Becoming a consumer-provider of mental health services: Dialogical identity development in prosumers in the U.S. and Japan

The aim of this study was to examine the process in which peer-delivered service providers, or prosumers, developed an identity as a prosumer in the United States and Japan. Participants were 25 prosumers from the United States and 23 from Japan, who provided peer-delivered services for wages. The authors analyzed data from qualitative, in-depth interviews and created a conceptual model of prosumer identity development. In addition, the authors identified common themes that characterized their experiences as developing prosumers and contextual factors that affected their identity development from a social constructionist perspective. Results indicate the following: (1) prosumers experience sense of worth and/or distress affected by societal, cultural, and historical factors of their environment associated with prosumer work; and (2) prosumers develop a prosumer identity as they pursue a sense of worth and actively address distress, by integrating the preexisting consumer and provider positions at a higher level. Participants who had established prosumer identity described how they created unique relationships with consumers and colleagues rather than seeking to fit into predesigned molds. In conclusion, the authors discuss the vital connection of prosumer identity development with relationships with consumers and colleagues, and roles and needs of supervision and training for prosumers to promote their identity development through open discussion as well as active exploration of sense of worth and distress, and possible impact of prosumer identity development for inducing organizational and systemic changes in mental health service system

Community integration: Conceptualisation and measurement

Purpose. To provide an overview of the conceptualisation of community integration as proposed in the literature, to review select measures of community integration that have been frequently used in disability and rehabilitation, and finally, to discuss future directions for community integration research. Method. Review of select measures published in PsycInfo- and PubMed-indexed literature representing a width of community integration conceptualisations. Conclusions. A variety of measures have been developed and validated in disability and rehabilitation research addressing different models of community integration, with additional measures originally developed in the adjacent disciplines presenting potential for application to research in community integration for individuals with disabilities. Research is needed to further clarify the multidimensional nature of community integration and to develop sound measures of community integration. To the extent that community integration is a function of various factors (e.g. individual and contextual) and involves multiple dimensions (e.g. physical, social and psychological), the advancement in research in this area should, in turn, contribute to planning and implementation of interventions directed at individual and societal levels, including relevant policymaking, towards expansion of community integration

Lupus: Vocational aspects and the best rehabilitation practices

BACKGROUND: Lupus (systemic lupus erythematosus; SLE) is a chronic autoimmune disorder, and is usually diagnosed initially in early to middle adulthood, which is the prime career-building phase of individual\u27s life. Persons with lupus report considerable financial burden not only because of healthcare costs but also because of compromised ability to engage in paid work due to illness as lupus can have a significantly negative impact on a person\u27s work participation, including loss of employment and reduced working hours. Rehabilitation counselors must be knowledgeable about the critical physical and psychosocial impacts of the illness and potential employment problems that the illness may cause. With this knowledge base, rehabilitation counselors can better assist individuals with lupus with obtaining and maintaining employment, economic independence, and balancing their life demands with their changing health care needs. OBJECTIVE: This paper first provides an overview of lupus and functional limitations that it may impose, followed by relevant vocational rehabilitation interventions, including workplace accommodations and education. CONCLUSIONS: We emphasize consumer advocacy, anticipatory coping and illness management, accommodations on the job, and need of active involvement of employers in problem solving as key elements of successful vocational rehabilitation for people with lupus

Participatory Action Research with College Students with Disabilities: Photovoice for an Inclusive Campus

College students with disabilities face various barriers to academic and social engagement. The present project was conducted based on principles of participatory action research (PAR) using Photovoice method with six students, gathering images representing such barriers, and developing narratives to describe the problems as well as possible ways to address them. With follow-up actions, the project prompted a number of attitudinal and architectural changes on campus. In addition, the participating students reported empowering effects of the project on themselves, consistent with the premise of PAR, indicating a potential of PAR with Photovoice methodology in both empowering students with disabilities and transforming university campuses to more inclusive environment. Photovoice can be employed by disability service providers to encourage students to be their own advocates to tell their stories about campus accessibility. Students’ perspectives can inform public policy to address barriers to be more inclusive to higher education that they experience

Qualitative analysis of the peer-mentoring relationship among individuals with spinal cord injury

Objectives: To identify salient dimensions and outcomes of the peer-mentoring relationship among individuals with spinal cord injury (SCI). To understand from the perspective of the mentee how the mentoring relationship differs from other supportive relationships. Study Design: Qualitative. Participants: Convenience sample of 7 mentees from a hospital-based SCI peer-mentoring project. Method: Telephone interviews with mentees were conducted 1-4 months postdischarge, and results were coanalyzed with grounded theory methodology. Results: Mentees emphasized the impact of the mentor in terms of his or her practical, emotional, and identity-changing influence. Relationship quality was influenced by multiple factors (e.g., age, friendliness). Five components of the relationship (credibility, equitability, mutuality, acceptance, normalization) differentiated mentoring from other supportive relationships. Conclusions: Peer mentors provide a unique combination of supportive elements not replicated by other relationships. Mentoring programs are useful interventions for facilitating adjustment after SCI. Recommendations for implementing a mentoring program are provided on the basis of participant suggestions

The effect of task-specific self-efficacy on stages of change of people with substance abuse problems

The objective of the study was to determine the effect of task-specific self-efficacy on stages of readiness for change among people with substance abuse problems. Participants were 140 men and 33 women with substance abuse problems receiving services in outpatient therapeutic community service programs. The Stages of Change Scale-Substance Abuse (SCS-SA) was the outcome measure. People with substance abuse problems receiving outpatient treatment services can be meaningfully classified into four stages of change groups: (1) Precontemplation, (2) Inactive, (3) Ambivalent-Conforming, and (4) Participation. Readiness for change is related to self-efficacy in work-related skills and risk-avoidance skills. Task-specific self-efficacy is related to stages of change. The findings of this study suggested that providing skill training to enhance task specific self-efficacy can help people with substance abuse problems progress from lower level to higher level of stages of change

Psychometric Validation of the Taiwanese Version of the Job Satisfaction of Persons with Disabilities Scale in a Sample of Individuals with Poliomyelitis

Objective: To evaluate the measurement structure of the Taiwanese Version of the Job Satisfaction of Persons with Disabilities Scale (JSPDS). Design: A quantitative descriptive research design using exploratory factor analysis (EFA). Participants: One hundred and thirty-two gainfully employed individuals from Taiwan with poliomyelitis participated in this study. Results: EFA result indicated a three-factor structure accounting for 54.1 per cent of the total variance. The internal consistency reliability coefficients for the integrated work environment, job quality, and alienation factors were 0.91, 0.77, and 0.59, respectively. Only the integrated work environment and job quality factors showed positive correlations with life satisfaction. People with higher educational attainment also reported higher levels of job satisfaction than people with lower educational attainment. Conclusion: The three-factor measurement structure of the JSPDS appears to be parsimonious, psychologically meaningful, and interpretable, and can be used to improve the comprehensiveness of vocational rehabilitation outcome evaluation