CRS Australia (formerly known as Commonwealth Rehabilitation Service) is an Australian Government agency providing vocational rehabilitation services to Australian citizens or residents beside a disability, injury or health condition. In 2003, as one slice of the Australian Government's Australians Working Together initiative, the Department of Family and Community Services and CRS Australia proceeded with a series of pilot programs to see greater participation within the workforce by at-risk groups such as youth, people beside chronic pain, and the mature-aged.
This treatise deals near the development, finishing, and evaluation of a pilot project to deliver pre-vocational services to mature age post seekers (i.e. aged 50 years and over). The mature age pre-vocational pilot program be prompted by an increase in government funding of vocational rehabilitation programs for this group (up from 293 in 2002-03 to 1823 by 2004-05). With the dramatic increase in referral came the concerning possibility of a corresponding rise in the number of cases that would not proceed from intake assessment (1) to a rehabilitation program due to perceived withdrawal of motivation or inability to make a substantial recovery in their circumstances. It be therefore earth-shattering to have a strategy surrounded by place to address these issues so that mature aged clients be effectively assisted to engage surrounded by services as early as possible.
Background
Retaining workers aged over 50 years in employment is a push button priority for the Australian Government, given trends of falling fertility and increased longevity (Business Work and Ageing, 2002). This is recognised in the abolition of compulsory retirement in most Australian states and territories (with the exception of Northern Territory and Tasmania) (Brooke, 2002; Winefield et al., 2002).
A report on workplace age nouns (Victorian South Australian and Western Australian Equal Opportunity Commissions and the Australian employers convention, 2001), however, found that "employment practices commonly prevent and discourage older workers from seeking and achieve employment" (Brooke, 2002; p 4). In the workplace, older workers also encounter nouns in access training opportunities (Australian Bureau of Statistics, 1997) and enjoy become the targets of corporate downsizing and restructuring. Those who move as the result of redundancy are smaller number successful in the vocation market than those who move by choice (Lawless, Martin, & Hardy, 1998).
Long-term job loss duration for Australian mature-aged workers has shown some concerning trends. In August 2002:
* Male jobseekers over 45 have an average duration of unemployment of 101.8 weeks--2.3 times that of younger jobseekers (44.2 weeks)
* For feminine jobseekers over 45, the figures are 109.7 weeks-2.5 times that of females lower than 45 (44.5 weeks) (Brooke, 2002)
Mature-aged job seekers are more expected to be perceived as being smaller quantity motivated (64% of mature-aged versus 57% of total job-seeking population, according to job seeker profile analysis by Department of Employment and Workplace Relations, 2002).
Mature-aged general public with disabilities are further disadvantaged. Evidence suggests that lots people who experience midcareer disabilities are more potential than ever before to help yourself to early retirement a bit than to attempt to surmount the disability and return to work (Bowe, 1986).
Not surprisingly, mature-age jobseekers are more than four times more likely than other age groups to be a discouraged opportunity seeker (Australian Bureau of Statistics, 2000b). These are defined as "have marginal attachment to the labour force who needed to work and were available to start work ... but whose prevalent reason for not actively looking for work be that they believed they would not find a job" (Brooke, 2002; p 21).
Almost half of discouraged opening seekers left work for disease, stress, or caring reason, and most saw their health as a enclosure to re-entering the workforce (Lim-Applegate, 2002). Vinokur & Schul (2002; p 72) also conclude that "out of work and claiming benefit people who are demoralised and depressed are also depleted of mental and physical punch needed for mounting successful job look into strategies".
Job loss in middle or latter age has be found to be more damaging to psychological robustness than unemployment for the immature (Winefield et al., 2002). Winefield et al. (2002) also state that 90% of retrenched mature-aged workers report a decline in mental or physical health, but interestingly 10% report an advance, which is usually associated with departing a job that be extremely stressful, mentally or physically.
The literature also supports the fact that the longer a individual is unemployed, the lower their probability are of returning to employment (Australian Bureau of Statistics, 2000a; Lawless et al., 1998; MacKay, 1998). This underscores the have need of for early intervention to make smaller the cost to the individual, the community and the government.
A review of the evidence for interventions beside mature aged on the dole was undertake, although there be little peer-reviewed published material available. Sanderson et al. (1999) tracked participant in work market scheme and analysed results in jargon of different age ranges. One theme to emerge be the success of personal nouns workshops with groups of clients experiencing similar problems near lack of motivation, confidence and self-esteem.
Recent literature on building motivation supports the application of a stage-based model which match interventions to the individual's (or group's) stage of readiness to metamorphosis. The Transtheoretical Model (TTM, also known as the "stage model") be first used to address alcohol abuse and other addictive behaviours (DiClemente & Hughes, 1990; Prochaska, DiClemente, & Norcross, 1992; Prochaska, Norcross, & DiClemente, 1994) but has be successfully applied to assessing readiness for vocational rehabilitation / return to work after a disabling injury (Mannock et al., 2002). It describes variation as progress, over time, through a series of stages: Precontemplation, Contemplation, Preparation, Action and Maintenance. For most people, the metamorphosis process is not linear, but spiral, with several relapses to in advance stages before they attain long-lasting behaviour translation (Prochaska et al., 1994).
The characteristics of each stage are summarised below:
Stage Characteristics
Precontemplation
* Denial of problem; Resistant to making change
* May hold given up the thought of changing because they are demoralised
Contemplation
* Can see the benefits of changing
* Over-estimate costs of changing; are ambivalent and not reasonably ready to change
* Seriously considering goings-on in subsequent 6 months Preparation
* Have decided to net a change within the next month
* Have already started to bear small steps toward goal Action
* Engaged surrounded by changing behaviours and are acquire new, well behaviours Maintenance
* Have been competent to sustain change for at least possible 6 months
* Actively striving to prevent relapse Adapted from Mannock et al. (2002)
When determining which stage the client is at, counsellors have typically relied on clinical judgement. A foreign tool, the University of Rhode Island Change Assessment--Vocational Counselling (URICA-VC) (Mannock et al., 2002), which aims to assess disabled workers' readiness to absorb in charge seeking behaviours, has be developed to complement clinical judgement. This instrument (a 12 question survey) be tested on 155 adults at a state rehabilitation centre within the USA, and results provided preliminary evidence for its construct validity. Test results are score as categorical data: any Precontemplation, Contemplation, Preparation or Action.
Interventions need to be particularly matched to the stage that the client (or group) is currently in. For example "if action-oriented interventions be offered to all workers who are disabled, the majority who are not prepared to want employment would be mis-served" (Mannock et al., 2002; p 17). A review of more than 100 empirical studies over the last 20 years (Prochaska & Norcross, 2001) also concluded that stage-matched interventions increase association and, therefore, the odds that the individual will take feat. They did, however, concede some limitations in the study designs as none of the outcome studies have directly and prospectively mismatched the therapist's relational style to the individual or group's stage of transmutation.
A similar approach that has yield encouraging results is the Vocational Problem-Solving Skills (VPSS) (Zanis, Coviello, Alterman, & Appling, 2001). This is a cognitive-based intervention for assisting the long-term unemployed surrounded by their transition to work. In a study of 109 clients from two Methadone treatment programs, improvements in employment functioning be noted in those who undergo the VPSS program, although there be several confounding variables, such as counsellor adherence to the VPSS manual and poor lenient attendance.
Objective
The major object of this pilot was to develop and deliver an evidence-based, time-limited and group-based intervention to the target group next to the aim of having participant ready to grip on completion in any a CRS Australia vocational rehabilitation program, mainstream Job Network services, a Disability Open Employment Service, or independent job-seeking. The pilot avoided duplication of services offered through other agencies, and be not to include vocational training.
Method
CRS Australia's Metropolitan South region of Western Australia was identified as a suitable site for the carrying out of the pilot, due to the ability to attract a suitable token size of mature aged livelihood seekers, staff interest and the existence of a suitable community agency to collaborate with. An analysis of client statistics for this demanding region indicated that mature aged-clients made up 21.8% of referral (n=205) but had a lower rate of taking up onto program (32.7%, n=67) compared to the overall rate of 36.7% (n=344). In 43% (n=60) of cases the reason for non-acceptance be "substantial gain unlikely" and in 27.5% (n=37) it was "client not interested".
Participants
All clients who met the age criteria (i.e. 50 years+) and be not offered a CRS Australia program in the preceding year for reason of "client not motivated" or "substantial gain unlikely" were contacted by dispatch and phone and invited to attend. Where there be insufficient uptake, newspaper advertisement were used to conscript suitable participants, and simply those who were assessed as untrained to commence a vocational rehabilitation program be invited to participate. Participation contained by the pilot was voluntary.
Thirty-seven (37) participant commenced the pilot (30 male and seven female) beside an average age of 56.2 years. Musculoskeletal injuries comprised the bulk of the primary disability recorded (59.4%; n=22 have a neck, rear legs, shoulder, knee or "other musculoskeletal" disorder) beside other major category being affective disorder such as depression (10.8%; n=4) and standard anxiety (8.1%; n=3).
Instruments
The reason for need of readiness for rehabilitation be recorded, along near current circumstances and demographic data (age, sex, disability type). All participant completed a URICA-VC on commencement and at completion, with concurrence from the tool's authors (ProChange Behaviour Systems, Inc.). The authors also gave written consent for a change contained by the wording of one question (Q9, which relates to a financial settlement for a compensable injury, be changed from "I believe looking for work will hurt my chances for a settlement, and I can't do that right now" to "I believe I might be financially worse stale if I find a job, as I will lose my allowance (or allowance) and my concession cards"). All tests be scored by the project bureaucrat (2).
Group facilitators reported weekly on participant attendance, drop-outs (including reason for this) and participant outcome on completion of the group program. Participants completed a written questionnaire on completion, and two separate focus groups (one for participant, one for facilitators) were conducted after adjectives groups concluded and qualitative themes extracted.
Procedures
All participant underwent a six week group program designed by the author, attending once per week for three hours. The group have the following core components:
* personal development workshops to develop communication skills, self-confidence and motivation (Chamberlin, 1997; Sanderson et al., 1999). These workshops be based on the VPSS program (Zanis et al., 2001) whose author big-heartedly gave say-so to use their manual and workbook. These be adapted to suit the participant group and time constraints (this pilot ran for six weeks, the VPSS is a 10 step program). Sessions covered be:
Week 1: Introduction and orientation
Week 2: Attractions to group participation and employment
Week 3: Barriers to group association and employment
Week 4: Identifying internal resources
Week 5: Identifying external resources
Week 6: Program review and evaluation
* linking with/referral to local vocational services (as appropriate) upon completion.
The facilitator approach was underpinned by the Transtheoretical Model of regulation with the assumption that most participant would be in the pre-contemplation or contemplation stages on commencement. Facilitator judgement and URICA-VC check results guided the initial approach taken for each group.
Four group programs be run consecutively, each beside a maximum of 12 participants. The first three be delivered surrounded by Fremantle, and the final group was deliver in Northbridge, Perth as the majority of participant in that group lived closer to that location.
CRS Australia's Service Delivery Support squad provided overall project management, next to key local staff designated as contact individuals in the pilot site (Fremantle office). A private contractor, "Bureau Gravitas", a local service provider for grow age unemployed be engaged to administer the URICA-VC at group start and conclude, deliver the group program, report on participant attendance, and provide written and verbal progress reports.
Results
Outcomes achieved
29.7 percent (n=11) of participant did not complete the group program; five of these obtained employment, three withdraw due to health problems, and others due to personal or kinfolk reasons, shortage of interest, and inability to be contacted.
At the conclusion of each group, contractors and CRS Australia staff completed a report describing the outcomes achieve by participants and their circumstances at the time. Although participant may achieve multiple outcomes, for this analysis participant were classified into one group representing their ultimate achievement on the outcome ranking presented in Table 1.
In sum, 54% of those that completed the group have achieved the group's aspiration (37.5% active engagement surrounded by vocationally directed activity and 13.5% contained by paid work) and a further 8.1% contracted to enrol in formal childhood. Of those that did not complete the group, 13.5% left to verbs work.
Participant motivation to make positive change in condition and vocational activity
A. Change in URICA-VC score
53.8% of participant moved forward one or more categories as illustrate in Table 2.
It is esteemed to bear contained by mind, however, that the URICA-VC results are categorical, and that those rated as Pre-Contemplation at the start of the group program could not regress, and those rate as Action could not go forward.
There be, however, some questions raise regarding the reliability of the URICA-VC notes. Many participants expressed concern roughly speaking how they answered the questions. Despite reassurance that results be confidential, many be fearful of repercussions on their income support. Those with low literacy also found the check confusing. For example, one question is stated as a refusal "I don't understand why I own to look for a job". To avoid a high pre-contemplation win for this question, the participant must select "strongly disagree", a double glum.
Facilitators commented that many participant felt the experiment had unknown "traps" so may not have answered next to complete candour. There be also a perception from facilitators that final test results did not clash observable vocational behaviours nor did they reflect the immensity of changes made by participant.
B. Participant self-evaluation
Using written feedback, participants be asked two questions relating to motivation to be in charge of health and vocational issues. These be:
* Q9 How prepared are you, right now, to succeed surrounded by managing your health/disability?; and
* Q 10 How prepared are you right now to look for work? Results are summarised within Table 3.
The questions be open-ended (that is, participants did not hold to select a score or rate themselves on a scale) and results be ranked by the Project Manager, and checked by an independent being. Categories arising from Q4 were exceptionally prepared, better prepared (than before group), and cold.
92 percent reported that they felt better prepared or enormously prepared to look for work and the same percentage also feel better prepared or very prepared to do paperwork their health/disability.
Participants were also asked whether they would recommend this group to a friend, and 96% responded positively.
Qualitative outcomes
C. Participant feedback
The written feedback and focus groups adjectives reinforced the importance of belonging to and socialising near a group of peers. Among the most frequent responses to the question "What parts of the program did you similar to the best?" were social aspects, group discussion, personal nouns sessions, and hearing others' experiences.
The piece that really gave me a buzz (was) that once
we get to know each other we be like brothers ...
we simply were competent to empathise with respectively person. As
respectively person get to their say, we'd ... provide them a
boost, bring them out of their shell and say "look,
you can do this" and by the conclusion of the session
they'd think "Gee, I can do that".
(Source: participant, Fremantle focus group)
Participants also notice when others were vastly negative or seem to be attending under duress (eg to fulfil a establishment income support Mutual Obligation requirement). There was debate surrounded by some focus groups as to whether these people be "holding the group back" or whether their negativity actually become a spur for others.
.. at the same time, it help people spark up if you
saw that they be being refusal ... It had the
in front of effect. Everyone came out of their shell a
bit more.
I've get a positive bias because I wanted to attend
(but) near were some empire who were refusal....
in a sense their negativity certainly brought out a lot
of positiveness from like mad of other people ... It be a
very positive incredible group
(Source: participant, Fremantle focus group)
Similarly, nouns stories within the group have a motivating effect on others:
The only female in our group be a quiet little point
and she ... had done the outdated fashioned drafts work,
and when I saw that she got a work and she was the
quietest female in the group ... I said "in good health if she can
do it, I can".
(Source: participant, Fremantle focus group)
A strong theme contained by the participant focus group was that of personal empowerment and enhanced self confidence and self efficacy. There was also praise for the facilitators, beside importance placed on the certainty that they were of a similar age and have experienced unemployment behind time in their career.
These guys have incontestably got the experience,
they've unquestionably been at hand and they know what
they're doing and they are the ideal race to have
training as resourcefully.
Someone could (have) come out of university and
landed contained by a job ... and they could run it, but I feel
more at home with (these facilitators).
(Source: participant, Fremantle focus group)
D. Facilitator feedback
Key themes included doubts going on for the validity of the URICA-VC (as discussed previously) the dent that people who did not surface forced to attend made the most gains, and some discomfort near the structured sessions and workbook activities. It is central to note that the facilitators contracted have previously developed a group product, the Personal Empowerment Program[TM] (PEP). While preparing to deliver the pilot, they worked with CRS Australia to blend the two programs. After deliver the second group, the contractors reported their concerns to the Project Manager, and then modified the program further to incorporate more endeavours from the PEP model. The implications of the loose change in the abdication model for the Mature Age Pilot are examined further in the Discussion section.
The contractors commented that they found the experience a positive one, and would be prepared to run the groups again. They highlighted the internal resources session (in which participant identified their own strengths and skills with the assistance of the group) as the most powerful of the program.
Discussion
There is evidence that this pilot met participant' needs and assisted the majority to engross in vocational stir and feel better equipped to govern their disability or health condition.
The design of the pilot group program number one a cognitive behavioural approach. Content and structure were base on the VPSS underpinned by the Trans Theoretical Model of behavioural change. There is evidence to support this as a valid intervention next to this target group, with facilitators reporting that assisting group member to generate their own arguments for change be important, and that the most powerful quantity of the process was the passport of internal resources.
As reported previously, the facilitators experienced some discomfort with the comings and goings and terminology used within the VPSS, and raised concerns next to the Project Manager after running the first two group programs. It was agreed that the primary structure needed to remain intact (i.e. attractions, barriers, solutions using internal and external resources) but at hand was flexibility surrounded by the manner within which these lessons be presented. It became adjectives during the evaluation phase, however, that the program delivered be more heavily influenced by the facilitators' own product (Personal Empowerment Program) in the latter two groups. Although the basic philosophy of participant empowerment be the same as the pilot's, the confinement model was subtly different. For example, the VPSS format works on identify attractions and barriers to form and vocational participation, consequently generating solutions to barrier using internal and external resources. The PEP[TM] avoids the term "barrier" and moves directly into a more solution-focused model. Facilitator adherence may own been better address through more intensive training in the TTM prior to the commencement of the study.
The evaluation is further complicated by the fact that participant in the first two groups be clients who had not be offered a CRS Australia program in the preceding year, while the latter two groups be mainly society responding to newspaper advertisement (3). By answering the advertisement, participant in the finishing two groups were self-selectors to the program, and maybe more willing to thieve steps towards vocational engagement. It is not surprising then that the contractors noted that participant in the first two groups needed longer to finish the same outcomes as those contained by the last two, and be in standard more challenging to work near.
Limitations
A number of issues have complicated the evaluation of this pilot. These are address throughout this paper. In summary, however here are six main issues:
URICA-VC. facilitators stated that a few participants
(for example near literacy problems) misunderstood
questions, and occasionally responded next to a
score surrounded by the opposite direction to what they may own
intended. Some participants be concerned that scores
may impact on their income or benefit and feel
compelled to indicate strong agreement with the opportunity
seeking questions
Difficulty applying in a statistical trial of significance to
changes within URICA-VC scores.
Because the URICA-VC produces a categorical or
nominal chalk up statistical analysis was predetermined to the
Cochran Q test. This required the exhaustion of data to a
dichotomous scale--improved versus not improved-which
did not do sprite to the complexity of data (e.g.
participant could progress or regress up to 3 stages,
depending on their start score). There was also the
dilemma of how to code facts for the large group of
participant whose results remained the same. Inclusion
of these score in any category would lead to any a
false positive or negative, so this analysis be not
pursued. Results are therefore presented as summary
statistics.
Lack of a inbred control group. There was no valid
control group for this pilot, so a one-group pretest-posttest
research design be utilised for comparison of
start and end URICA-VC score. End-group client outcomes
are also presented with no comparator. Those
clients who decline to participate be unable to be
used as a control group as in attendance may have be confounding
reasons as to why they decline. For example,
they may have have extremely low motivation, resulting
in the intervention groups having exaggerated positive/
better outcomes.
Recruitment of participants. Lack of referral numbers within
latter groups resulted in the involve to advertise surrounded by local
newspapers. The majority responding to advertisement
were screen for suitability for the group, but by
answering an advertisement may enjoy been more motivated
to sort a change, thereby biasing the preview.
Lack of facilitator adherence to the VPSS manual surrounded by the
later Mature Age groups. This issue is examined in the
discussion sector and is complicated by the recruitment
of participant noted above. Interestingly, counsellor
adherence was also raise as an issue by the authors of
the VPSS in their innovative paper (Zanis et al, 2001).
The timing, of the evaluation. This evaluation is base on
data collected hastily after the service-delivery
phase. A more thorough measurement of impact would
Include long-term follow-up.
Conclusions and Implications
The quantitative and qualitative information show that the design of this group intervention was nouns for mature age out of work who had lost confidence and motivation to engross in vocationally directed leisure. A clear majority of participants feel it met their needs, and would recommend it to a friend. Furthermore, most achieve a measurable change contained by their circumstances on completion of the program, with 27% (split evenly between those who completed the group and those who moved out before completion) working, 37.5% better unavailable in vocational services or events, and a further 8.1% engaged surrounded by formal education.
Specifically, the evaluation have provided evidence to support the TTM as a theoretical font of group programs for clients with low motivation. There is also evidence to support a structured cognitive/behavioural approach such as the VPSS program beside this group, although activities and gobbledygook used may need to be modified for respectively group taking into account literacy and age. There be some difficulty in applying the framework of the VPSS to the Mature Age group, and this warrant further research.
References
Australian Bureau of Statistics. (1997). Education and Training Experience (ABS Cat No. 6278.0).
Australian Bureau of Statistics. (2000a). Australian Social Trends 2000. Work--under-utilised labour: long possession unemployment. Australian Bureau of Statistics. Available: http://www. abs.gov.au/ausstats/ABS@nsf access 17 December 2002.
Australian Bureau of Statistics. (2000b). Persons not in the Labour Force, Australia (ABS Cat No. 6220).
Bowe, F. (1986). Coming stern: Directions for rehabilitation and disabled workers. Fayetteville: Arkansas Research and Training Centre in Vocational Rehabilitation.
Brooke, L. (2002). Draft paper: The ageing job force: conflicts between global trends and work practices. A statistical analysis of trends affecting elder jobseekers. Melbourne: Business Work and Ageing.
Business Work and Ageing. (2002). Fact sheet: Australia's changing age profile. Melbourne: Business Work and Ageing (BWA).
Chamberlin, J. (1997). A working definition of empowerment. Psychiatric Rehabilitation Journal, 20(4), 43-46.
DiClemente, C. C., & Hughes, S. O. (1990). Stages of shift profiles in outpatient alcoholism treatment. Journal of Substance Abuse, 2, 217-235.
Landy, F. (1985). Psychology of work behavior (3rd ed.). Homewood, IL: Dorsey.
Lawless, P., Martin, R., & Hardy, S. (Eds.). (1998). Unemployment and social exclusion. London: Jessica Kingsley Publishers.
Lim-Applegate, H. (2002, 27-30 October 2002). Outcomes for grown-up aged people who vanished employment in the decade to 2000. Paper presented at the Maturity Matters: Sixth Global Conference of Ageing, Burswood International Convention Centre, Perth.
MacKay, R. R. (1998). Unemployment as exclusion: Unemployment as choice. In P. Lawless & R. Martin & S. Hardy (Eds.), Unemployment and social exclusion. London: Jessica Kingsley Publishers.
Mannock, T., Levesque, D., & Prochaska, J. (2002). Assessing enthusiasm of clients with disabilities to rivet in chore seeking behaviours. Journal of Rehabilitation, 68(3), 16-23.
McDaniel, J. (1976). Physical disability and human behaviour. New York: Pergamon.
Michaels, C. A. (1998). Transition to employment. Austin, Texas: Pro-Ed.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how those change: Applications to the addictive behaviours. American Psychologist, 47, 1102-1114.
Prochaska, J. O., & Norcross, J. C. (2001). Stages of adjustment. Psychotherapy, 38(4), 443-448.
Prochaska, J. O., Norcross, J. C., & DiClemente, C. C. (1994). Changing for good. New York: William Morrow and Co. Inc.
Robbins, S., Waters-Marsh, T., Cacioppe, R., & Millett, B. (1994). Organisational routine: Concepts, controversies and applications: Australia and New Zealand. Sydney: Prentice Hall Australia.
Roessler, R. (1989). Motivational factors influencing return to work. Journal of Applied Rehabilitation Counselling, 20(2), 14-17.
Sanderson, I., Walton, F., & Campbell, M. (1999). Back to work: local motion on unemployment. York: York Publishing Services Ltd.
Victorian South Australian and Western Australian Equal Opportunity Commissions and the Australian employer convention. (2001). Age limits: Age-related nouns in employment affecting workers over 45.
Vinokur, A. D., & Schul, Y. (2002). The net of coping resources and pathways to reemployment following a charge loss. Journal of Occupational Health Psychology, 7(1), 68-83.
Winefield, A., Montgomery, B., Gault, U., Muller, J., O'Gorman, J., Reser, J., & Roland, D. (2002). The psychology of work and unemployment within Australia today: an Australian Psychological discussion paper. Australian Psychologist, 37(1), 1-9.
Zanis, D. A. P., Coviello, D. P., Alterman, A. I. P., & Appling, S. E. (2001). A community-based trial of vocational problem-solving to increase employment among methadone patients. Journal of Substance Abuse Treatment, 21, 19-26.
Lisa O'Brien
Monash University
(1) When assessing eligibility for a program next to CRS Australia, Rehabilitation Consultants undertake an individual Initial Needs Assessment beside each client. This assessment identify the barriers face by the client, and begins the process of identify strategies to overcome these. It is at this point that a decision desires to be made regarding the potential for desire achievement--that is, will substantial gain be made towards the goal contained by a reasonable timeframe and cost?
(2) For initial groups, scoring be done by both the project manager and a CRS Australia staff contributor involved in delivery of the pilot. Inter-rater reliability be 90%.
(3) This was due to the low take-up rate of clients previously not offered a CRS Australia program, and poor referral rates to the Pilot program.
Lisa O'Brien, Department of Occupational Therapy, Monash University, Peninsula Campus, McMahons Road, Frankston 3199. Victoria, Australia.
Email: Lisa.OBrien@med.monash.edu.au
Table 1
Hierarchy of outcomes achieve by pilot participants at conclusion
of group
Outcome at Conclusion of Pilot group Percentage of
participant
Completed group 70.3
Obtained employment# 13.5#
Referred for vocational rehabilitation# 8.1#
Referred to Disability Employment Service# 0#
Referred to Job Network# 0#
Independent job seeker# 32.4#
Attending education--Technical & Further Education 8.1
Attending education--secondary institution 0
Attending education--other 0
Obtained voluntary work 5.4
Referred elsewhere (eg health services) 2.7
Other 0
Obtained employment# 13.5#
Self employed# 0#
Attending another vocational service# 0#
Independent livelihood seeker# 0
Attending education * 0 *
Did not complete group 297
Attending form service / other health object 8.1
Not interested 2.7
Personal or family issues 2.7
Unable to contact 2.7
Language problem 0
Other 0
TOTAL 10%
Key:
# Achieved Pilot end
* Engaged in tuition
The elements may not sum to totals due to rounding. The order
presented represents the coding ranking, with outcomes interview
the Pilot objective shaded.
Table 2
Change contained by URICA-VC score after attending group
Went No Went Total
backwards 1 transmutation forward
or more stages 1 or more
stages
Number of participants 5 7 14 26
% 19.2% 26.9% 53.8% 100%
Table 3
Participant feedback concerning willingness to direct health
and vocational issues
How prepared are you, exceptionally: 54%
right now, to succeed surrounded by better: 38%
managing your health/ disability? no response: 8%
How prepared are you right now markedly: 50%
to look for work? better: 42%
not ready: 8%
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