Neuropsychological assessment and the rehabilitation of persons with severe psychiatric disabilities.

Discusses barriers facing psychologists seeking appropriate testing material for use with persons with severe psychiatric disability (SPD), including lack of knowledge, understanding the meaning of impairment, and the need for individual testing and qualitative observations. A test protocol is offered, and findings from the author's practice are presented. Results reveal combinations of cognitive defects among persons with SPD and suggest that practical knowledge is crucial to the success of rehabilitation. The applicability of cognitive rehabilitation measures for persons who are brain-injured is discussed, and it is argued that such measures can contribute significantly to the rehabilitation of patients with SPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accelerating entry into transitional employment in a psychosocial rehabilitation agency.

Hypothesized that the process of vocational rehabilitation could be accelerated by artificially limiting the length of time members were assigned to prevocational crews. 107 clients admitted to a psychosocial rehabilitation program classified according to prior work experience, were assigned to either the standard gradual vocational program or an accelerated program requiring their early involvement in transitional employment. After 15 mo, 20% of the accelerated Ss were in competitive employment, compared with 7% of gradual Ss. 15% of accelerated Ss were in prevocational crews, compared with 35% of gradual Ss. All 7 of the members working full-time at 15 mo were in the accelerated group. Work-experienced Ss benefited from the accelerated approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analyses of employment incentives and barriers for individuals with psychiatric disabilities.

Objective: Individuals with psychiatric disabilities experience 90% unemployment rates; however, individuals experience 61% employment rates when engaged in high-fidelity individual placement and support programs. To build on current research of variables influencing employment outcomes, we hypothesized that an Incentive factor and a Barrier factor are related to employment status. This mixed method study developed the Employment Commitment Measure (ECM) and explored the correlation between employment commitment and employment status. Method: In our 1st phase of this mixed method study, we developed the ECM consisting of an Incentive factor with 5 items and a Barrier factor with 6 items through community-based participatory research. In our 2nd phase of this mixed method study, 198 randomly picked individuals with psychiatric disabilities completed a demographic survey and the ECM. We completed independent sample t tests with Bonferroni correction, cross-tabulated chi-square analyses, confirmatory factor analysis, Cronbach's alpha tests, a logistic regression, and a slope plotting. Results: The ECM consists of 11 items, with 5 items loading on an Incentive factor and 6 items loading on a Barrier factor. Results indicated that the Incentive factor scores were associated with employment status and significant differences on Incentive factor scores between employed and unemployed participants. Results indicated nonsignificant differences between employed and unemployed participants by age, education, gender, ethnicity, housing, mental health tenure, and agency tenure. Conclusions: Our findings indicated incentives for employment may provide a better guide for correlations of and commitment to employment when compared to barriers. We discuss the implications for employment for individuals with psychiatric disabilities. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Are individuals with severe mental retardation and multiple disabilities cost-efficient to serve via supported employment programs?

The relations between cost-efficiency (from the perspective of worker, taxpayer, and society) and personal characteristics of supported employees (i.e., IQ, level of mental retardation, multiple disabilities, gender, ethnicity, and age) were examined. Results suggest that when sheltered workshops were used as alternative placements, supported employees with high IQs benefited more from employment within the community than did supported employees with lower IQs. From society's perspective, African American and male supported employees were more cost-efficient than were European American and female supported employees. Further, regardless of the severity or number of disabilities, all individuals were cost-efficient from each perspective (i.e., worker, taxpayer, and society) and time period (i.e., 1990, 1994, and projected lifelong).     

The New Hampshire study of supported employment for people with severe mental illness.

This study compared supported employment services in 2 contrasting programs: (a) Group Skills Training, a professional rehabilitation agency outside of the mental health center that provided preemployment skills training and support in obtaining and maintaining jobs, or (b) the Individual Placement and Support (IPS) model, which integrated clinical and vocational services within the mental health center. People with severe mental disorders who expressed interest in competitive employment (N?=? 143) were randomly assigned to 1 of these 2 programs. Results showed that clients in the IPS program were more likely to be competitively employed throughout most of the 18-month follow-up. Among those who obtained jobs, there were few group differences, although workers in the IPS program did work more total hours and earn more total wages during the 18-month followup. There were no group differences on nonvocational outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of participants in a supported education program for adults with psychiatric disabilities

OBJECTIVE: Supported education programs provide assistance, preparation, and support to individuals with psychiatric disabilities who desire to pursue postsecondary education. To determine the extent to which "typical" clients with severe mental illness can participate in a supported education program, the study examined characteristics of participants in a large supported education program. METHODS: Baseline interviews with participants in a supported education program in the metropolitan Detroit area gathered demographic data, as well as information about school, work, and psychiatric history; social adjustment and support; psychiatric symptoms; and self-perceptions in the areas of school efficacy and self-esteem. Cluster analysis used five variables (sex, age, educational attainment, work background, and symptoms) to produce a client typology. RESULTS: Five clusters emerged: well-functioning young men, young aspiring women, young dependent men, well-functioning but unemployed participants, and distressed unemployed participants. The clusters also differed on a large number of variables not used in the cluster analysis. However, members of all clusters had similar rates of program participation and first-semester attendance. Overall, the supported education participants were younger, better educated, and higher functioning than subjects in general samples of persons with severe mental illness. Although many participants had significant problems with symptoms, social adjustment, and substance abuse, they were able to remain active program participants. CONCLUSIONS: The results indicate that supported education is a feasible alternative for many individuals to meet goals for educational advancement, personal development, and better jobs.     

Sexual abuse treatment for persons with developmental disabilities.

Recent research by the Sexual Abuse and Disability Project at the University of Alberta included a survey of 119 sexual abuse (SA) victims with developmental disabilities (DDs). Their responses indicated that SA treatment services for people with DDs are typically inaccessible, unavailable, and inappropriate. Inadequate treatment services appear to be due to the paucity of qualified professionals in the area of SA and DDs coupled with the slow development of appropriate SA treatment approaches. The application of adapted therapy approaches for people with DDs and examples of adapted SA treatment for children and women abused as children are presented. SA treatment issues for the developmentally disabled are discussed for practitioners' considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of supported education for individuals with psychiatric disabilities: results from an experimental study

In recent years post-secondary education has been recognized as a viable option in the psychosocial rehabilitation of individuals with mental illness. This study reports the first evidence of effectiveness of a supported education demonstration project which used an experimental design to compare the effects of different model types. A total of 397 participants were assigned to one of three conditions: group, classroom, and individual (control). At graduation from the program significant differences in program participation rates were found; group members participated most, followed by classroom participants, then those assigned to the individual condition. Also, immediate, intermediate, and long term outcomes were examined. On four immediate outcomes (motivation, satisfaction, enjoyment, and learning) significant participation effects were found (high participants scoring highest, followed by moderate participants, and then non-participants). On two intermediate outcome (empowerment and school efficacy) condition differences were found (classroom scoring highest followed by group, then individual). Although no condition differences were found on behavioral outcomes, the percentage of individuals enrolled in school or vocational education was more than twice that reported at baseline. Overall, the results demonstrated success in engaging participants, affecting self-perceptions, and increasing enrollment in post-secondary education.     

Psychometric testing and reasonable accommodation for persons with disabilities.

Addresses the legal and psychometric issues related to nondiscrimination in employment testing for persons who have disabilities. The Rehabilitation Act of 1973, as amended; the Americans with Disabilities Act of 1990; and psychometric literature on nondiscriminatory testing have introduced and extended the concept from the federal government to the private sector. The comparability of results on the Scholastic Aptitude Test and Graduate Record Examinations, when accommodations are made in the testing process for persons with hearing, vision, and physical impairments and learning disabilities, were examined by the Educational Testing Service and reported by W. W. Willingham et al (1988). Test timing appears to be the critical accommodation for these tests. Testing accommodations are discussed in terms of testing medium, time limits, and test content. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reasonable accommodations in the workplace for individuals with psychiatric disabilities.

Discusses the role of psychologists in promoting reasonable workplace accommodations for the mentally handicapped. Historical and current trends in employment-related psychological treatment are reviewed. The relevant provisions of the Americans with Disabilities Act are described, including areas of ambiguity. The specific difficulties of integrating the mentally disabled in mental-health and rehabilitation employment settings are considered. The responsibilities of psychologists to the disabled and to employers are assessed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anticipating evaluative social interactions involving persons with disabilities.

Purpose: Similar to other types of social interactions, the expected outcomes of interactions between persons with and without disabilities likely are influenced by global self-esteem such that individuals with high self-esteem should fare better than those with low self-esteem. The present set of laboratory studies examined whether simple and complex evaluative situations affect the role of self-esteem when anticipating interactions with individuals who have a physical disability. Design: In Study 1, participants completed a measure of global self-esteem and then were randomly assigned to expect either a brief (5 minutes) or extended (45 minutes) interaction with a confederate in a wheelchair. Participants then completed measures of state affect and meta-evaluations (expected evaluations from the partner). Study 2 replicated the design of Study 1 and additionally randomly assigned participants to be outcome-dependent on the partner or not. Results: Study 1 found that individuals reported affective experiences and expected meta-evaluations that were consistent with global self-esteem when expecting a brief interaction but not an extended interaction with the partner. Study 2 replicated and extended the results from Study 1, demonstrating that self-esteem resumed a priority when participants expected an extended interaction that also placed the participant in an outcome-dependent role. Implications: Taken together, the results seem to support a dilution of the role of self-esteem in simple evaluative situations but not in situations that are nonevaluative or situations with combined evaluative factors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Same- and cross-gender attitudes toward persons with physical disabilities.

Used the Disability Factor Scale-General (DFS-G) of J. Siller et al (1967) to measure 147 male and 139 female 11th-graders' attitudes toward persons with physical disabilities. A subgroup of Ss responded to a specially prepared version of the DFS-G that referred to males with disabilities, while a 2nd subgroup responded to a 2nd version of the questionnaire that referred to females with disabilities. A multivariate analysis of variance (MANOVA) was performed, with scores on the 6 attitude scales of the DFS-G as the dependent variables. The 2 independent variables were Ss' gender and the sex of the person with the disability. Attitudes toward females with disabilities were less positive than attitudes toward males with disabilities. These less positive attitudes were expressed more by boys than by girls. Findings support the theoretical assumption that being disabled and female represents a double minority status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes of management undergraduates toward persons with disabilities: A need for change.

Objective: To examine attitudes toward persons with disabilities of management undergraduates who will be the next generation of professionals and managers hiring and working with employees or clients with disabilities. Participants: A convenience sample of 231 volunteer management undergraduates (129 men and 102 women) ranging in age from 19 to 51 years (M?=?22.89, SD?=?4.43) from 7 human resource management and organizational behavior management classes in a small western Canadian university. Main Outcome Measures: L. Gething's (1991) Interaction With Disabled Persons Scale (IDP) along with openended questions and the Marlowe-Crowne Social Desirability Scale (D. P. Crowne & D. Marlowe, 1960). Results: This Canadian sample expressed a complex set of positive and negative attitudes toward persons with disabilities. Conclusions: There is a need to sensitize management undergraduates to issues regarding employment of people with disabilities. Recommendations are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to special issue: Rehabilitation psychology and persons with psychiatric disabilities: Are they mutually exclusive?

This guest-edited issue of the journal illustrates the relevance of psychiatric rehabilitation to rehabilitation psychologists. It demonstrates that the focus of psychiatric rehabilitation includes some areas of functioning typically identified with rehabilitation psychologists, for example, vocational, residential, and family functioning. Further, it shows that traditional assessment methodologies and treatment settings are beginning to reflect a psychiatric rehabilitation orientation. Finally, it illustrates the philosophy and treatment models that form the basis of physical rehabilitation as also underlying psychiatric rehabilitation. It is hoped that this issue of Rehabilitation Psychology will assist in the resolution of the debate over contextual issues by considering why psychologists working with psychiatrically impaired persons may be identified as rehabilitation psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using concept mapping to develop a conceptual framework of staff's views of a supported employment program for individuals with severe mental illness.

Describes the use of concept mapping to develop a pictorial multivariate conceptual framework of staff views of a program of supported employment (SE) for individuals with severe mental illness. The SE program involves extended individualized supported employment for clients through a mobile job support worker who maintains contact with the client after job placement and supports the client in various ways. Participants were 14 staff members of a psychiatric rehabilitation agency with assignments associated with the SE program. They brainstormed a large number of specific program activity statements (N?=?96), sorted and rated the statements, and interpreted the map that was produced through multidimensional scaling and hierarchical cluster analysis. The resulting map enabled identification of 4 issues that should be included in any theory of SE programs: the specific activity sequences that characterize the program itself, the pattern of local program evolution, the definition of program staff roles, and the influence of key contextual factors such as the client's family or the program's administrative structure. The implications of concept mapping methodology for theory development and program evaluation are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability disclosure effects on employment interview ratings of applicants with nonvisible disabilities.

Objective: To investigate the effects of timing of verbal disclosure of a disability on employment interview ratings of applicants with nonvisible disabilities. Study Design: Participants (56 college students) viewed 2 videotaped employment interviews: 1 involving an applicant who disclosed a nonvisible disability (transverse myelitis), either early or late in the interview, and 1 with an applicant who did not disclose a disability. Outcome Measures: Qualifications/hiring, liking, and comfort with disability disclosure scales. Results: Applicants with nonvisible disabilities who chose to disclosure their disability were rated as more qualified and likeable when disclosing early in an interview. Conclusion: Individuals who wish to disclose an externally caused nonvisible disability (similar to transverse myelitis) should consider doing so early in an interview rather than at the end. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of assertive community treatment on homeless persons with co-occurring severe psychiatric and substance use disorders

To investigate the possibility of engrafting fetal liver hematopoietic cells by in utero intraperitoneal transplantation, we transplanted donor cells obtained from mouse fetuses at 13, 15 and 17 days of gestation to mouse fetuses at 15, 16 and 17 days of gestation. Engraftment was assessed by Sry gene amplification of DNA extracted from peripheral blood samples of transplanted mice six weeks after birth. In comparison, we performed an in vitro colony-assay of fetal liver cells at 13, 15, and 17 days of gestation. The incidence of engraftment was significantly higher in cells of 15 days of gestation than in cells of 13 or 17 days of gestation, whereas the colony forming activity decreased gradually from 13 to 15 days of gestation. From these results, we suggest that the 15 day liver contains hematopoietic progenitors which have the specific characteristics required for engraftment by intraperitoneal transplantation.     

Variables associated with employment following severe traumatic brain injury.

Results of a survey of employment outcome and their relationship to psychometric indices indicated that competitive employment following severe traumatic brain injury is an ambitious endeavor. While 98% of the 94 Ss sampled were either employed or in school premorbidly, 43% of them were unemployed postinjury. Psychometric variables were most highly related to employment outcome which suggested a useful role of neuropsychological testing in assisting in vocational rehabilitation planning. Furthermore, the psychometric test results indicated that many Ss who were unemployed may be capable of parttime employment. Future studies are needed to further examine those neuropsychological abilities which subsequently affect employability following severe traumatic brain injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)