Supported employment: A catalyst for service development

KARE is a not-for-profit parents’ organisation in County Kildare, Ireland, which provides services to individuals with intellectual disabilities and their families. We currently provide services for approximately 400 individuals divided equally between children and adults. The organisation has been in existence for 30 years and from the outset, the ethos has always been to support families and provide services in community based settings. Over the years, KARE has endeavoured to provide a comprehensive range of services that are of high quality and reflect current best practice in the field. In many ways you might say the organisation is similar to many other providers in the field, in that we talk about a commitment to best practice and high quality. The question that faced us as an agency some years ago when we reviewed our adult services was this: Does the actual provision of services reflect the philosophical aims of the organisation? At that time, approximately five years ago, we were heavily invested in traditional vocational training and the outcome of this for the majority of our clients was placement into a sheltered workshop. In effect, the outcome for individuals within the programme was to participate in day services that primarily removed them from the mainstream of society and congregated them together in segregated facilities. Yet, the whole idea of best practice was speaking about inclusive policies, participation in mainstream activities and facilitating individuals with intellectual disabilities to live an ordinary life. Philosophically, as an organisation, we had absolutely no difficulty with these ideas; however, the way in which we were allocating our resources was not likely to lead to these outcomes for the people we served. We decided something had to change and that change was likely to be radical. At the same time, the organisation was learning a lot more about the concept of Supported Employment, which enabled individuals, including those with significant intellectual disabilities, to be employed in real jobs in regular settings, where training and other supports were provided in the company on an ongoing basis. For many within the organisation, including myself, the introduction to this concept seemed to contradict most things that we had believed about vocational training; i.e., that people needed intensive preparation before entering the labour market, and this was best done in specialised vocational training centres. It has been said, that Supported Employment in fact “puts the cart before the horse” in that it’s an outcome based model which emphasises finding the job first and then addressing the issues of training with regard to job skills and whatever other skills the individual needs to perform effectively within that environment. On further examination of course, the concept of Supported Employment is based on solid principles, particularly with regard to the whole issue of generalisation of learning. We have known for many years from research that individuals with intellectual disabilities in particular have difficulty transferring what they have learned from one situation to another. It is not surprising therefore, that the number of people with intellectual disability who have successfully made the transition from segregated