The IPS fidelity scale as a guideline to implement Supported Employment

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Arbeidsre-integratie. Personen met psychische problemen, arbeidstrajectbegeleiders en hulpverleners.

Employment constitutes a major and important pa rt of our lives and contributes to welfare and wel l-being. Yet, the competitive employment rate of p eople with (severe) mental health problems is low. The Individual Placement and Support (IPS) m odel of Supported Employment is an evidence-b ased vocational rehabilitation (VR) model proved t o increase competitiveemployment rates. For t his, IPS programs adhere to some important princip les, e.g. working with patients’ preferences , quick job searching, focusing on competitive emp loyment and integration of employment counselorsin ¨mental health teams. Within the V R process, three stakeholders need to join forces: ¨the patient, the mental health practitioner andth e VR counselor. The VR process can be hindere d when the patient and the mental health practitio ner have different ideas and goals concerning ¨the VR process. Moreover, when even the VR counse lor is not intending tofocus on competitive jobs,¨ low competitive employment outcomes can be expecte d. Although there is some proof that the abovement ioned barriers can occur, many questions rema in. This doctoral project aims to increase knowled ge and consists of two research parts covering thr ee studies. In the first research¨ part we answered the following questions: “W hich vocational goals are held by hospitalized pat ients with severe mental health problems?” a nd “Do patients and mental health pract itioners hold the same perspectives concerning VR¨ goals, barriers and support?”. For thi s, a cross-sectional study in which answers of pat ients were linked with answers of their mental hea lth practitioners. The second research part covere d two studies. First, VR programs were assessed on ¨whether they implement IPS principles. Second, we ¨answered the question “What determines VR counselors’ intentions to focus on compe titive jobs?” using a questionnaire based on the Theory of Planned Behavior. T he results of the first studies show that more pat ients than practitioners find a competitive job a prospect. They also hold different perspectiv es concerning vocational barriers and supports nee ded to overcome goals.In the second research part, ¨we conclude that VR services focus too less on in tersectoral collaboration with mental health servi ces, a quick job search and a focus on competitive ¨jobs. VR counselors seem to focus onsuch job s when they hold positive attitudes, are supported , have prior experiences with focusing on competit ive jobs and when they recognize the fact that the ir behavior can have an important influence o n the life of others (moral aspect of the job ). Different practical implications can ¨be made. Practitioners must actively assess vocat ional goals and try to work out a treatment plan.¨ For this, the VR counselor must be involved. The V R counselor should be trained and coached intensiv ely in order to stimulate positive attitudes¨ towards competitive jobs. Colleagues and superviso rs must form a solid team in which they offer supp ort toeach other. Moreover, practitioners and VR c ounselors must be regularlyupdated about outcomes¨ of VR counseling, even after counseling has ended. The study calls for more research conc erning those who no longer desire a job as a resul t of inconsistent regulations, stigma, and ne gative perspectives of professionals.Summary Samenvatting Contents List of figures List of abbreviations Chapter 1. Introduction 1 1. Evolutions in mental health care 3 2. Employment 8 3. Vocational rehabilitation 13 4. Stakeholders in the VR process 25 Chapter 2. Objectives and methods 33 1. Research gaps 35 2. From research gaps to studies 37 Chapter 3. The Theory of Planned Behavior 41 1. Core concepts of the TPB 43 2. Appraisal of the TPB 46 Chapter 4. Hospitalized patients and their practitioners 51 Chapter 5. VR programs and IPS 69 Chapter 6. Counselors’ focus on competitive employment: Theory of Planned Behavior 93 Chapter 7. Beliefs of Vocational Rehabilitation Counselors 115 Chapter 8. General discussion 141 1. Key findings 144 2. Strengths, limitations and future perspectives 153 3. Suggestions for future research 158 4. Implications and general policy recommendations 162 5. Conclusion 167 References 169 Appendices 179 Professional career 187 List of publications 189 List of national and international presentations 189 List of reports and articles in non-peer reviewed journals 190 Dankwoord 193nrpages: 207status: publishe

De perspectieven over arbeid van patiënten met een psychiatrische problematiek en hun begeleiders

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The IPS Fidelity Scale as a Guideline to Implement Supported Employment

Abstract. Objective: Despite the wish of many people with SMI to work in a competitive job, employment rates are low. IPS is more effective than other vocational rehabilitation methods in achieving employment and its use should be extended to bridge the gap between user wish and reality. This study measures possibilities to implement IPS in Flanders, by investigating current use, barriers and facilitators across a wide range of services. Method: Semi-structured interviews with 17 vocational rehabilitation agencies were conducted, using the IPS Fidelity Scale and a list of open-ended questions on perceived barriers and opportunities. Results were analyzed via thematic analysis. Results: Results show an overall lack of implementation of IPS in Flanders, especially on the four core elements for which most evidence exists. An external style of attributing barriers to environment factors or client characteristics is apparent which could lead to a sense of resignation among counselors. Conclusions: The use of the IPS fidelity scale and open-ended questions has provided concrete levers to prepare for implementation: a strong leadership in the agencies to encourage optimism towards regular employment for people with SMI; closer co-operations between employment agencies, care agencies and employers; and a more facilitating legislation concerning using IPS.status: publishe

Supported employment fidelity in Flemish vocational programs

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Supported employment fidelity in Flemish vocational programs

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Perspectives of hospitalized patients with mental disorders and their clinicians on vocational goals, barriers, and steps to overcome barriers

People with mental disorders experience difficulties with finding competitive jobs. In countries with longer psychiatric hospitalization periods, the vocational rehabilitation process can start during hospitalization. Yet, rehabilitation can be hindered by a lack of focus by clinicians on the patients' vocational goals and a lack of agreement between clinicians and patients.peerreview_statement: The publishing and review policy for this title is described in its Aims & Scope. aims_and_scope_url: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ijmh20status: publishe

Counsellors' focus on competitive employment for people with severe mental illness: an application of the theory of planned behaviour in vocational rehabilitation programmes

© 2015 Taylor & Francis. Although the evidence-based Individual Placement and Support programme highlights the importance of the vocational rehabilitation (VR) counsellors' focus on competitive employment during career counselling, studies have shown that counsellors do not always target such jobs. This study examines which determinants affect the counsellors' intentions using an extended version of the Theory of Planned Behaviour. Cross-sectional data of 263 VR counsellors of three public employment services were analysed using structural equation modelling. A path model comprising attitudes, prior behaviour, and subjective and moral norms explained 69% of the variance in intentions. The findings indicate that counsellors focus more on competitive employment when they (1) view the placement in a competitive job as positive, (2) experience support and (3) have prior relevant experiences.peerreview_statement: The publishing and review policy for this title is described in its Aims & Scope. aims_and_scope_url: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=cbjg20status: publishe

Op weg naar een Vlaams mantelzorgplan: Een moedig, nuttig en ambitieus initiatief

Vlaams welzijnsminister Jo Vandeurzen maakt het ontwerp van zijn langverwachte beleidsplan mantelzorg bekend. Is dat een goed of slecht plan?no ISSN. no volume/issuestatus: publishe