Joni N. Dolce

The relationship between hope and symptoms.

OBJECTIVE Hope is a critical aspect of the recovery process for persons with serious mental illnesses. The goal of this pilot study was to assess the relationship between hope and symptoms for a cohort of individuals with mental illnesses receiving supported employment services. METHOD A total of 74 participants enrolled in supported employment were assessed on their level of hopefulness, hopelessness and psychiatric symptoms. Correlations were performed to determine the relationship between hope and psychiatric symptoms, and hopelessness and psychiatric symptoms. RESULTS The findings indicated a significant inverse relationship between hope and symptoms, and a significant positive relationship between hopelessness and symptoms. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Hope and symptoms were inversely related, highlighting the importance of developing a wellness strategy that addresses managing symptoms as part of ones recovery process. Additionally, this finding highlights the critical role of PsyR providers in supporting people in recovery with developing a wellness strategy that will both help ameliorate symptoms and increase hope.

A study of the impact of social support development on job acquisition and retention among people with psychiatric disabilities

The current study examined the relationship between specific techniques for developing social support (i.e., Person Centered Planning) and job related outcomes among 110 individuals with psychiatric disabilities receiving Supported Employment (SE) services in a northeastern state. Seven SE programs participated. All individuals receiving SE services from any of the seven SE programs were eligible to enroll in the study. Participant data were collected on demographics, psychiatric history, work history, and social support over a period of two years. Data on the use of Person Center Planning practices were collected from SE staff every three months for the first 12 months of the study. This information was recorded in the Quality Indicators Survey, an instrument developed for this study. A positive relationship was found between total days employed and the number of non- paid supporters an individual reported having; a negative relationship existed between total days employed and number of paid supporters; and there was a positive correlation between total days employed and Person Centered Planning techniques used at nine and 12 months.

A Case Illustration of Strategies to Improve Employment Outcomes Among Individuals Receiving ACT Services

This article describes a New Jersey Assertive Community Treatment (ACT) teams experience of enhancing employment outcomes. Through specific interventions focusing on increasing the teams skills and knowledge in providing employment services and commitment to this endeavor, this team was able to successfully improve consumer employment rates from 5% to 24% in a 12-month period. The strategies and interventions that can be generalized with other ACT teams with the goal of increasing employment outcomes are discussed.

The Paradoxical Relationship Between Hope and the Educational Level of People in Recovery

Education is considered a critically important asset in our society. Many people living with serious mental illnesses possess college and advanced degrees. However, the disruption to ones life from serious mental illness is often a barrier to actualizing career goals that were formulated before the onset of mental illness. The current study explores the relationship between educational level and hopefulness, after controlling for psychiatric symptoms, for a sample of participants in rehabilitation services seeking employment. A total of 84 participants enrolled in supported employment services completed assessments of hopefulness, psychiatric symptoms, and educational level. Hierarchical multiple regression was utilized to determine the relationship between the criterion variable hope and the predictor variables. The findings indicated a significant inverse relationship between hope and symptoms and a significant inverse relationship between hope and educational level. The findings suggest that maintaining hope of people in recovery with higher educational attainment may be a cogent issue for the field. Future research is indicated.

In-vivo job development training among peer providers of homeless veterans supported employment programs.

TOPIC This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). PURPOSE Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. SOURCES USED The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record

Improving Employment Outcomes in Assertive Community Treatment (ACT): The Role of the ACT Nurse.

Assertive community treatment (ACT) for individuals with serious mental illness is a community-based mental health service model where nurses play a significant leadership role as health and wellness educators and consultants to consumers and fellow staff members. The ACT model was designed to include a vocational focus as an important aspect of community integration. Nevertheless, research suggests that ACT does not assist a significant number of consumers in achieving employment goals. Nurses can play a critical part in the recovery and wellness of individuals receiving ACT services. Individual placement and support principles provide a foundation for implementing employment into current services.

A study of the perceived barriers to the implementation of circles of support.

OBJECTIVE The purpose of this study was to identity barriers to implementing the social support intervention, Circle of Support, in supported employment (SE) services for people with psychiatric disabilities. METHOD Semi-structured interviews were administered to SE staff at three month intervals up to one year. Two focus groups were held with service recipients who did not participate in a circle of support. Interviews were conducted with two individuals receiving SE services who participated in a pilot project in which study researchers implemented circles of support. RESULTS Common themes regarding the barriers to implementing a circle of support developed from the data. Service recipients who did not participate in a circle of support and those who did expressed the perceived and actual barriers to this approach as being: time, too much focus on the participant, and lack of control/facilitation of circle activities. Service recipients who participated in a pilot who had circles of support reported that this intervention was beneficial to them. Staff and service recipients identified time, running of the actual circle of support meetings, and supporter issues as barriers to implementing this technique. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although certain barriers to this technique were identified, there were features of this approach that both staff and service recipients, who had a circle of support, found beneficial. Since ongoing support is a critical component of successful employment, individuals may benefit from the use of these Circles of Support techniques.

Effect of Psychiatric Symptoms on Employment Outcomes for Individuals Receiving Supported Employment Services: A Preliminary Study

Psychiatric symptoms are often cited by community-based providers as barriers to employment for individuals with mental health conditions. The current study assessed whether psychiatric symptoms and hospitalization in the past year predicted employment outcomes for participants receiving supported employment (SE) services. A total of 105 participants enrolled in SE services were assessed on their level of psychiatric symptoms, hospitalization in the past year, and employment outcomes. Simultaneous logistic regression was used. Eighty-two participants met for the 6-month follow up. Findings indicate that higher overall scores on the 6-month Brief Symptom Inventory (BSI) are predictive of an employment outcome, and suggest that psychiatric symptoms were not a barrier to employment. Participants with higher overall scores on the BSI, thus suggesting greater symptoms, were more likely to gain employment than individuals with lower BSI scores. [Journal of Psychosocial Nursing and Mental Health Services, 56(3), 33-38.].