Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

Supported Employment

Workbook
Chapter 10: Skills: Harnessing the help of other critical stakeholders

Chapter overview

Teamwork among all possible stakeholders and good communication are keys to successful supported employment. This chapter introduces some specific strategies for working with employers, other practitioners, and family members to meet the consumer’s work goals.

Employment specialists need to involve as many stakeholders as possible in the process of exploring job possibilities, searching for work, and providing support after work is obtained. Stakeholders may include anyone with an important role in the consumer’s life, or who is interested in playing a bigger role, including family members and close friends, other members of the treatment team, other potential support persons in the community (e.g., a member of the clergy), and (for working consumers) employers.

Other stakeholders
Potential allies in supporting a consumer’s worklife

• Family members
• Close friends
• Other members of the treatment team
• Community members such as clergy or teachers
• Community business leaders
• Employers

Supervisor’s note

When meeting with the employment specialists, brainstorm a list of potential supportive stakeholders in your area. Keep this list in the room where you do the group supervision and add to it over time .

Communication

Maintaining good communication among all stakeholders, and getting everyone’s input, ensures that all people involved are working together towards the same shared goal. Keeping everyone involved also increases the chances of identifying creative solutions to problems that interfere with achieving goals, as there are more people and more resources available to participate in the problem-solving. Finally, teamwork minimizes the possibility that some excluded stakeholders will undermine the consumer’s work goals because they are perceived to be inconsistent with their own goals.

Specific strategies for talking with employers
Consumers who do not disclose thieir illness to employers

The strategies for communicating with employers depend foremost on whether the consumer has elected to disclose his or her psychiatric disability to a prospective employer. If the consumer has chosen not to reveal his or her disability, your contacts with employers are naturally quite limited, and often there is no contact at all. For consumers to choose not to disclose, you may have contacts with prospective employers in the process of conducting generic job development. The focus of these contacts is on exploring with employers the nature of an expectation for different jobs, characteristics of ideal employees, and other information that may be helpful to a job applicant. Job leads based on generic job development can then be passed on to consumers who wish not to disclose their disability, who can pursue these jobs with the extra help of the information gathered by the employment specialist. Thus, in the case of consumers who choose not to disclose, your contacts with employers are usually limited to the job development phase. Of course, such consumers may choose to disclose their psychiatric disability at some point after they have obtained the job, and there may be other opportunities for you to have contacts with employers to facilitate job support.

Consumers who do disclose thieir illness to employers

For consumers who choose to disclose, your contacts with employers are crucial to the success of helping consumers find and keep jobs. There are three features of effective communication with prospective employers. First, you must strive to demonstrate good social skills yourself, as it will make you a more effective communicator on behalf of the consumers and will create a favorable impression with the employer.

Display social skills

Examples of good employment specialist social skills

• Good eye contact
• A firm voice tone
• Responsiveness to questions and concerns raised by the employer
• A firm handshake
• Dress professionally to match standards of employer where the job is being sought

Show respect for employer’s time

Second, employment specialists need to be focused in their interactions with employers, recognizing in the business world that “time is money” and keeping their interactions as brief and to the point as necessary in order to get the job done. This does not mean that conversations are devoid of some socially pleasant exchange, but rather that the employment specialist is always mindful of not wasting the employer’s time and of achieving a specific goal during the interaction.

Follow up on contacts

Third, employment specialists need to follow through on their contacts with employers, including checking in to determine whether the employer is satisfied with the consumer’s work and being available to provide ongoing support. Many employers appreciate the help and support of an employment specialist when hiring a consumer and value the partnership with the specialist. Even when the consumer is doing well on the job, occasional contacts are often appreciated.

Specific strategies for talking with other practitioners on the team
Participate actively on the team

Being a member of the consumer’s treatment team, and maintaining communication with other team members, are crucial for supported employment services. True integration of vocational and clinical services occurs when you and the other practitioners have regular and free exchange about vocational and clinical issues on an ongoing basis. During team meetings, you should be an active participant rather than a passive listener. Just as with employers, your relationship with other members of the treatment team reflects true partnership.

You won’t always agree

Sometimes, you will have a different perspective than other team members on consumers’ vocational or clinical functioning. In such cases, it is useful to listen carefully to the perspectives of other team members, and to reflect back your understanding to ensure your perception is accurate. Then, efforts can be made to close the gap in perspectives by offering alternative vantage points. During such discussions, it is always crucial to keep the consumer’s goals at the forefront of the discussion in order to avoid losing the focus on helping that person achieve his or her goals.

Good personal relationships help professional interactions

In addition to being an active team member, it is helpful if the employment specialist also enjoys a good relationship with each individual member of the team, and has at least some individual contact on a regular basis with the other members, including manager, doctor, nurse, residential worker, and so on. While striving to maintain the team approach, consumers should be kept aware of the nature of team efforts and the on-going collaboration.

Specific strategies for working with family members
Families can help a lot

The first step to involving family members is to obtain the consumer’s permission to contact relatives. Involving family members can be useful in supporting consumers in pursuing jobs, providing possible job leads, providing support once a consumer has obtained work, and problem-solving around obstacles to work or difficulties encountered on the job. If the consumer has certain responsibilities at home, such as childcare, involving family members may also be useful in negotiating how and when these responsibilities will be fulfilled, and addressing concerns about whether work will interfere with these responsibilities.

Addressing concerns about involving families

Many consumers readily agree to involve their family members in supported employment. However, some express concerns. The most common concerns are that involving relatives will either result in increased stress on the consumer or will be a burden to the family members. Concern about increased stress on the consumer can be addressed by assuring the consumer that you will strive to make meetings with family members positive, upbeat, and helpful, and that such meetings may actually reduce stress rather than increase it. Concern about being a burden to families can be addressed by explaining that one of the purposes of involving relatives is to reduce possible stress or burden on them by taking their perspectives into account and ensuring that supported employment services are consistent with their own needs and values.

Similar to collaboration with employers and other team members, collaboration with family members is a partnership that requires ongoing communication and mutual respect for different perspectives. Family members need to be informed about the nature of the job search so they can support consumers and network to provide possible job leads. Concerns that family members have about the consumer’s search for work, such as the effects of work on entitlements need to be addressed. If other members of the treatment team already have a good working relationship with family members, these team members can be used to facilitate the employment specialist’s relationship with those members.

Ongoing connection is helpful

Once a job has been obtained, maintaining communication with family members can be helpful for several reasons. You can explore with relatives ways they can continue to encourage and support the consumer in his or her work. Family members can be very helpful in detecting problems at work, based on their close relationships with the consumer. When problems are identified, they can use problem-solving with the consumer to address the difficulties or alert you. By identifying and responding to problems early, unnecessary job terminations may be averted. Maintaining contact with family members can also be useful in tracking the satisfaction consumers derive from work. Often, early after obtaining a job, consumers experience a range of positive feelings, including increased self-esteem and quality of life. However, these benefits sometime evaporate over time as the drudgery of work sets in, and consumers become less satisfied with their job. Ongoing communication with family members can help detect these shifts in mood and apparent benefits of work, and can cue you to begin addressing these with the consumer (e.g., exploring the possibility of job advancement or other jobs, pursuing education in order to obtain more satisfying work). Because all stakeholders need to work together, communication with family members need to be shared with consumers (if the consumer was not present) and the treatment team.

Specific strategies for working with other agencies such as Vocational Rehabilitation (VR)
Vocational Rehabilitation counselors enhance the employment process

Some practitioners on the team may work for other agencies. For example, the VR counselor from the Division of Vocational Rehabilitation (also known in some states as Office of Rehabilitation Services or Bureau of Rehabilitation Services) is sometimes a member of the team. The VR counselor brings added resources and services. For example, training, job-related equipment and supplies, school tuition, planning assistance, and support are available for people with a psychiatric disability and have a work goal.

For people who have physical health problems, a nurse from the Visiting Nurses Association may be a member of the team. Any practitioner from another agency who provides services to a consumer is included on the treatment team.

Regular communication among all practitioners is essential

Practitioners from other agencies are invited to be part of the treatment team and attend team meetings. While schedules usually do not permit these practitioners to attend all meetings, frequent communication through telephone calls, voicemail messages, and email are helpful. Be sure to keep in mind that different agencies have different policies and procedures for service delivery. The goal is to work out the barriers as much as possible so that the consumer receives seamless services and is not caught between agencies and systems.

Chapter summary

Establishing and maintaining allies among stakeholders is extremely important in supporting the work lives of consumers. This chapter reviewed some specific skills that will help you work effectively with employers, other clinical team members, and families such as seeking their perspectives early and often in the process and communicating regularly.

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