Sourcebook of Rehabilitation and Mental Health Practice

490 Pages·2003·2.232 MB·English

by  David P. Moxley, John R. Finch (auth.), David P. Moxley, John R. Finch (eds.)

Sourcebook of Rehabilitation
and
Mental Health Practice
Plenum Series in Rehabilitation and Health
SERIES EDITORS
Michael Feuerstein
Uniformed Services University of the Health Sciences (USUHS)
Bethesda,Maryland
and
Anthony J. Goreczny
Chatham College
Pittsburgh,Pennsylvania
ENABLING ENVIRONMENTS:Measuring the Impact of Environment on
Disability and Rehabilitation
Edited by Edward Steinfeld and Gary Scott Danford
HANDBOOK OF HEALTH AND REHABILITATION PSYCHOLOGY
Edited by Anthony J. Goreczny
INTERACTIVE STAFF TRAINING:Rehabilitation Teams that Work
Patrick W. Corrigan and Stanley G. McCracken
SOCIAL RELATIONS AND CHRONIC PAIN
Ranjan Roy
SOURCEBOOK OF OCCUPATIONAL REHABILITATION
Edited by Phyllis M. King
SOURCEBOOK OFREHABILITATIONAND
MENTAL HEALTH PRACTICE
Edited by David P. Moxley and John R. Finch
A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume
immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact
the publisher.
Sourcebook of Rehabilitation
and
Mental Health Practice
Edited by
David P. Moxley
Wayne State University
Detroit,Michigan
and
John R. Finch
Rehabilitation Consultant
Columbus,Ohio
KLUWER ACADEMIC PUBLISHERS
NEW YORK,BOSTON, DORDRECHT, LONDON, MOSCOW
eBookISBN: 0-306-47893-5
Print ISBN: 0-306-47745-9
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List of Contributors
JOHN B. ALLEN JR., Director, Bureau of Recipient Affairs Office of Mental Health,
Albany,NY.
LARRY ABRAMSON, Director of the Back to Work Program, St Luke’s House, Bethesda,
Maryland.
ANNROSEGRANTALVAREZ,Wayne State University School of Social Work,Detroit,Michigan.
ROBERT BAER, Outreach Center for Innovation in Transition and Employment, Kent State
University,Kent,Ohio.
CREIGSBEVERLY,Wayne State University School of Social Work,Detroit,Michigan.
BEVERLYM. BLACK,Wayne State University School of Social Work,Detroit,Michigan.
MARGARETBRUNHOFER,Wayne State University School of Social Work,Detroit,Michigan.
MATTHEWBURNS,Vinfen Corporation,Boston,Massachusetts.
JOHN CORRIGAN, Department of Rehabilitation and Physical Medicine, College of Medicine
and Public Health,Ohio State University,Columbus,Ohio
WILLIAM CRIMANDO, Rehabilitation Administration and Sciences Program, Rehabilitation
Institute,Southern Illinois University,Carbondale,Illinois.
GARY M. CUSICK, Administrator of Planning and Research, Louisville & Jefferson County
Health Department,Louisville,Kentucky.
ELIZABETH DANTO, Hunter College School of Social Work, City University of New York,
New York,New York.
ROBERTERLANDSON,Wayne State University College of Engineering,Detroit,Michigan.
ELLENFABIAN,CAPS Department,University of Maryland,College Park,Maryland.
MARIANNE FARKAS, World Health Organization Collaborating Center, Boston University
Center for Psychiatric Rehabilitation,Boston,Massachusetts.
ALISONFAVORINI,Huntington Woods,Michigan.
JOHNR. FINCH,Rehabilitation Consultant,Columbus,Ohio.
STUARTFORMAN,Wayne State University,Detroit,Michigan.
v
vi List of Contributors
CHERYL GAGNE, Boston University Center for Psychiatric Rehabilitation, Boston,
Massachusetts.
GREGORY G. GARSKE, Division of Intervention Services, Bowling Green State University,
Bowling Green,Ohio.
CHARLESGARVIN,University of Michigan School of Social Work,Ann Arbor,Michigan.
BARBARAGRANGER,The Matrix Center at Horizon House,Inc.,Philadelphia,Pennsylvania.
LAURIE R. GWILLIAM, Department of Rehabilitation and Physical Medicine, College of
Medicine and Public Health,Ohio State University,Columbus,Ohio.
JAMESJ. HENNESSY,Fordham University Graduate School of Education,New York,New York.
LORENHOFFMAN,Wayne State University School of Social Work,Detroit,Michigan.
PAMELA S. HYDE, Secretary, New Mexico, Department of Human Services, Santa Fe,
New Mexico.
CHRISTINEHYDUK,Marygrove College Department of Social Work,Detroit,Michigan.
EVETTEJACKSON,The Technical Assistance Collaborative,Inc.,Boston,Massachusetts.
GERALYN L. JANECZKO, Director of Support Services, Southfield Public Schools, Southfield,
Michigan.
MARTHA B. KNISLEY, Director of the District of Columbia Department of Mental Health,
Washington,D.C.
MARTIN KOEHLER, Boston University Center for Psychiatric Rehabilitation, Boston,
Massachusetts.
KATHYKUSTOWSKI,Visiting Nurses Association of Southeast Michigan,Detroit,Michigan.
KRISTAMAGAW,Tecumseh Land Trust,Yellow Springs,Ohio.
PAMELAK. MANELA,Southfield Public Schools,Southfield,Michigan.
ROGERW. MANELA,Detroit Public Schools,Detroit,Michigan.
ERNESTINEMOORE,Wayne State University School of Social Work,Detroit,Michigan.
DAVIDP. MOXLEY,Wayne State University School of Social Work,Detroit,Michigan.
DEBBIE NICOLELLIS, World Health Organization Collaborating Center, Boston University
Center for Psychiatric Rehabilitation,Boston,Massachusetts.
JERRY OLSHESKI, Department of Counseling and Higher Education, Ohio University,
Athens,Ohio.
NATHANIELJ. PALLONE,Rutgers,The State University of New Jersey,New Brunswick,New Jersey.
JANETL. PRAY,Gallaudet University Department of Social Work,Washington,D.C.
DENISERABOLD,NeuroRehab,Inc.,Columbus,Ohio.
MELVYNRAIDER,Wayne State University School of Social Work,Detroit,Michigan.
RICHARDSCHELAT,Ohio Bureau of Vocational Rehabilitation,Athens,Ohio.
List of Contributors vii
SANDRASCHIFF,Wayne State University School of Social Work,Detroit,Michigan.
LEROY SPANIOL, Senior Director of the Boston University Center for Psychiatric
Rehabilitation,Boston,Massachusetts.
PATRICKSULLIVAN,Indiana University School of Social Work,Indianapolis,Indiana.
JAMESTRIPP,Wayne State University School of Social Work,Detroit,Michigan.
WAYNE TYRELL, Boston University Department of Rehabilitation Sciences, Boston,
Massachusetts.
NOELLEVANDERTUIN,Migrant Health Promotion,Progresso,Texas.
JOSEPH WALSH, Virginia Commonwealth University School of Social Work, Richmond,
Virginia.
MARGARETS. WALSH,State Human Rights Director,Commonwealth of Virginia Department
of Mental Health,Mental Retardation,and Substance Abuse Services,Richmond,Virginia.
ARLENEN. WEISZ,Wayne State University School of Social Work,Detroit,Michigan.
SHARIWILLIS,CAPS Department,University of Maryland,College Park,Maryland.
ANTHONYZIPPLE,Vinfen Corporation,Boston,Massachusetts.
Preface
We live in a day and age in which many fields come together to define new ones,and out of
these newly defined areas come innovative practices, and emergent ways of thinking. The
Sourcebook on Rehabilitation and Mental Health Practicedocuments one of these new fields,
one formed by the coalescence of rehabilitative and mental health services and employment.
Only recently have human service practitioners,policy makers,and administrators recognized
that there is a growing synergy among these areas once separated by great gulfs of differences
in culture,perspectives and values,and technologies.
It is not happenstance that rehabilitation,mental health,and employment are becoming
increasingly integrated in contemporary human services. There is considerable interest
in work in contemporary society although different values and perspectives mediate this
interest. For people with disabilities,an interest in work often comes from deep frustration—
from not having ready access to work,and from not having enough of it to facilitate an accept-
able quality of life or independent living. Some people find work to be a source of problems
that negatively affects their functioning. They find the workplace stressful and unsupportive,
or they feel that work exacts too much from them, reducing their quality of life and setting
into motion numerous negative personal effects (Beck,2000).
Over the past several decades,American society has accelerated its expectations of work
and of those who engage in it. The decade of the 1970s saw economic upheaval in American
society, an acceleration of inflation and the emergence of stagflation. Other countries, most
notably Japan,overtook the United States in productivity and quality. In the 1980s,expecta-
tions of worker performance heightened and the workplace was restructured through new
management and work engineering practices, quality management approaches, and new
workplace expectations of employees for autonomy, self-sufficiency, and technical mastery
(Appelbaum & Batt,1994). These changes to the workplace continued into the decade of the
1990s, but the American economy took off, some say because of the macro-economic
policies of the 1980s,while others underscore the ingenuity of American enterprise,and still
others point to the great investment workers have made. But all was not right in the 1980s and
1990s. Despite societal assertions that people ought to work and work a lot, workers
themselves felt more insecure about the permanence of work. The fall out of restructuring and
the re-engineering of the workplace took its toll not only at the lower echelons of corporate
enterprises,but also at mid-level echelons,and within the ranks of professionals,once areas
of employment thought secure and permanent (Meyer, 1995). The restructuring of perform-
ance expectations,pensions,and salaries meant that work was increasingly more performance-
based and subject to competitive forces.
Perhaps the net effect of these changes in the workplace were the feelings that work was
as much a potential problem to people as it was a positive area of human development
ix
x Preface
that could foster personal identity and meaning. Workplace violence,harassment of workers,
and job stress were stark reminders that employment could create negative mental health
consequences and that people may need to seek human services to cope with the conse-
quences of work and to sustain their performance on the job (Ryan & Oestreich,1998). The
emergence of work-related services for employees, such as employee assistance programs,
critical incident intervention, and substance abuse treatment and counseling, have become
standard practices in many areas of business and industry.
During the decades of the 1970s,1980s,and 1990s,human services were not insulated
from the necessity to prepare people for work, to help people sustain work, and to facilitate
their performance on the job. Of course,there had always been models of rehabilitation and
employment that emulated work,such as sheltered workshops,industrial enclaves,and work
adjustment that focused on the preparation of people for work and on the facilitation of work
readiness. Yet,over these three decades there was a critique emerging within human services
that these models only simulated the real thing and only served to create deviance and stigma
by amplifying people’s disabilities and preventing them from enjoying involvement in
real-life work settings.
Many people with disabilities, particularly those with developmental disabilities or
serious mental illness,had difficulty getting work and sustaining it. This was not because they
were unfit for involvement in employment, but employer and organizational attitudes; the
structure and engineering of work; and disability benefits literally coalesced into major barriers
to employment. To this day,people with disabilities,particularly serious ones,are underrep-
resented in the workforce and this lack of representation may reinforce prevailing societal
stereotypes that people with disabilities do not make good employees or do not want to work.
Movements developed within fields such as serious mental illness, developmental dis-
abilities, and physical disabilities that emphasized normalization, inclusion, and community
support. The availability of work in real work settings in which people with disabilities could
work alongside people without disabilities were seen as the policy and practice aims of many
innovations in human services including supported employment,self-employment,and com-
petitive employment. The achievement of social integration, from this perspective, required
people to be involved in real work and in nothing less. To be deprived of employment was
seen as a violation of human rights. From this perspective the competence of human services
was situated in the ability of systems of services to facilitate the participation of people with
disabilities in mainstream community employment. Major policy products in the 1980s and
1990s and into the first decade after 2000 underscored the importance of the availability of
work and the transition and movement of people with disabilities into employment.
So,the field we speak of in this book,rehabilitation and mental health practice,is linked
to employment from at least two vantage points. First,there is work as a source of problems
that can create negative consequences for functioning and mental health. Second,there is the
facilitation of the involvement in work of people who often can experience deprivation in this
area of human development or exclusion because of their physical, cognitive, emotional, or
social qualities.
Within this first segment of the field one may find rehabilitation and mental health
services that address the negative consequences of work by:
1. facilitating a better fit between individuals and their work settings or between
individuals and their specific work responsibilities;
2. bolstering the skills and competencies of individuals so they perform more
effectively; and
3. helping individuals reduce the scope and severity of negative consequences.
Preface xi
Within this second segment of the field one may find rehabilitation and mental health supports
that facilitate access to employment and that,in the words of psychiatric rehabilitation profes-
sionals, help people to “choose, get, and keep employment.” Strategies that compose this
segment of the field may be accommodative in their focus and aims. That is, they help
people to make the requisite changes to their environments that support their vocational
development or their achievement of employment outcomes and vocational success. Other
strategies may facilitate changes in the person so that he/she gains the skills, competencies,
and capacities to work successfully in the work settings of a competitive and market-oriented
society that values self-sufficiency and autonomy.
It is the purpose of the Sourcebookto illuminate the practices that form the field of reha-
bilitation and mental health. We, as editors, understand that this field is complex, emergent,
and growing and so it is difficult to cover it exhaustively. However,we feel that we capture in
the Sourcebook a large portion of the contemporary domain through the diverse array of
authors—practitioners,administrators,and academics who are active in the field of rehabili-
tation and mental health practice—who write from different substantive areas of practice and
from different perspectives.
Through five sections the contributing authors illuminate many of the thematic areas of
rehabilitation and mental health practice that are significant to today’s practice as well as to
the practice of the near future. This coverage is of great enough scope to justify the idea that
this book truly is a sourcebook,a volume that is deep and broad enough to serve as a textbook
and reference for students preparing for practice,and yet relevant to experienced practition-
ers looking for insight and new understanding. We will save the overview of chapters for those
introductions we incorporate within major sections. But let us underscore that each section
and the chapters that compose them offer frameworks, practices, and perspectives that will
enable the reader to obtain a good understanding of the field of rehabilitation and mental
health practice.
Section I, “The Promise and Challenges of Employment,” is composed of six chapters
that give the reader a sense of why employment is important to human development and the
conditions that influence employment, for better or worse. The four chapters of Section II,
“Service Roles and Contexts in Rehabilitation and Mental Health Practice,” offer a broad
review of professional roles and systems devoted to the integration of rehabilitation and men-
tal health service for the purpose of achieving employment outcomes. In Section III, we
devote six chapters to the development of readiness for employment in which rehabilitation
and mental health services are brought together for individuals to facilitate their involvement
in work. Section IV offers seven chapters that focus on the themes of sustaining employment
and developing self-employment options,two areas that have considerable contemporary rel-
evance. The nine chapters of Section V, “Responding to Rehabilitation, Mental Health and
Employment Needs,”address service strategies for specific populations with a special focus
on the arrangements and resources that influence the facilitation of employment for these
groups and the issues that practitioners and recipients must address to achieve successful out-
comes. The authors of these chapters seek to assemble promising or best mental health and
rehabilitation practices that are relevant to the achievement of employment outcomes within
the context of specific service situations.
Contributing authors represent the spectrum of professionals and disciplines that com-
pose the field of rehabilitation and mental health practice. The reader will find represented
among the contributing authors the disciplines of social work, engineering, psychology,
rehabilitation counseling,nursing,law,sociology,and business. No one discipline can claim
rehabilitation and mental health practice as an exclusive domain. It is truly an
interdisciplinary field benefiting from the ideas and practice of professionals from a diversity