vietnam delegation vr presentation
TRANSCRIPT
Vocational Rehabilitation Services: Service Development
Presented By:Michael Walsh, Ph.D, LPC, CRC, CPRP
andKimberly Tissot, Executive Director: Able South
Carolina
Agenda
Welcome and Introductions Your Thoughts and Questions History: Vocational Rehabilitation Services in
the U.S. Disability Rights Movement Types of VR Services Customization of VR Services by States Customization of VR Services by Consumer
"Tell me and I'll forget; Show me and I may remember; Involve me and I'll understand."-Chinese Proverb
What do you hope to get from today’s meeting?
How may we be most helpful to you?
(Open Discussion)
VR service development typically follows economic need--
◦ History as a blueprint
Early 1900’s- World War One: Dawn of Industrial Age: People with disabilities begin to be seen as needed by industry, especially as casualties mount. Medical advances allow for increased survival rates, leading to more people with disabilities returning from war.
Soldiers with Disabilities Rehabilitation Act of 1918-First public funding for VR training for new jobs post-disability. Expanded in 1920 to include all people with disabilities.
VR service development typically follows economic need--
◦ History as a blueprint
Soldiers with Disabilities Act and 1920 expansion matched programs already in place in many states.
Only for people with physical disabilities.
State by state model begins to be seen as a way to tailor services to local need/custom.
VR service development typically follows need
◦ History as a blueprint—State by State model retained for feasibility reasons. Optional Blind/Low Vision Services.
1940’s-World War II: As more people with disabilities return from war, and as industrial needs multiply. Interest in adaptive equipment expands as well as interest in expanding the workforce to meet need.
Expansion of Rehab Act in 1943 led to service eligibility for people with mental illness and developmental disabilities, as well as blindness/low vision (Optional by state).
Expansion of financial support for rehabilitative medical services (surgeries, corrective procedures, etc.) in support of employment.
VR service development typically follows need
◦ History as a blueprint
1950’s and 1960’s-Korean War/Vietnam: Interest in economic expansion and industrial needs peak. VR programs are further expanded as service needs become more complex.
1954 Amendments to the Rehab Act
Funded scientific research
Led to development of National Institute on Disability and Rehabilitation Research (NIDRR)
VR service development typically follows need
◦ History as a blueprint
1950’s
Initial results promising:
For every $1 spent on VR services at that time, $7 was returned in paid taxes by newly employed clients.
VR service development typically follows need
◦ History as a blueprint 1960’s-
Rehab Act Amendments of 1965: Definition of disability dramatically expanded.
Services had to be “streamlined” and became less flexible and choices more limited as expansion grew.
People with most severe disabilities were often not getting what they needed.
VR service development typically follows need
◦ History as a blueprint
Early 1970’s: Interest in rehabilitation expands as does interest in civil rights of individuals.
Completely new Rehabilitation Act of 1973:
Dictates VR serve those with most significant disabilities.
Counselors and consumers directed to work together to tailor VR services to each individual. The Individualized Written Rehabilitation Program (IWRP) was born.
VR service development typically follows need
◦ History as a blueprint
Mid to Late 1970’s: Disability Rights Movement: Interest in rehabilitation expands as does interest in civil rights of individuals.
Disability advocates begin to call for increased community inclusion for people with disabilities as well as enhanced consumer choice.
Independent living becomes a priority.
Kimberly Tissot,
Executive Director of able-South Carolina
VR service development typically follows need
◦ History as a blueprint
Some of these ideas come to fruition in the Rehabilitation Act of 1986
Shifted the focus from sheltered workshops to competitive employment in typical jobs in the community.
VR service development typically follows need
◦ History as a blueprint◦ Rehabilitation Act of 1992
Created a new section of the Act that detailed many of the principles and definitions involved in rehabilitation.
Created locally-based state Rehabilitation Councils designed to enhance local and consumer involvement in the design and implementation of VR services.
Increased the role of the consumer and mandated training and outcome measures for VR services.
VR service development typically follows need
◦ History as a blueprint
◦ Rehabilitation Act of 1998
Increased consumer choice.
Streamlined processes.
Mandated partnerships between VR and other state and federal agencies providing VR services.
VR is fundamentally based on two guiding principles:
◦ Employment and productivity lead to independence.
◦ Independence is a fundamental right of every American citizen.
VR service development typically follows need
◦ History as a blueprint
◦ Rehabilitation Act Amendments of 1998
◦ Rehab Act becomes Title IV of the Workforce Investment Act
◦ Provides specific services for people with disabilities whose needs are not met by other work-related programs.
Train and Place◦ Equipping the consumer with new of different
knowledge and skills prior to job placement.
Involves “work hardening” prior to placement.
Instruction
Development of skills prior to going on a job site
Assumes the ability to generalize information from one setting to another.
Place and Train◦ Placing the client on the job site first and allowing
the client to learn in place.
Often used in conjunction with Supported Employment (Job Coach accompanies consumer to job site and facilitates learning).
Utilizes situational assessment for real-time information on work performance.
Often used for people who have a difficult time generalizing information from one setting to another
Different service types utilize different Models.
◦ Traditional VR services are based on a Train and Place Model.
◦ Supported Employment and many services specific to people with intellectual disabilities or mental illness are based on a Place and Train model.
Service Choice is driven by the functional impact of disabilities as well as the strengths and capabilities of the individual:
◦ Physical disabilities: Train and Place (Traditional Services)
◦ Psychiatric Disabilities: Place and Train/Supported Employment
◦ Learning Disabilities: Train and Place with Situational Assessment
◦ Developmental Disabilities: Place and Train/Supported Employment
◦ Vision-Related Disabilities: Train and Place and Initial Supports
◦ Hearing-related disabilities: Train and Place and Initial Supports
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Supported Employment and Vocational Outcomes
Individual Placement and Support augmented with social skills training superior to traditional VR services among people with SMI (Tsang, et al, 2009).
Supported Employment services are more cost-effective than work center-based services (Cimera, 2010)
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Supported Employment and Vocational Outcomes
Among individuals with brain injuries, the type of initial placement was the best predictor of vocational outcomes and early intervention was shown to be a best practice (Malec, et. al, 2000).
RCT’s (Tsang, 2009) have demonstrated the effectiveness of Integrated Supported Employment Services (IPS plus social skills training) as compared to IPS alone among people with mental illness.
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Maximizing Natural and Systemic Supports in SE Services
◦ Family Supports
◦ Infrastructure supports (transportation, social decision making)
◦ Fostering social supports
◦ Fostering social decision making skills
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Models and types of services are highly individualized.
Designed to enhance independence and function.
Development of effective services continues to evolve.
We welcome your questions and comments.
For more information, please contact:
Michael Walsh, Ph.D, LPC, CRC, CPRP E-mail: [email protected] Phone: 843-304-1662
Kimberly Tissot, Executive Director: able South Carolina
E-mail: [email protected] Phone: 803-779-5121, Ext. 124