A Consumer-Initiated Job Search Training Program (1993)

The field of psychosocial rehabilitation services emphasizes the fostering and strengthening of consumer-initiated supports. In contrast to other fields of mental health practice, including the community mental health movement and medical approaches to treatment, the service framework of psychosocial rehabilitation stresses the importance of not only involving consumers in the process of service development but also respecting the role of consumers in supporting one another (Chamberlin, Rogers, & Sneed, 1989) and in initiating their own supports. Accountability in this field emphasizes the importance of client satisfaction and the involvement of consumers in active choices both about the environments in which they to live and in choices about roles they to fulfill (Farkas, Anthony, & Cohen, 1989). Involving consumers directly in the process of determining what they want and how they to obtain services and supports is becoming a hallmark of psychosocial rehabilitation ideology (Cohen & Anthony, 1988). There is considerable compatibility between psychosocial rehabilitation and that aspect of the consumer movement which emphasizes client self-determination in setting service goals and in identifying the means of achieving these ends (Moxley & Freddolino, 1990). Thus, self help and social support options undertaken by consumers themselves (Chamberlin, 1989) or by consumers working in partnership with rehabilitation professionals are viable aspects of the psychosocial rehabilitation model (Freddolino, Moxley, & Fleishman, 1989). In this manner, the field itself reflects a larger trend in the human services underscoring the critical importance of both self-help and social supports -- that is, the exchange among people of affective, material, and instrumental resources -- in responding to people's needs (Maguire, 1991; Powell, 1987; 1990). The recent National Plan of Research to Improve Services (1991), undertaken by the National Institute of Mental Health, complements psychosocial rehabilitation's value of consumerism by emphasizing the importance of enhancing consumer involvement in decision-making about service delivery. Consumer-initiated supports are easy to define and recognize. These supports are not controlled or dominated by professionals. They involve any service and support consumers themselves initiate, plan, organize, deliver, and evaluate (Chamberlin, 1989). Or, alternatively, they may involve actual initiation and planning of services and supports while professionals collaborate in the delivery of the program perhaps through the provision of technical assistance. However, this delivery is controlled and evaluated by consumers. At a minimum two qualities are important. First, consumers offer the leadership and inspiration for the program. Second, any subsequent programming is based on the self-identified needs of consumers themselves. Consumer-initiated supports may be most important in vocational development. Assessments of consumer preferences regarding supports illustrate the high priority consumers place on obtaining training, educational, and vocational development opportunities which result in employment (Freddolino, Moxley, & Fleishman, 1988). Relevant vocational development opportunities, transitional employment, and supported employment have been successfully offered by psychosocial rehabilitation professionals (Danley, Rogers, & Nevas, 1989; Danley, Sciarappa, & MacDonald-Wilson, 1922; Yankowitz, 1990). Yet, given the relatively high unemployment rate among people with serious psychiatric problems, and the interest among consumers in vocational opportunities, it is unlikely that professionals can fulfill all of the expressed need in this area. In recognition of these limitations, beginning in 1985 the Ohio Department of Mental Health formulated, as part of its state Community Support Program, Consumer Operated Services Demonstration Projects. …