U.S. Dept of Labor Veterans’ Employment & Training Service
Competitive Grantees Training Conference
Doubletree Hotel and Conference Center Denver, CO August 2, 2006 Rich Toscano, M.A. Rehabilitation Counseling Project Director, ODEP / Georgia Workforce Action Grant Public Service Faculty / University of Georgia Dept of Veterans Affairs / NEPEC Consultant National VA CWT/SE Initiative Email:

Customized Employment
 individualizing

the employment relationship between an applicant and employer in ways that meet both parties’ needs.  outgrowth of changes in society, business and employment. It results from a business climate that demands more flexibility and creativity in a global market.  job description becomes a creative tool for addressing the unmet needs of the employment applicant and employer.

CE Policy Change Issues
Customized Employment should not be designated as the new model for persons with disabilities, but should expand the use of common sense and universally accepted practice which recognizes the power of community and highlights relationships Customized Employment:  gives power back to individuals, families, employers and community stakeholders  fosters flexibility, individuality, unique strengths and desires and a partnership with the natural community

Given a choice… by Robert E. Drake, M.D., Ph.D.
Given the choice between work and idleness, People will almost always choose work. Regardless of our station in life, the conditions of our bodies and minds, or the amount of money in our bank accounts, the need to work remains one of our strongest drives. Work is central to our lives, and as such, gives a large measure of structure to our days. Common sense tells us that we feel better about ourselves when we are working regularly.

Outdated Perceptions

Assess Employability and Develop Readiness Criteria for Entry or Re-Entry into the Workplace Place Veterans into Vocational Preparation Programs to Determine Viability for Employment Veterans Graduate into Community Employment Opportunities

A Customized Perspective
 Assume

Employability and Avoid Readiness Traps for Success and Determine the Most Appropriate Environments and Supports Employment as an Integral Part of Treatment Planning with a Focus on Rehabilitation and Recovery

 Assess

 Promote

…Recovery, as we currently understand it, means growing beyond the catastrophe of mental illness and developing new meaning and purpose in one’s life. It means taking charge of one’s life even if one cannot take complete charge of one’s symptoms… …Much of the chronicity that is thought to be a part of mental illness may be due to the way the mental health system and society treat people with severe mental illness. Contributing to people’s chronicity are factors such as stigma, lowered social status, restrictions on choice and self-determination, lack or partial lack of rehabilitation opportunities, and low staff expectations. Drastic system changes are needed if we wish to support people’s recovery, rather than hinder people’s recovery… …A recovery vision has been stifled by a lack of innovative treatment and rehabilitation options, and by a mental health culture which fails to recognize and rejoice in the person’s potential behind the illness…
by William A. Anthony, Ph.D. Excerpt from Psychosocial Rehabilitation Journal, 16(4)

Rehabilitation/Recovery Vision
“…taking charge of one’s life even if one cannot take complete charge of one’s symptoms…” …chronicity factors:
    

stigma lowered social status restrictions on choice lack of rehab options low staff expectations



Employment Provides:
 Sense  Status

of Identity and Belonging

 Economic

Potential to Raise Oneself out of Poverty to Address Needs at Times of Crisis and Tragedy

 Means

Terrorism, Earthquakes, Hurricanes, Floods…

Evidence-Based Principles
1. Integration of Rehab Services with service / treatment 2. Rehabilitation Unit 3. Open Enrollment / Zero Exclusion Criteria 4. Ongoing Work-based, Comprehensive Assessment 5. Individualized Rapid Search for Gainful Employment 6. Individualized Job Search 7. All Jobs Viewed Positively as Part of Rehab / Recovery 8. Competitive Jobs Prioritized 9. Time-Unlimited, Follow-Along Supports 10. Diversity of Jobs Developed 11. Community-Based Services 12. Assertive Engagement and Outreach

Customized Teams Nurture Creativity

What are the Key Features of an Integrated, Individualized and Customized Approach to Employment?

Vocational Assessments that Assume Employability and Do Not Screen Out Due to Level Symptoms, Illness or Disability Partnerships Between Employment Resources and Supports in the Form of Integrated Treatment Teams and Blended / Braided Resources Dollars that Follow the Individual Providing for Creativity and Flexibility in the Negotiations with Employers… Individual Accounts

Rehabilitation / Recovery Considerations


 Stigma

can be approached by understanding and exploring the value of DISCLOSURE in the employment planning process

The stigma associated with mental illness prompts persons who live with it to conceal their need for support and understanding. Discovery and the identification of ideal conditions and contributions are enhanced when the individual trusts that disclosure can free them from being defined by their symptoms. Disclosure can help the employer understand what and how a person who still struggles with some symptoms can contribute immediately to the workplace and will grow in their ability to perform and expand their skills as the symptoms are reduced or eliminated.

Disclosure As a Tool for Opening the Door to Dignity; Overcoming the Stigma of a Difficult Past
Larry was homeless and described as depressed, paranoid and suicidal.  Larry was described as non-compliant with TX.  Larry was described as a criminal with felonies on his record.  Larry was described as having significant medical issues including seizures and blackouts.

A Customized Approach For Larry Involved Community Exploration (Discovery) Related To Positives In His Past

 

Larry is now described as a man who travels 2 hrs in LA traffic to get to the job he loves. Larry was the recipient of Home Depot employee of the month honors and is entering his 4rd year of f-t employment. Larry is re-married and has started a new family. After a few slips early in his employment, Larry is now sober, clean and well along on his path to recovery.

 Powerlessness

can be addressed by recognizing the importance of STATUS

The passions or interests that individuals present in the profile assessment / discovery process can provide insight to how this person sees himself or herself beyond the label of mental illness. It is very POWERFUL to discover the dreams and aspirations people have or once had. Discovery, in this case, often requires having others who know the person well be present and share stories of life experiences that may not have been clouded with symptoms of mental illness. There is a tendency in employment to look at entry level experiences as a way of building confidence and advancing an employment planning process when, in fact, it may reinforce a feeling of “hopelessness” in the mind of the person who didn’t see themselves that way in the past and desperately desires hope for the future.

Some Individuals Do Not Fit Into Traditional Employment Settings; Customized Employment Can Offer Other Power-giving Options

Jeff has tried to reenter the workplace as a stockperson, assistant manager in retail environment, but the symptoms of his illness prevented him from keeping those jobs. He is now developing a customized approach to his passion – Leather Tooling.


The Identity Trap Is The Way In Which Veterans Become Defined By The Symptoms Of Their Illness Rather Than Their Unique Qualities
There is a tendency to define the person with a mental illness based on the current symptoms they present rather than who they were and who they will become once the symptoms are under control. Service providers tend to see individuals at their worst (the times they need intensive treatment, medication and/or counseling) and experience difficulty envisioning a more competent, independent and productive person. This results in low expectations and the continuation of the “hopelessness” cycle. Be open to the possibilities; there is no such thing as an unrealistic dream or aspiration. From dreams, we can discover parallel paths in our communities that satisfy the person’s desire to be in a certain type of environment or meet a particular status / identity need.

Manny’s Bipolar Diagnosis and Substance Use Became His Identity Resulting in Divorce, Limited Access to His Kids and Major Depression

Manny Ran A Paint Contracting Business For Ten Years Manny Had Limited Business Skills And Relied On His Wife To Handle The Accounting Symptoms Of Manny’s Illness Finally Caught Up To Him His Business Quickly Fell Apart and Manny Started to Explore Other Work Currently His VA Supports are Exploring Re-establishing His Business with a Customized Self Employment Design

Contact Information
Rich Toscano, M.A. Rehabilitation Counseling
Project Director, ODEP / Georgia Workforce Action Grant  Public Service Faculty / University of Georgia  Dept of Veterans Affairs / NEPEC Consultant National VA CWT/SE Initiative