bluuebunny/crossref_metadata_2025 huggingface dataset:
Tailoring a vocational rehabilitation program to the needs of	people with HIV/AIDS: The Harbor-UCLA experience
Authors: Martin David J. , Chernoff Robert A. , Buitron Michael
Published: November 2024

New treatments introduced in the early to mid 1990s led to greatly improved health and quality of life for many people with HIV/AIDS, prompting some to consider workforce reentry. In this paper, we relate three projects we have undertaken since 1996 in which we have worked to develop an understanding of the workforce reentry process for people with HIV/AIDS. In the first, a survey of HIV/AIDS case management clients throughout Los Angeles County, we noted a substantial need for workforce reentry assistance services, and noted six broad categories of workforce-reentry concern for people with HIV/AIDS. Our second project was designed as a demonstration project to assist people with HIV/AIDS in their efforts to return to work. We found, among other things, that significant obstacles unrelated to employment also thwarted workforce reentry efforts. Finally, in our current clinical-trials study, we continue to learn from participants in their efforts to rejoin the workforce. We discuss our cumulative results to date, and highlight certain future directions for research and service.
Vocational counseling for people with HIV: The client-focused	considering work model
Authors: Goldblum Peter , Kohlenberg Betty
Published: November 2024

With increased efficacy of HIV antiviral medications and subsequent improvement in health status, many people with HIV face new decisions regarding work. The Client-Focused Model of Considering Work describes the interplay between four domains of influence (medical, financial/legal, psychosocial, and vocational). In each of these domains, persons with HIV can experience both pressures to make work related changes and barriers to making these changes. A nonlinear decision-making process is articulated in four phases. The authors discuss and contrast this model with other rehabilitation models, describe its implications for planning and delivery of rehabilitation services, and cite research results from a career counseling program based on the model.
Health-related barriers to employment among people with	HIV/AIDS
Authors: Razzano Lisa A. , Hamilton Marie M.
Published: November 2024

With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvements in physical and mental health, making many of their ongoing career goals more realistic. However, many people with HIV/AIDS who are unemployed but would like to work continue to have major concerns regarding the impact of employment on their benefits and entitlements. In addition to issues regarding potential financial hardships, many people living with HIV/AIDS express uncertainty related to their health status, and they worry that some working conditions could deleteriously affect their health. The present evaluation focuses on two major issues identified in previous research: health perceptions and sources of insurance and health benefits. In addition, the study utilizes a standardized instrument, the MOS-HIV Scale, designed specifically to characterize aspects of health and well-being among people with HIV/AIDS.
Factors associated with disclosure of HIV/AIDS to employers among	individuals who use job accommodations and those who do not
Authors: Conyers Liza , Boomer K.B.
Published: November 2024

This article presents the findings from a research study investigating the patterns of job accommodation use and factors associated with disclosure of HIV/AIDS status to employers among a sample of 84 employed individuals with HIV/AIDS. Overall, more than half of the sample (52%, n = 43) used some form of job accommodation. Of these, 14% reported that they could not work without their accommodations and 34% indicated that they did not know if they could work without accommodation. Logistic regression analyses indicated that the factors associated with disclosure of HIV/AIDS status to employers are different among participants who used accommodations and those who did not. Implications for rehabilitation practice and research are discussed.
Performance-based funding of supported employment: A multi-site	controlled trial
Authors: McGrew John H. , Johannesen Jason K. , Griss Melina E. , Born Dennis L. , Katuin Colleen
Published: November 2024

Background. To help mitigate empirically-identified shortcomings in Supported Employment (SE) outcomes for consumers with severe mental illness in Indiana (e.g., few long-term placements), Vocational Rehabilitation Services (VRS) and the Indiana Division of Mental Health and Addictions (DMHA) proposed the implementation of a results-based funding (RBF) system, in which providers received payment only when clients successfully attained each of 5 employment milestones. The current study presents the results of a multi-site controlled trial of RBF vs. a traditional fee-for-service (FFS) model.

Method. The sample included 122 (RBF=81, FFS=41) consumers of SE (52% schizophrenia, 35% mood disorder). Assessments of clinical and life outcomes were conducted quarterly across 12 months.

Results. Those served in RBF were more likely to attain all milestones collectively, and to have a completed person-centered plan and attain 9-months of employment, specifically. There were few differences between those in RBF and FFS on non-milestone employment variables (e.g., job match, wages) or clinical measures (e.g., quality of life, functioning).

Conclusions. RBF produces better overall vocational outcomes, specifically, higher rates of completion of a person-centered plan and retention of employment for 9 months. However, improvements with RBF were limited to those specified and did not generalize to vocational areas not targeted by the milestones (e.g., wages, benefits) or to changes in other life domains typically valued by psychiatric rehabilitation.
The Milestone Payment System: Results based funding in vocational	rehabilitation – 2005
Authors: O'Brien Dan , Revell Grant
Published: November 2024

As State budgets tighten, Vocational Rehabilitation (VR) Agencies and Community Rehabilitation Providers face a daunting challenge to collaboratively craft methods to improve the efficiency and effectiveness of community-based employment services while preserving consumer informed choice. Results Based Funding methods push service systems in the direction the consumer chooses by creating incentives for consumer valued outcomes. Alternatively, hourly funding can push in the wrong direction, with incentives for more service activity, thereby unintentionally generating outcome interference for both the provider and the customer. Milestone funding systems have been shown to improve outcomes for consumers while simultaneously increasing the number of successful rehabilitations for the VR agency. Service providers have successfully learned to shift the focus of their work from process and activities to outcomes and results. This article discusses the key elements that make a Milestone or Results Based funding strategy successful.
Workplace discrimination and mental retardation: The national EEOC	ADA research project
Authors: Unger Darlene D. , Campbell Leanne R. , McMahon Brain T.
Published: November 2024

Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with mental retardation is documented. Researchers compare and contrast the key dimensions of workplace discrimination involving Americans with mental retardation and persons with other physical, sensory, and neurological impairments. Specifically, the researchers examine demographic characteristics of the CPs; the industry designation, location, and size of employers against whom complaints are filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcome or Resolution of these complaints.

Chi-square analyses revealed that persons with mental retardation were more likely to encounter discrimination involving matters of involuntary termination (discharge), involuntary resignation (constructive discharge), and harassment. They were less likely to encounter discrimination related to reasonable accommodation, promotion, demotion, and reinstatement. Allegations of employment discrimination by persons with mental retardation were more likely to have merit in comparison to allegations by CPs with other disabilities. Implications for policy and advocacy are addressed.
Multiple sclerosis and workplace discrimination: The national EEOC	ADA research project
Authors: Rumrill Phillip D. , Roessler Richard T. , McMahon Brian T. , Fitzgerald Shawn M.
Published: November 2024

Information from the Integrated Mission System of the United States Equal Employment Opportunity Commission (EEOC) was used to investigate the employment discrimination experience of Americans with multiple sclerosis (MS) in comparison to Americans with other physical, sensory, and neurological impairments. Specifically, the researchers examined demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom allegations were filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcome or resolution of these allegations. Findings indicate that persons with MS were younger than the comparison group and comparatively overrepresented by Caucasians and women. People with MS were proportionally more likely than the comparison group to allege discrimination related to reasonable accommodations, terms or conditions of employment, constructive discharge, and demotion. People with MS were proportionally more likely than the comparison group to file allegations against employers in the service and financial/insurance/real estate industries, employers with 500 or more workers, and employers in the North United States Census region. People with MS were proportionally more likely than the comparison group to receive merit resolutions as a result of the EEOC's Americans with Disabilities Act Title I investigatory process. Implications for policy and advocacy are addressed.
Workplace discrimination and asthma: The national EEOC ADA	research project
Authors: Lewis Allen N. , McMahon Brian T. , West Steven L. , Armstrong Amy J. , Belongia Lisa
Published: November 2024

This study investigates the nature, scope, and dynamics of employment discrimination among Americans with asthma using data from the US Equal Employment Opportunity Commission. When compared to a general disability group, higher proportions of employment discrimination allegations filed by persons with asthma involved females, African Americans, Native Americans, and people between 22 and 29 years of age. Allegations of employment discrimination were also greater for people with asthma for issues involving discipline, harassment, reasonable accommodation, and suspension. Allegations involving asthma were more likely to occur among large Respondents (employers) with industry designations of finance/insurance/real estate, service, or public administration. Charging parties within the asthma group had proportionately fewer cases closed With Merit. Implications of these findings are offered related to training, research, policy, and advocacy.
A national survey of consumer attitudes towards companies that	hire people with disabilities
Authors: Siperstein Gary N. , Romano Neil , Mohler Amanda , Parker Robin
Published: November 2024

Employers' negative attitudes and fears have long been a barrier to the employment of individuals with disabilities. Accordingly, attitude literature on the employment of people with disabilities has focused almost exclusively on employers. However, due to their influence over business practices, the successful employment of people with disabilities is also contingent on the views of the consumer. This study extends previous studies that focused on the attitudes of employers, and went directly to the consumer. Consumer attitudes toward companies that hire individuals with disabilities were assessed through a national public survey (N=803). Most of the participants (75%) had direct experience with people with disabilities in a work environment. Moreover, these experiences were positive. All participants responded positively towards companies that are socially responsible, including 92% of consumers who felt more favorable toward those that hire individuals with disabilities. The participants also had strong positive beliefs about the value and benefits of hiring people with disabilities, with 87% specifically agreeing that they would prefer to give their business to companies that hire individuals with disabilities. Implications of consumer support on company hiring practices are discussed.
The Ticket to Work Program: Marketing strategies and techniques to	enhance implementation
Authors: Wehman Paul , Revell W. Grant
Published: November 2024

The purpose of this paper is to provide a comprehensive review and critique of the marketing strategies best suited to expanding participation in the Social Security Administration's (SSA) Ticket to Work Program by Ticket holders and to increasing the number and diversity of Employment Networks (ENs). Direct mail, web based outreach, targeted marketing to selected opinion makers, specialized media outlets, and a number of other marketing strategies are critiqued and analyzed as a way to reach beneficiaries and ENs. The emphasis is on cost efficient strategies to maximize utilization of the Ticket.

The two main marketing issues related to ENs are: 1) There are not enough quality ENs, and 2) the ENs in place are not taking Tickets and making a sufficient number of placements for the Ticket to Work Program to be successful. Marketing considerations for ENs must expand the base of existing ENs to include the business community. EN partnerships are needed among the rehabilitation and business community, as are marketing strategies that reach business and encourage partnerships. The main marketing issue for reaching beneficiaries of Social Security Disability benefits who are current or potential Ticket holders is recognizing that at its very core, marketing the Ticket to Work involves first marketing employment. Marketing considerations for beneficiaries must recognize and address the employment-related fears, interests and support needs of Ticket recipients.
Technology use by people with intellectual and developmental	disabilities to support employment activities: A single-subject design meta	analysis
Authors: Wehmeyer Michael L. , Palmer Susan B. , Smith Sean J. , Parent Wendy , Davies Daniel K. , Stock Steven
Published: November 2024

Objectives: Technology has the potential to improve employment and rehabilitation related outcomes for persons with disabilities. The purpose of this study was to examine the impact of technology use on employment-related outcomes for people with intellectual and developmental disabilities.

Study design: A comprehensive search of the literature pertaining to technology use by people with intellectual disabilities was conducted, and a single-subject design meta analysis was conducted for a subset of those studies, which focused on employment and rehabilitation related outcomes.

Results: The use of technology to promote outcomes in this area was shown to be generally effective, in particular when universal design features were addressed.

Conclusions: Technology has the potential to enable people with intellectual and developmental disabilities to achieve more positive employment and rehabilitation outcomes. It is important to focus on universal design features important to persons with cognitive disabilities, and there is a need for more research in this area.
Technology for access to text and graphics for people with visual	impairments and blindness in vocational settings
Authors: Strobel Wendy , Fossa Jennifer , Arthanat Sajay , Brace Jennifer
Published: November 2024

The unemployment rate of people with disabilities has long been out of proportion to the general community despite federal goals and mandates to ameliorate the problem. A consistent issue is the access and knowledge related to accommodations. The need for accommodations for specific disability groups will vary according to the functional limitations presented by the disability. For instance, the accommodation needs for an individual with a significant physical disability will be very different than what one might need for a sensory disability such as hearing or vision loss. This paper will focus on the need for accommodation and emerging technologies in the employment of people with visual impairments.
Wheelchair ergonomics: Implications for vocational	participation
Authors: Arthanat Sajay , Strobel Wendy
Published: November 2024

Technological advancements and research in wheeled mobility devices continue along many paths. For people with mobility impairments, use of wheelchairs is imperative to vocational functioning and wellbeing. At the same time, a high prevalence of secondary complications attributed to long-term wheelchair usage is clearly indicated in literature. This article reviews research in wheelchair seating, propulsion, and transportation as three domains of wheeled mobility that embody wheelchair ergonomics in work settings. In doing so, some important biomechanical and ergonomic guidelines are drawn from research findings. The information is expected to provide useful directions to people using wheelchairs, co-workers, clinicians, and technology developers in addressing ergonomic issues with wheeled mobility.
Three-factor Model of multicultural counseling for consumers with	disabilities
Authors: Lewis Allen N.
Published: November 2024

This article provides counselors with a simplified representation of critical constructs in multicultural counseling: adjustment to disability, stage of development, and cultural identity. Exploring these factors will facilitate the working alliance and thereby serve to enhance the effectiveness of counseling interventions. The development and application of the Model is highly individualized in a manner consistent with rehabilitation philosophy.
The development of supported employment in Scotland
Authors: Ridley Julie , Hunter Susan
Published: November 2024

Supported employment is consistently identified as an effective employment or practice model. Its economic, social and other benefits are well documented, although several studies show variable outcomes especially in terms of economic benefits. It has been claimed that supported employment is widely implemented, not only in the United States, but also in many European countries including the UK and Scotland. However, this paper uses findings from research commissioned in Scotland to investigate the range of employment support available to people with learning disabilities and/or autistic spectrum disorder (ASD) and shows that for the majority, their aspirations for real paid jobs remain unfulfilled. Indeed, some of what currently passes for supported employment would not meet international conventions for defining supported employment. The findings are discussed in the context of a literature review of best practice.

The research identified examples of good practice, which provide just cause for celebration and fertile ground for growth. Nonetheless, the inconsistencies found arguably demonstrate that implementation of the model is weak or variable at best, which undermines the potential benefits of supported employment. Better and consistent implementation and, consequently, better outcomes from supported employment requires greater emphasis to be placed on self-determination, person centred planning, a career based approach and quality job development, all ensuring that the person remains at the centre of the process. Establishing a UK definition of, and quality standards in, supported employment would be beneficial.
Not just any job: People with psychiatric disabilities build	careers
Authors: O'Day Bonnie , Killeen Mary , Goldberg Susan
Published: November 2024

This article explores the career aspirations of thirty individuals with severe psychiatric disabilities who had been employed from 3 to 33 years. We included people in the study who had been hospitalized as adults or had been determined eligible for Social Security Disability benefits due to a psychiatric disability and were currently employed for pay at least 18 hours per week. Some had received assistance from vocational rehabilitation agencies; others had not. Through in-depth interviews, we examined how they view career development and how they set and obtain their long term goals. We found that the sample fell into two groups based upon their attitudes about the future and their employment aspirations over the next five years. Group One, consisting of 17 participants, said they wanted to change jobs or move ahead in their careers and had developed strategies to obtain their specific employment or career goals. The remaining 13 participants, those in Group Two, wanted to remain in the same position or obtain a similar job. We describe the factors Group One participants considered in establishing their career goals and the reasons why Group Two participants wanted to keep their current employment.
Vocational rehabilitation following traumatic brain injury: A	quantitative synthesis of outcome studies
Authors: Kendall Elizabeth , Muenchberger Heidi , Gee Travis
Published: November 2024

This study is a quantitative synthesis of research relating to Traumatic Brain Injury (TBI) and employment outcomes. Using broad inclusion criteria, 26 studies were selected for review. The study comprised a combined sample of 3688 participants aged 16 years and above who had sustained a TBI as an adult. Aggregate results across selected studies indicated that individuals with TBI returned to competitive employment and other productive activities earlier with vocational intervention than without intervention. The current synthesis also demonstrated that the use of a narrow definition of return-to-work (i.e., full-time competitive work only) produced more apparent unemployment than an inclusive definition (i.e., any competitive work or productive activity). Although this finding is not surprising, full-time employed persons seemed more likely to remain 'employed' over time compared to those who were in any type of employment or productive activity.

These findings have important implications regarding the timeliness of vocational interventions and highlight the need for competitive employment (full-time) preparation to ensure optimal long-term outcomes following TBI. The definition of employment and the nature of pre-injury employment is crucial to any interpretation of return-to-work in TBI. The current study also highlights the importance of measuring employment outcomes using multiple points over time, rather than single data points or first return-to-work.
Predictors of successful job finding in psychiatric vocational	rehabilitation: An expert panel study
Authors: Michon Harry W.C. , van Weeghel Jaap , Kroon Hans , Smit Filip , Schene Aart H.
Published: November 2024

The aim of this study is to understand the central focuses of work assessment in psychiatric vocational rehabilitation (PVR). Employing the RAND/UCLA panel method and multiple linear regressions, we analyzed the insights of experienced professionals to identify which client characteristics are key to the successful completion of vocational rehabilitation programs, aimed at integration into competitive jobs. It was found that successful job finding was predicted most strongly by better functioning in terms of generic work performance, followed by less severe psychiatric symptoms, better self-insight, a perceived need for change, and an ability to cope with work pressure. Basic social functioning, work history and acceptance of guidance were not identified as predictors. A next step would be empirical research in practice settings, systematically gauging the relative importance of the predictors identified here and elsewhere, as well as testing how useful it could be to base assessment in PVR on a crucial set of personal-level characteristics.
Salient and subtle aspects of demand side approaches for	employment retention: Lessons for public policymakers
Authors: Habeck Rochelle , Kregel John , Head Colleen , Yasuda Satoko
Published: November 2024

Public policies to stimulate demand side factors that affect the employment status of people with disabilities need to consider workplace efforts that support the continued employment of employees who develop work limitations from any cause (back door factors), as well as the hiring behaviors of employers (front door factors). Workplace participation rates are influenced by employment exits as well as placements. Little focus has been given to preventing separation from employment, despite evidence of the progression to public disability benefits. Factors that place employees who develop impairments or work limitations at risk for early exit from employment are discussed. Preliminary findings from a qualitative study of successful firms are identified and illustrated with practice examples. Implications of these effective interventions are raised, including the provision of workplace based services, the need for accommodations over time, and the role of employer incentives for retention.
Addressing employer personnel needs and improving employment	training, job placement and retention for individuals with disabilities through	public-private partnerships
Authors: Unger Darlene
Published: November 2024

As social and economic forces impact business practices, the significance of delivering effective employer-driven, employment services (i.e., demand-side model) to facilitate employment and retention for individuals who have not traditionally benefited from labor force participation is of increased importance. The purpose of this paper is to provide descriptions of two public-private partnerships (Manpower, Incorporated and Community Rehabilitation Programs; Project Search), that currently operate a market-driven or demand-side model in an effort to increase the labor force participation and job retention of persons with disabilities. Factors that increase employers' interest in collaborating with rehabilitation providers and critical components of effective partnerships are discussed.
Section 21 of the 1992 Rehabilitation Act Amendments and diversity	articles
Authors: Lewis Allen N. , Shamburger Aisha , Head Colleen , Armstrong Amy J. , West Steve L.
Published: November 2024

This study explores whether the passage of Section 21 of the Rehabilitation Act Amendments of 1992 is associated with an increased publication of articles on diversity topics in four mainstream rehabilitation journals to understand the correlation between the passage of this legislation and publication behavior among rehabilitation academics. The findings revealed that twice as many diversity-related articles were published after the passage of Section 21 of the 1992 Rehabilitation Act Amendments as before. Diversity themes among articles published before Section 21 differed from those published after its passage.
Maryland issues in supported employment
Authors: Conley Ronald W.
Published: November 2024

This paper describes how supported employment programs are part a set of comprehensive employment programs that began with the rehabilitation program in 1920. It describes a survey of the directors of supported employment programs in 24 service providers in Maryland (85 percent response rate). Two important conclusions were drawn. First, the individuals who are primarily responsible for the provision of supported employment services believe that improvement is needed to find more jobs, higher paying jobs, and jobs with more weekly hours for supported employees. Second, They acknowledged that a number of issues must be resolved. Transportation must be improved, particularly to jobs available during the evenings and weekends. Improved methods of funding should developed that more accurately support the individual service needs of diverse consumers, and with financial incentives to encourage both efficiency and effectiveness. All respondents agreed that meaningful data systems should be developed that would identify successes, failures, and problems, and most respondents believed that the system should identify the performance of each service provider.
Analysis of case managers' support of youth with disabilities	transitioning from school to work
Authors: Garcia-Iriarte Edurne , Balcazar Fabricio , Taylor-Ritzler Tina
Published: November 2024

In this study we analyzed employment-related supports provided by case managers in a transition program for urban ethnic minority youth with disabilities. We further assessed the influence of these supports on employment outcomes. Urban ethnic minority youth with disabilities often have lives that are complicated by a host of factors related to living in poverty that influence their ability to find and maintain employment. We found that program staff provided two types of supports to address work needs and living issues of these youth: job specific, related to on-the-job tasks, and off-site work supports, related to other areas of daily living. The results showed that both job specific and off-site work supports predicted higher employment retention for youth with disabilities.
General practitioners' awareness and understanding of vocational	rehabilitation in schizophrenia: A Tasmanian perspective
Authors: Crawley Tess , Fitzerald Natalie , Graham Holly
Published: November 2024

Objective: Meaningful employment is a common goal for those with schizophrenia [27] and can lead to significant clinical gains [18]. General practitioners provide a pivotal role in the care of individuals with schizophrenia, but lack of integration between clinical and rehabilitation services is a significant barrier to receiving vocational rehabilitation [31]. This study investigated general practitioners' awareness and understanding of the benefits of vocational rehabilitation in the treatment of schizophrenia.

Method: A 20-item questionnaire was mailed to 498 Tasmanian general practitioners accessed via the mailing lists of the Divisions of General Practice from each of the three Tasmanian regions: South, North, and Northwest. Responses were received anonymously from 102 participants. Results are reported as the percentage of responding general practitioners endorsing each item on the questionnaire.

Results: The majority of respondents indicated average knowledge of schizophrenia and the benefits of meaningful employment for these patients. However, results indicated low rates of referral for vocational rehabilitation, which participants attributed to restricted information about available services, poor integration of clinical and rehabilitation services, and lack of time to discuss vocational rehabilitation goals.

Conclusions: The current sample of Tasmanian general practitioners recognised the benefits of vocational rehabilitation in the management of schizophrenia, however they lack the appropriate resources (information, consultation time) to effect appropriate referrals to these services. Improved information dissemination to general practitioners, in particular information relating to available services and referral pathways, may improve referral rates for patients with schizophrenia to appropriate vocational rehabilitation services.
Does type of provider organization affect fidelity to	evidence-based supported employment?
Authors: Campbell Kikuko , Bond Gary R. , Gervey Robert , Pascaris Alysia , Tice Shaleigh , Revell Grant
Published: November 2024

Objective: To compare fidelity of implementation of supported employment in different types of provider organizations.

Methods: Using opportunity sampling, a multi-state survey yielded a sample of 106 supported employment programs, including 33 located in community mental health centers (CMHCs), 18 located in psychosocial rehabilitation centers, 31 located in comprehensive rehabilitation centers, and 24 housed in other social service agencies. Program directors completed a telephone interview on the Quality of Supported Employment Implementation Scale (QSEIS), a 33-item supported employment fidelity scale.

Results: CMHC-based programs rated significantly higher on fidelity than programs housed in psychosocial rehabilitation or comprehensive rehabilitation centers. Integration with mental health treatment was the key factor differentiating the types of provider organizations.

Conclusions: Type of provider organization is an important factor in facilitating implementation of evidence-based principles of supported employment.
Perception of illness as a barrier to work in consumers of	supported employment services
Authors: Johannesen Jason K. , McGrew John H. , Griss Mélina E. , Born Dennis
Published: November 2024

Although supported employment (SE) helps most individuals with mental illness find employment, many continue to face significant barriers to achieving their vocational goals. In this 12-month prospective study, consumer perceptions of illness-related (e.g., medication side effects) and common (e.g., transportation) barriers to employment were assessed in relation to work and rehabilitation outcomes. At the time of SE enrollment, endorsement of illness-related barriers correlated negatively with hopefulness and quality of life, whereas endorsement of common barriers correlated negatively with clinician ratings of independent functioning. Both total barriers and common barriers correlated negatively with later employment attainment.
Situational assessment in psychiatric rehabilitation: A	reappraisal
Authors: McGuire Alan B. , Bond Gary R. , Evans Jovier D. , Lysaker Paul H. , Kim Hea Won
Published: November 2024

Background: One widely-used approach in the vocational rehabilitation field is the situational work assessment, in which staff rate general worker behaviors relevant to any employment setting. The Work Behavioral Inventory (WBI) is a standardized situational assessment developed specifically for individuals with severe mental illness (SMI). Originally developed in a sheltered workshop environment, its application in community settings has not been studied. We examined the predictive validity for the WBI in a range of community and agency settings.

Methods: Using a prospective longitudinal study, we assessed 52 clients with schizophrenia spectrum disorders newly enrolled in a vocational program at a psychiatric rehabilitation agency. Participants were followed for nine months and assessed every two months on the WBI.

Findings: WBI ratings were unrelated to employment outcomes in the full sample at nine months. However, among participants who obtained paid employment at some time during follow-up, WBI ratings were positively associated with total wages earned, weeks worked, and paid hours worked.

Conclusions: Situational assessment is a useful method for predicting employment outcomes for individuals with schizophrenia who obtain work. However, its utility in predicting initial job acquisition is uncertain. In addition, the limitations in the use of situation assessments in community employment settings raise questions about how it would be best adapted in programs implementing evidence-based supported employment.
Determinants of return to work among spinal cord injury patients:	A literature review
Authors: Anderson Donna , Dumont Serge , Azzaria Leila , Bourdais Marie Le , Noreau Luc
Published: November 2024

This paper presents a review of the literature of articles that examined determinants of return to work, among persons who experience spinal cord injury. Results of the review highlight the low rate of employment among persons with spinal cord injury. A total of fourteen common factors that influence professional reintegration were identified. These factors include: education, type of employment, severity of the lesion, age, time since injury, gender, marital status and social support, vocational counselling, medical problems, employer's attitudes, race, psychological state, and environment. While a number of variables associated with return to work were identified, there exists great variability across studies. Consequently, no clear conclusion on return to work can be drawn from the literature. This article highlights factors that facilitate professional reintegration, identifies gaps in the literature and suggest paths for future research.
Slow change in the employment services market: The early years of	Ticket to Work
Authors: Thornton Craig , O'Leary Paul
Published: November 2024

The Ticket to Work program, together with other initiatives created by the Ticket to Work and Work Incentives Improvement Act, attempts to develop a new employment services marketplace to increase the level and mix of employment support services for SSA beneficiaries interested greater self-sufficiency. Rather than setting up a single training program, TTW establishes payment mechanisms designed to induce employment-service providers to increase the supply of programs and the range of approaches. In this paper we review early finding for the three essential ingredients necessary for TTW success: the sufficiency of beneficiary demand for employment services with an aim toward eventually leaving SSA benefits; the adequacy of the supply of new employment service providers to meet beneficiary demand with efficient and innovative approaches not already available through the previous state VR system; and the sufficiency of SSA support to facilitate the new market, providing information to beneficiaries and providers, and efficient management of the ticket payment system. Supporting survey data indicate that there may be substantial unmet demand for employment services that TTW could fill. The supply of new and innovative employment service providers, however, has thus far been anemic due to a perception by providers that the new program is too risky and cumbersome relative to potential payments offered. SSA has made strides in implementing the program and continues to offer program changes to improve how TTW functions. We conclude that it is too early to tell whether the changes implemented and proposed thus far will revive interest in the program and energize the service delivery market.
Social Security disability beneficiaries: Characteristics, work	activity, and use of services
Authors: Livermore Gina A. , Goodman Nanette , Wright Debra
Published: November 2024

We present findings from the 2004 National Beneficiary Survey (NBS), a nationally representative survey of Social Security disability beneficiaries conducted by Mathematica Policy Research for the Social Security Administration as part of the Ticket to Work program evaluation. The NBS data provide an overview of the health and sociodemographic characteristics of Social Security disability beneficiaries, and highlight their employment activity, work aspirations, and use of employment-related services. Although most beneficiaries have significant health problems that limit their ability to work, the NBS data suggest that there is potential demand for employment and employment-related services among Social Security disability beneficiaries. While only a small share of beneficiaries are employed or actively seeking employment, a rather substantial number have goals that include work and see themselves working in the future, and many have used employment-related services during the previous year. The NBS data also suggest, however, that even if beneficiaries have employment aspirations and attempt to work, many potential challenges to successful employment may need to be addressed. In addition to the activity limitations and poor health associated with their disabling conditions, most beneficiaries: have low levels of education that might limit their employment opportunities; are living at or near poverty, suggesting that they and their families may rely on public programs for which eligibility could be jeopardized by earnings; and many have experienced work-related obstacles such as a lack of reliable transportation, inaccessible workplaces, and discouragement from work either by others or through their own experiences.
Beneficiary participation in Ticket to Work
Authors: Stapleton David , Livermore Gina , Gregory Jesse
Published: November 2024

This article examines the participation of Social Security disability beneficiaries in the Ticket to Work (TTW) program through December 2004. On an absolute scale, participation is very low, and perhaps much lower than many had hoped. Participation is not low relative to the historical rate for program exits due to work, however, and certain groups of beneficiaries participate at higher rates than others. A large majority of participants assign their Tickets to state vocational rehabilitation agencies (SVRAs), predominantly under the traditional, cost reimbursement payment system. Most SVRA administrators indicate that they have not made major changes to the way they serve their beneficiary clients as a result of TTW. These findings suggest that, through December 2004, TTW does not represent a significant departure from the past. Participants with Tickets assigned to ENs are substantially more likely than those with Tickets assigned to SVRAs to earn at a level that will lead to program exit. This finding likely reflects the strong incentives that ENs have to serve only those with a high likelihood of exiting the rolls, but might also reflect greater EN focus on achievement of high earnings.
Experiences of State Vocational Rehabilitation Agencies with the	Ticket to Work program
Authors: O'Day Bonnie , Revell Grant
Published: November 2024

This article describes the experience of State Vocational Rehabilitation Agencies (SVRAs) with the Ticket to Work (TTW) program. We examined administrative data from the Social Security Administration and the Rehabilitation Services Administration and conducted site visits and telephone interviews with SVRA officials in 25 states as part of a five-year evaluation of the TTW program.

The recession of 2001–2002, along with recent financial constraints due to increased service demand and shrinking state budgets, has negatively affected TTW implementation. SVRAs have spent significant time and energy implementing TTW, particularly assigning Tickets with little apparent benefit to its clients, according to SVRA officials. They also expressed concerns about conflicts between the necessity to obtain Ticket assignments from new and existing clients to receive SSA payments under the traditional cost reimbursement system and the requirements to provide maximum consumer choice under the Rehabilitation Act. New draft regulations rescind this requirement and it remains to be seen what the future role of SVRAs in the Ticket program will be.
The involvement of Employment Networks in Ticket to Work
Authors: Silva Tim
Published: November 2024

In creating the Ticket to Work (TTW) program to move more disability beneficiaries off the rolls and into self-supporting employment, Congress felt that a major key to success would be increasing consumer choice and establishing a competitive market for return-to-work services. State vocational rehabilitation agencies long had been the dominant players in this field, but under TTW, a wide variety of private and public entities can register as Employment Networks (ENs) to accept Tickets from, and provide services to, disability beneficiaries who want to work at a level that will take them off cash benefits. Given the potential importance of ENs, the national evaluation of TTW has devoted considerable attention to understanding their involvement in the program. For three consecutive years, we analyzed administrative data on EN enrollment and on Ticket assignments and payments, and interviewed many EN representatives from around the country. This paper highlights the evaluation's findings concerning ENs' involvement in Ticket to Work.

A variety of measures suggest that ENs' involvement has been limited. By June 2005, about 1,400 organizations were registered as ENs, but they were not necessarily readily available to many Ticket-eligible beneficiaries. A majority of ENs had not accepted a single Ticket, and ENs accounted for less than 10 percent of all Ticket assignments. ENs' involvement in TTW has been substantially influenced by three main factors: concerns about financial feasibility, low demand for EN services, and administrative challenges. These issues became apparent early in the program's rollout and continue to affect EN involvement today. In September 2005, SSA proposed new regulations intended to reduce the financial risk to ENs but, as of this writing (September 2007), the changes had not been implemented. It remains to be seen whether the proposed changes, if implemented, really will stimulate greater EN involvement.
Priorities and changing practices: Vocational rehabilitation and	community colleges improving workforce development programs for people with	disabilities
Authors: Flannery K. Brigid , Slovic Roz , Benz Michael R. , Levine Ellen
Published: November 2024

Short-term training programs are viable employment training options for individuals with disabilities seeking family-wage jobs. The purpose of this article is to describe (a) a community college short-term training program that was adapted in partnership with vocational rehabilitation to meet the needs of vocational rehabilitation consumers attending these programs, and (b) the continuous improvement process, which includes a self-assessment tool and action planning that was used to adapt the program to address the needs of vocational rehabilitation consumers. After identifying a set of features and indicators of successful short-term training programs, a self-assessment/continuous improvement process was implemented. This collaborative process provided a mechanism for the college programs and stakeholders to make necessary adjustments to support students also served by the vocational rehabilitation system. The self-assessment tool and action-planning process were demonstrated to be efficient, flexible across college and vocational rehabilitation regions, and important ingredients for assisting stakeholders from a variety of agencies to work together to improve outcomes for individuals with disabilities.
Self-efficacy and interdependence as predictors of life	satisfaction for people with disabilities: Implications for independent living	programs
Authors: Gooden-Ledbetter Melva J. , Cole Michele T. , Maher Jill K. , Condeluci Al
Published: November 2024

Independent Living Programs continue to search for ways through which their services can have a more positive impact on people with disabilities and can provide increased satisfaction with their lives. This study, conducted at a nonprofit community rehabilitation organization in southwestern Pennsylvania, was designed to assess the extent to which two different teaching goals of one Independent Living Program, self-efficacy and interdependence, influenced life satisfaction for people with disabilities. The study found that while both were significant variables, interdependence was a more significant predictor of life satisfaction. The recommendation for Independent Living Programs is that they focus on teaching interdependence as a life-style approach, in combination with teaching self-efficacy skills, to maximize the person's ability to achieve life satisfaction.