Preliminary evidence on combined cognitive behavioral therapy and motivational interviewing intervention efficacy to improve employment motivation for persons with intellectual disability

This study investigated the efficacy of a combined modified cognitive behavioral therapy (CBT) and motivational interviewing (MI) approach on motivating persons with intellectual disabilities (ID) in obtaining employment. The sample consisted of a total of 52 individuals with ID who were clients of an independent vocational-rehabilitation services provider (females = 42%; males = 58%), ranging in age from 19 to 47. They were randomly assigned to an intervention group (n = 26) and a control group (n = 26). The intervention group received a combined modified CBT and MI intervention and the control group a fact sheet on career-dysfunctional thoughts and lack of motivation to obtain employment. Outcome measures comprised a career-dysfunctional thoughts scale and employment seeking action scale. Results indicated that the intervention group reported higher motivation in obtaining employment than the control. Practitioners seeking to improve employment prospects for persons with ID should consider the use of a combined modified CBT and MI intervention for increasing the chances of employment seeking by people with ID.

Determinants of employment outcomes of transition-age youth with depressive disorders

BACKGROUND: Transition-age youth (TAY) with depressive disorders struggle with finding and retaining gainful employment. Thousands of these youth enroll in the state-federal vocational rehabilitation (VR) program each year to improve their employment outcomes. However, there is a dearth of information on the factors that facilitate or impede their success in the program. OBJECTIVE: The study aims to shed light on the demographic characteristics and vocational rehabilitation services and their association with successful employment and earnings of TAY with depressive disorders in the state-federal VR program. METHOD: The sample comprised of 4,772 participants drawn from the Rehabilitation Services Administration dataset. Regression analyses were employed to examine the effects of demographic characteristics and vocational rehabilitation services on successful employment and earnings. RESULTS: Results indicated that employment outcomes varied by demographic characteristics such as race/ethnicity, severity of disability and level of education. Also, certain VR services had significant positive or negative relationships with successful employment and earnings. CONCLUSIONS: Highlighting the promise of the state-federal programs for supporting TAY with depressive disorders to successfully participate in the labor market, findings from this study expand upon the literature by suggesting practices and services for optimizing employment potentials of this population.

Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Early Impacts from a Multi-Site Random Assignment Evaluation

Background PROMISE was a federal initiative to support youth receiving Supplemental Security Income (SSI) during the transition to adulthood. Objectives This article presents estimates of the impacts of the six PROMISE projects on youth and family outcomes as of 18 months after enrolling in PROMISE. Research Design The study uses a randomized controlled trial design. Subjects The six PROMISE projects each enrolled a minimum of 2000 treatment and control youth (and their parents) residing in their service areas who were aged 14 to 16 and receiving SSI. Measures We estimated impacts on outcomes related to youth and family service use, school enrollment, training, employment, earnings, and federal disability program participation using survey and administrative data. Results The projects succeeded in connecting more youth to transition services and more families to support services during the 18 months after enrollment, and most increased the likelihood that youth applied for state vocational rehabilitation services. On average, there was no impact on youth’s school enrollment, but there were favorable impacts on youth’s receipt of job-related training, employment, earnings, and total income. The projects did not affect parents’ employment, earnings, or income, on average. For most outcomes PROMISE affected, the impacts varied substantially across the projects. Conclusions The positive short-term impacts of PROMISE on youth’s use of transition services, youth employment, and families’ use of services are consistent with the program logic model and suggest there might be potential for longer-term favorable impacts on youth and family outcomes.

Implementation and use of video tele-technologies in delivery of individualized community-based vocational rehabilitation services to rural veterans

BACKGROUND: Telerehabilitation is an effective health delivery method for patients with a variety of health conditions. There is insufficient knowledge about use of telerehabilitation to support patients with disabilities and chronic illness in obtaining or sustaining competitive employment. Employment rates of Veterans are lower than civilian rates, and the employment gap is higher for Veterans living in rural areas. OBJECTIVE: To investigate factors that enabled and constrained routine use of video tele-technologies in delivering individualized community-based vocational rehabilitation (referred to as Tele-VR) services and to identify impacts and promising practices in implementation. METHODS: Semi-structured interviews with providers from two Veterans Health Administration Medical Sites that use telerehabilitation to supplement their existing face-to-face individualized community-based VR services. Interviews were analyzed using thematic analysis. RESULTS: Five themes in the implementation of Tele-VR were identified (1) Enhancing Workflow for Providers, (2) Improving Quality of Therapeutic Care, (3) Practicalities in Implementing Tele-VR, (4) Embedding Vocational Rehabilitation into Interdisciplinary Care as a Facilitator to Implementation, and (5) Impact of Tele-VR. CONCLUSIONS: The telerehabilitation delivery of employment service to Veterans with disabilities is a viable means for remotely providing or enhancing face-to-face individualized and community-based VR services that support Veterans’ competitive employment and job stability within their communities.

An analysis of training and vocational rehabilitation services for individuals with intellectual disability

BACKGROUND: WIOA encourages providers such as Vocational Rehabilitation (VR) to seek higher wages and more than part-time hours for those with disabilities. Previous studies have evaluated the relationship between (VR) and job outcomes for individuals with intellectual disability (ID). OBJECTIVE: The present study evaluated the effect of VR services on wage and hours worked. METHOD: We obtained a national dataset from the Rehabilitation Services Administration to analyze individuals with ID on variables specially related to training and VR services. RESULTS: Results indicated more training resulted in more hours worked, while using more VR services resulted in less hours worked and pay. Differences in hours worked and wage were found within training and VR services. CONCLUSION: Individuals with ID should consider utilizing job counseling with VR agencies and focus on occupational training, as these services may contribute to increased wages and hours worked.

Vocational Rehabilitation for Persons With Visual Impairment at the Community: A Case Study in Dong Da District, Hanoi City, Vietna

Work has been emphasized by the WHO, ILO, and UNESCO for years as to how individuals can escape poverty, secure the necessities and improve his/her economic and social status. In this sense, vocational rehabilitation is regarded as the means for persons with disabilities to access work. However, in the absence of either these programs or full respect for their right to work, they have been encountering different barriers in employment accessibility. This happens more seriously in developing countries, including Vietnam. Through mixed methods of desktop reviews, a survey with 110 persons with visual impairment in the community, and in-depth interviews with 10 key stakeholders, the article aims at briefing an overview on current situations of their employment as well as vocational rehabilitation services and support for occupations in Dong Da District, Hanoi City. Several key findings indicate that they have been coping with unemployment or low-tech and low-paid jobs. There is an intensive gap between needs and service supplies in physical, cognitive, and psychosocial components. In the community, available programs target supporting them in terms of physical aspects rather than cognitive and social components. Finally, the authors discuss more various vocational programs, capacity building to other potential providers, and awareness-raising.

The tripartite efficacy beliefs model in vocational rehabilitation: Implications for working alliance and client engagement

BACKGROUND: Given the importance of working alliance to client engagement and outcomes in vocational rehabilitation, there is a need to better understand predictors of the client counselor relationship. Research has shown the tripartite efficacy model as a way of understanding working alliance in various contexts but has never been examined in vocational rehabilitation. OBJECTIVE: This study evaluates the relationship among tripartite efficacy beliefs constructs (self-efficacy, other-efficacy, and relation-inferred self-efficacy [RISE]), working alliance, and engagement for 350 clients receiving state vocational rehabilitation services. METHODS: Researchers used a path analysis to assess the hypothesis that the tripartite efficacy model would predict client engagement through its impact on working alliance. RESULTS: The hypothesized model had a close fit. Other-efficacy and RISE beliefs had significant positive direct effects on working alliance and indirect effects on client engagement. Self-efficacy had a significant negative direct effect on working alliance and client engagement. CONCLUSIONS: The study supports the tripartite efficacy beliefs model as a way of better understanding client perceptions of working alliance in vocational rehabilitation.