An Effective Vocational Rehabilitation Strategy for the severe disabled

- Supported Employment program -

Kyung-Min Park, a Down’s syndrome man, is 25 years old. He has mainly staid his home all day with watching TV, surfing the Internet, playing the cyber game since graduating special school for the students with an intellectual disability. He does never have friends and job until 25 years old. At some day in 2001, he and his mother visit me to ask his vocational rehabilitation. Like the other people with an intellectual disability he also has complicated troubles such as education, job, sex, marriage, and the others. However, he is a good and pure man. First of all, he has a good healthy unlike the other Down’s syndrome. After I performed suitable vocational counseling and assessment, I decide that he participate my supported employment program.

There are many issues in a vocational rehabilitation field for the people with an intellectual disability. First, there is controversy about quality of vocational rehabilitation services. A services’ quality is determined by not service provider's judgment but customers' service satisfaction. Unlike present the number of vocational rehabilitation agencies in the community is very scarce in the past; therefore, rehabilitation agencies do not feel necessity to care their services' quality and customer’s service satisfaction. However, recently because service quality competition is highly raised between rehabilitation agencies and consumerism concept begin to be used in rehabilitation fields, rehabilitation agencies have to care their services' quality and customer service satisfaction. Second, how is vocational rehabilitation service effectively achieved in the economical side? Namely, how many benefits can vocational rehabilitation agencies give to the disabled people? In fact, an effectiveness of every social welfare service including rehabilitation program was criticized from neoconservatives especially when country has an economic crisis. Accordingly issue of rehabilitation service's cost and benefit is a very critical problem. Third, what are differences of role between professionals and non-professionals? Unlike national economy and defense because social welfare is not universal and major issue but marginal and minor issue, its available resources is very limited. Accordingly not only professionals but also non-professionals such as family members, businesses and volunteers have no choice but to participate in the rehabilitation processes. Consequently role share and cooperation between professionals and non-professionals is very important issue in the rehabilitation fields. Finally, how much does rehabilitation service contribute for the disabled people’s social integration? Actually ultimate purpose of rehabilitation is a complete social integration for the disabled people. However many rehabilitation programs have been still provided under the separated training and service setting.

Supported employment program is more effective program than any other vocational

rehabilitation program for the people with an intellectual disability in the above all issues. First, supported employment program is the best suitable program for mentally retarded people’s characteristic. Second, supported employment program is more economical than traditional vocational rehabilitation programs. Third, supported employment program uses a variety of community resources such as business members, family members, and volunteers throughout whole rehabilitation process. Finally, supported employment program pursues social integration of the people with an intellectual disability through vocational rehabilitation.

Traditional Vocational Rehabilitation Strategy and Supported Employment Program

Generally, supported employment compares with traditional vocational rehabilitation approaches. According to the Renzaglia, A, & Hutchins, M. (1988) they explain that supported employment is more community referenced program than traditional vocational rehabilitation programs. Namely, traditional approaches are based on institution centered paradigm and individual model about the disability while supported employment is bases on community centered paradigm and social model about the disability. Also assessment, curriculum, training method/settings, and placement/follow-up ways are different each other. Traditional approaches use standardized assessment instruments, simulated jobs, work adjustment skills, and time-limited follow-up while supported employment uses informal assessment procedures targeted community-based employment, a systematically select skill training, on-the-job training, and ongoing support.

Definition and History of Supported Employment

There are a variety of definitions about supported employment. However, definition of the Rehabilitation Act Amendment of 1986 is the most general definition received by rehabilitation professionals. According to the definition of this act supported employment is defined as “competitive work in integrated work settings for individuals with severe handicaps for whom competitive employment has not traditionally occurred, or for individuals for whom competitive employment has been interrupted or intermittent as a result of a severe disability, and who because of their handicap, need ongoing support services to perform such work”. Supported employment is a combination of employment and ongoing serves. It is a powerful and flexible way to ensure normal employment benefits, provide ongoing and appropriate support, create job opportunities, and achieve full participation, integration, and flexibility.
Supported employment program began to appear around the beginning of 1970s. Most rehabilitation services’ histories go with history of the United State’ law development. In 1973, the Rehabilitation Act included regulations about supported employment for the first time in the U.S. and then enactment of the Development Disabilities Act (1984) and amendment of the Rehabilitation Act (1986) became an important turning point and chance for development of supported employment. Recently many developing countries as well as the U. S. use supported employment as an effective vocational rehabilitation strategy for the severe disabled people

Stages and Models of Supported Employment

Commonly, process of supported employment program can classify basic five stages such as job development, job analysis, client-to-job matching, on-the-job training, and worker evaluation. Fadely, D. C. (1987) explains five process of supported employment program through describing job coach’s role. First, job coach locates competitive jobs in the community for the severe disable people. Second, job coach performs task analysis or break down of a specific job step by step. Third, job coach tries to match client and job based on results of vocational assessment and job analysis. Fourth, the people with a severe disability take part in on-the-job training in the workplaces. Lastly, job coach conducts ongoing and intensive evaluation and supports for the people with a severe disability.

There are four typical models of supported employment such as individual placement model, enclave model, mobile work crew model, and small business model. First, an individual placement model is the most typical model of the supported employment models. In this model, only 1 job coach provides ongoing and intensive supports to a person with a severe disability in the workplace; therefore service quality provided by job coach is better than any other supported employment model. Second, enclave model is a type to place 2-3 disabled people and 1 job coach in one workplace at the same time. In this model, the people with disability can help each other and because 1 job coach charges 2-3 disabled people at the same time, it is more economical than an individual model. Third, mobile work crew model makes mobile group which is consist of the people with a severe disability. This model mainly uses service industry such as building cleaning work or park maintenance work. Finally, small business model is to operate small business being consist of the people with a severe disability in a private enterprise. This model has an advantage employing many people with a severe disability at the same time while it has a disadvantage reducing integration chance more than other modes relatively.

Criticism of Supported Employment

Opponents claim that supported employment is not useful for most severe disabled people. Because supported employment pursues competitive employment excessively, many severe disabled people cannot get proper employment chances. Also, they insist that supported employment may plunder opportunities participating sheltered workshop program of the severe disabled people under the pretence of social integration and human lights. In fact, supported employment program is not a panacea. However, effectiveness of supported employment has proven through many researches (Wehman, P., Sale, P., Parent, W, S. 1998 ; Ronald, W, C & Jack, H, N. 1990) and the fact that many vocational rehabilitation agencies and most countries prefer to use supported employment program for the severe disabled people’s vocational success exhibit supported employment’s benefits and effectiveness well.

Benefits of Supported Employment

Supported employment program has a lot of benefits more than traditional vocational rehabilitation approaches.

First, supported employment program is the best suitable program for mentally retarded people’s characteristic. According to the AAMR (American Association on Mental Retardation)’ definition the person with an intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. Also this disability originates before age 18; therefore, they need to ongoing and intensive supports throughout their all life. Supported employment program began to base on mentally retarded people’s characteristic. Job coach’s role, assessment and training method and ongoing support system display supported employment program’s such features well. Job coach’s role is one of the most important facts in supported employment processes. Success or failure of supported employment is determined by job coach’s ability. Job coach already understands the person with intellectual disability’ characteristics fully and responds to the disabled people’s needs continuously. Assessment and training method in supported employment also design and perform on the workplaces considering intellectual disability’ characteristics. Also, one of the most important benefits in supported employment program is the fact that it provides the people with a severe disability unlimited services.

Second, supported employment program is more economical than traditional vocational rehabilitation programs. First, using supported employment program can make a retrenchment in the budgets which are spent for vocational rehabilitation. Traditional vocational rehabilitation approaches are based on institution or agency. In other words, because these strategies have to equip special training setting for the people with disability and change the facilities and equipment frequently regarding changes of training lesson and contents, these strategies need many budgets to provide appropriate services for the people with disability. On the other hand, supported employment program is one of the most economical programs in vocational rehabilitation field because this program chiefly performs in the real workplaces which do not need additional facilities and equipment. Also, using supported employment program can help the disabled and rehabilitation agency to save time during the vocational rehabilitation process. In traditional vocational rehabilitation programs the people with a severe disability have wasted useless time performing simulated work and participating boring rehabilitation programs. However, the people with disability who participate supported employment program can use time effectively without wasting time through training and employment performing at the workplace or business.

Third, supported employment program uses a variety of community resources such as business members, family members, and volunteers throughout whole rehabilitation process. Generally, traditional vocational rehabilitation programs such as sheltered workshop program, vocational adjustment training program and work activity center program perform nearly every activity in the agency or institution; therefore, almost all services and supports are provided by professional. On the other hand, because supported employment program mainly performs all services and supports in the workplace and community, it uses a variety of community resources such as business’s workers, family members, and volunteers. There is one concept, a natural supports, to explain such various community resources for the people with a severe disability. The term natural supports refer to the inherent resources in community environments that can be used for rehabilitative and supportive purposes. West, M.D., and his colleagues (1997) explain that “natural supports within the supported employment service context were intended to included to include; (a) individuals at the job site, such as employers, supervisors, or co-workers, (b) friends or family members in supportive roles, and (c) volunteers or members from work or the community”. Business members are the most important natural supporters in supported employment. They play a role as trainer, supervisor, evaluator, and advocator for the people with a disability. Job coach tries to transfer a critical role as a trainer and evaluator to business members such as employers, supervisors, or co-workers. Accordingly business members’ role is very important for supported employment’s success. Family members well know the people with a disability’s characteristics and preferences better than any other supporter. Sometimes positive parents may become more wonderful mentor and supporter than vocational rehabilitation professionals for the people with an intellectual disability. They are a great supporter not only in the job world but also in the daily life. Finally, many volunteers such as students, friends, and neighbors can play a role as a good assistant. Specialists in supported employment field positively have to use such volunteers to lead supported employment successfully. Although there are many community resources, they can contribute for supported employment’s success effectively when they actively cooperate and communicate each other targeting the people with a disability’s vocational success. In the other words, cooperation and communication between community resources is vary important factor for an appropriate support and supported employment’s success.

Finally, philosophy and principle of supported employment program pursue social integration of the people with an intellectual disability. First of all supported employment program performs at the integrated workplace in the community; therefore, it provides the people with a disability more social integration opportunities than any other vocational rehabilitation program. The people with a disability work and communicate with the people without disability. They can integrate society automatically through their vocational life. Next, because supported employment positively uses a variety of community resources such as business members and volunteers, the people with an intellectual disability who participate supported employment program can obtain chances contacting mainstream or society, in other words, it can help the people with an intellectual disability’s social integration more effectively than any other vocational rehabilitation programs. Finally, supported employment program is a community-based vocational rehabilitation program. Whole processes of supported employment perform in the people with disability’s community. Job coach tries to find jobs for the disabled people in the community and the disabled people train and work for companies and workplaces in the community. Accordingly, the disabled people who use supported employment program can work and live under the most familiar environment.

In conclusion, every people with a disability have abilities which can do something. However, for the long time they have been ignored form mainstream of society and they have been excluded from majority group of society. Obviously, it is a social discrimination, inequality, and prejudice. Supported employment program will save the people with a disability from such discrimination and unfairness through ongoing and intensive supports. Supported employment program is the most effective program of the vocational rehabilitation programs for the people with an intellectual disability. First, supported employment program is the most appropriate program for the people intellectual disability because this program considers the mentally retardation’s characteristics thoroughly. Next, supported employment program performs economically through training and support in workplace and community. Third, supported employment program positively attempt to use not only job coach but also community resources to achieve the disable people’s vocational success. Finally, supported employment program completely intent on social integration for the people with an intellectual disability

In the future, not only rehabilitation specialists but also community resources should endeavor to improve supported employment program’s quality. First of all, vocational rehabilitation specialists try to observe philosophy and principle of supported employment thoroughly. In fact, most vocational rehabilitation specialists have trouble keeping philosophy and principle of a good rehabilitation program because there are a lot of barriers such as agency’s bureaucratic authoritarianism, social prejudice and the others preventing specialists’ attempts and efforts. Also specialists try to develop new job types and new supported employment models. Even though the disabled people can do a lot of tasks and jobs in the world, they have not entered these jobs for the long time because of social prejudice and physical barriers. If specialists develop more job fields and training models for the disabled people, the more disabled people would obtain employment opportunities. Next, business should provide the disable people an equal employment opportunity without prejudices about the disabled people’s ability. It is the most reasonable accommodation provided by businesses. Finally, family member’s role also is very important. Especially, parents need to understand labor market’s actual condition and vocational rehabilitation processes precisely. If family does not understand both factors, they have unrealistic vocational needs or do not become appropriate supporters.

Kyung-Min Park is one of the most successful cases through supported employment. A government agency located near his house provides him building maintenance job without prejudice. His parent and older sister play an important role as a wonderful trainer and assistant. Vocational rehabilitation professionals also serve ongoing and intensive services faithfully. Working for his company for the 6 years, Kyung-Min Park become a great tax-payer be not depended on his parent and rehabilitation agencies any more.


References

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Wehman, P., Sale, P., Kregel, J. (1998). Supported Employment: Growth and Impact, (pp. 3-28). Wehman, P., Sale, P., Parent, W, S. (Ed). Supported Employment: Strategies for Integration of Workers with Disabilities

Wehman, P. & Bricout, J. (2001). Supported Employment; New Directions for the New Millennium (pp.3-22). Wehman, P. (Ed.). Supported Employment in Business; Expanding the Capacity of Workers With Disabilities. St. Augustine, Florida, Training Resource Network, Inc.

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