Forms of Supported Employment

Chapter 12

Forms of Supported Employment

Intensive, initial training of persons with severe vocational handicaps in natural work environments.

Continuing intervention (support) often provided by a job coach or employment training specialist to help person sustain work and maintain employment

Work in individual jobs, small groups, or mobile work crews

Social integration at the work site w/non disabled individuals who are not paid caregivers. (JOB ANALYSIS, MATCHING CLIENTS TO JOBS, OJT, ADVOCACY W/EMPLOYERS, TRANSPORTATION, AND HOUSING ASSISTANCE)

Models of supported employment

Individual placement approach - placed in regular community jobs (support is provided as needed)

Enclave approach - small group (8) trained and supervised together in the midst of an ordinary mainstream work environment.

Mobile crew approach - singular purpose business is established by a service provider, crews (about 5 people) work with one supervisor

Bench work approach - offers more supervisory attention (behavioral problems)

TYPICAL SUPPORTED WORK MODEL IS INDUSTRIALLY INTEGRATED

The industry or employer is described as the host industry, and clients w/dis may be placed in OJT either individually or in groups.

Supported work approaches may also be run as satellites of community rehab facilties or alternatives replacing community workshops altogether.

OVERALL CONCERN FOR COUNSELOR IS ADVOCACY FOR INTEGRATION

ON SITE ASSESSMENT

Real concrete experience and realistic basis for assessment

Assumption that Voc Rehab incorporates a learning potential format as well as a training process

JOB SITE Clients experience job changes, production demands, hierarchy of supervision, can also provide a functional appraisal of behavior

The term "ecological" means individual interacts with their environment and that both change as a result

Individual abilities are matched with a job or specific skills. A shift from Prediction (PSYCHOMETRIC APPROACH) to an ability training orientation that fosters the remediation of skill deficiencies and development of skills needed to sustain employment.

ON SITE ASSESSMENT EMPHASIZES IMPORTANCE OF DIRECT ASSESSMENT OF ACTUAL SKILLS AND BEHAVIORS OVER A PERIOD OF TIME AND IN THE ACTUAL WORK ENVIRONMENT.

Not merely an event yielding data ---highly dynamic process charged with meaning for both client and evaluator

GOALS FOR A SUPPORTED EMPLOYMENT ENVIRONMENT

ID clients employment goals, interests or preferences (some may have difficulty articulated their goals)

ID clients entering behaviors in relationship to those exiting job

ID or resources (people, place, things, activities that client needs to be successful in work environment

Appraisal of client's work performance (ESPECIALLY Problem behaviors) (Work adjustment behaviors, productivity behavior, interpersonal skills, occupational job skills)

Formulation from assessment information that proceeds on a step by step basis toward specified behavioral objectives derived from actual job demands

Exploration of clients satisfaction w/ job in supported environment

Id social factors as the attitudes of co-workers, the extent of supervisory support or encouragement, degree of work stress or pressure, understanding of physical setting (lighting, temperature, task variety, awareness of financial rewards and ability and training requirements. Transportation to and from work site should also be considered.

TO ACHIEVE ASSESSMENT GOALS

KEEP IT SIMPLE!

EVALUATING PROGRESS

PERFORMED WITH CLIENTS

Client input is important Ð'- preferences and perceived capabilities and limitations are important to solicit from clients.

IDEALLY the job coach is the person who handles the evaluation.

Observations should be accomplished in short periods of time during clients work day.

Information should be recorded daily.

Particular attention should be given to critical behaviors.

A Critical Review of Functional

Capacity Evaluations

The role of functional capacity evaluations (FCEs) appears to be increasing as employers and insurers rely more heavily on them for decision making. To meet credibility requirements, and the American Physical Therapy Association's standards for measurement and documentation, all FCE suppliers need to validate and refine their systems. This article provides information that can be used to make informed decisions in the selection of an FCE and in functional assessment practices. Features of well-designed FCEs are discussed. Ten well-known FCE systems are analyzed according to these features and other common characteristics. Current issues such as the qualifications of the evaluators, reliability and validity, length of assessments, projection of endurance to 8 hour workdays, standards of practice, safety protocols, and behavioral assessment and management strategies are discussed. [King PM, Tuckwell N, Barrett TE. A critical review of functional capacity evaluations. Phys Ther. 1998;78:852-866.1

Functional capacity evaluations (FCEs) have become part of practice in work injury prevention and rehabilitation. These tools are supposed to define an individual's functional abilities or limitations in the context of safe, productive work