Academic journal article The Journal of Rehabilitation

The Perceived Importance of Integrated Supported Education and Employment Services

Academic journal article The Journal of Rehabilitation

The Perceived Importance of Integrated Supported Education and Employment Services

Article excerpt

Individuals with a psychiatric disability drop out of educational programs more often than those without a psychiatric disability (Swanson, Gur, Bilker, Petty & Gur, 1998; Waghorn, Still, Chant, & Whiteford, 2004). These individuals often experience their first major symptoms during late adolescence or early adulthood. The timing of the onset of these initial symptoms often postpones educational pursuits indefinitely. It's been estimated that almost 5 million people in the U.S. would have participated in a college education were it not for a psychiatric disability (Kessler, Foster, Saunders, & Stang, 1995).

Supported education (SEd) for individuals with psychiatric disabilities is a practice which is gathering increasing support and national attention (Leonard & Bruer, 2007). Supported education (SEd) is an intervention model designed to assist individuals with a psychiatric disability to complete educational goals. There are four major types of supported education models currently being utilized: (1) the self-contained classroom, (2) on-site support (3) mobile support, and (4) freestanding (for further description of these models see: Collins & Mowbray, 2005 and Mowbray, Brown, Furlong-Norman, & Soydan, 2002). Although, each of these models has different qualities, they often provide similar services. Historically, funding for SEd services has been a precarious mixture of state, local, and foundation sources. There continues to be a lack of a defined delivery system for supported education and an attendant financing mechanism that would make SEd more readily available to people with psychiatric disabilities.

Several recently published systematic reviews have identified SEd as providing positive outcomes for individuals with psychiatric disabilities (Chandler, 2008; Leonard & Bruer, 2007; Parrish, 2009; Rogers, Farkas, Anthony, & Kash-MacDonald, 2009). The reviews report that there is preliminary evidence indicating that SEd helps individuals obtain educational goals, achieve vocational success, increase self-esteem and self-perception, learn to manage their symptoms, and improve levels of satisfaction with services; all of which have been linked to elements of a recovery process. However, these positive outcomes must be interpreted with caution as most of the research conducted has been descriptive, qualitative or had other methodological limitations.

While qualitative and descriptive research is important, especially given that obtaining an education is a subjective experience, this research needs to be augmented by high quality effectiveness studies. Most of the quantitative studies conducted on SEd have either been non-randomized or non-experimental. For instance there have only been five pre-post studies (Unger et al., 1991; Cook & Solomon, 1993; Unger, Pardee, & Shafer, 2000; Best, Still, & Cameron, 2008; Morrison & Clift, 2005), four experimental or quasi-experimental studies (Collins, Bybee, & Mowbray, 1998; Collins, Mowbray, & Bybee, 1999a; Collins, & Bybee, 1999; Hoffman & Mastrianni, 1993), nine correlational, survey or observational designs (e.g. Collins, Mowbray, & Bybee, 2000; Collins, Mowbray, & Bybee, 1999b; Mowbray, Bybee, & Collins, 2001; Mowbray, Bybee, & Shriner, 1996) and four posttest only designs (e.g. Isenwater, Lanham, & Thomhill, 2002; Tutty et al. 1993). One of the only studies that used a randomized controlled trial methodology (Collins et al., 1998) could not determine which specific type of supported education model was most effective or why the supported education interventions tested were effective. The other major quantitative design studies all had design issues such as a self-selected sample, non-standardized measures, small sample sizes, lack of randomization, large attrition rates, or insufficient follow up.

Supported employment (SE) is an umbrella term which includes segregated and non-segregated supports and services designed to assist individuals with a variety of disabilities in obtaining employment. …

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