for minimum wage or above, and then placing the person on the job and providing the training and support services needed to remain employed Wehman, One of the more notable SE programs was developed at Thresholds, the site for the present study, which created a new staff position called the mobile job support worker MJSW and removed the common six month time limit for many placements.
Time limits for many placements were removed so that clients could stay on as permanent employees if they and their employers wished. There are two key psychosocial outcome constructs of interest in this study. The first is the overall psychological functioning of the person with SMI.
This would include the specification of severity of cognitive and affective symptomotology as well as the overall level of psychological functioning.
The second is the level of self-reported self esteem of the person.ABOUT APA STYLE. This section summarizes the very basic guidelines for APA Style as four primary guideposts: your writing should be concise, clear, considerate, and correct..
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ABOUT APA STYLE. This section summarizes the very basic guidelines for APA Style as four primary guideposts: your writing should be concise, clear, considerate, and correct.. Concise. Check your writing to make sure it is "to the point" -- that you are saying only what needs to be said, without digressions and extraneous information.