CENTER FOR EBPs

THE CHEESE WALL

Zero-exclusion is the ultimate optimism; everyone who wants to work receives Supported Employment services

—by Matthew K. Weiland and Paul M. Kubek

In the mental health profession, we rarely use statements of the absolute. Here’s an exception: Never underestimate a person’s desire and ability to get a job and succeed—no matter how severe or frequent his or her symptoms or inconsistent his or her track-record with jobs might be. And never deny anyone the opportunity to find a job if he wants one. This is called “zero exclusion”: it is one of the 7 core principles of Supported Employment (SE), the evidence-based practice. SE is designed to help people who are diagnosed with severe mental illness find a job of their choice with rapid job-search and placement services (see sidebar).

There is a story that Steve Shober, BS, LSW, uses frequently to illustrate his passion for the SE model and its zero-exclusion principle. It’s a story from his past experience as a vocational specialist and team leader. It’s about a man diagnosed with schizophrenia who wanted to work at a grocery store in his town. Steve and his colleagues did not believe the man could do it, because his symptoms were so strong and his thoughts so disorganized. But they took a leap of faith, because the evidence behind the SE model assured them that people who feel and express the desire to work are likely to succeed if they receive encouragement and support.

The Connection to Benefits Planning
“Personalized benefits planning” is another core principle of SE, and it complements the zero-exclusion policy. With benefits-planning services, people who are pursuing jobs will have a better understanding of how their monthly paychecks from part-time or full-time work might influence the following:

• Reduce their dependence upon cash benefits (non-earned income) from programs like SSI.
• Maintain their eligibility for other benefits that support their recovery (e.g., Medicaid, housing subsidy).
• Increase their ability to save money.
• Increase their ability to make the purchases they want and need.

It is important for case managers, employment specialists, and other service providers to have a basic knowledge of benefits programs, so they can complement the work of full-time benefits specialists and help people make informed decisions about getting a job and maintaining a stable financial future. (To learn more about our benefits-planning series, see sidebar.)

The Conversation

This is one installment in a collection of stories from conversations with Steve Shober, BS, LSW, about the importance of benefits planning.  Steve is a former vocational specialist, job coach, and benefits counselor who works as a consultant and trainer at the Ohio Supported Employment CCOE. (Learn more about Steve.)

.MP3 PLAYLIST

1.) Disbelief Does Not Work (1m, 33s)

Steve Shober had been employed by a mental health agency that sponsored a sheltered workshop and a “work adjustment” program to teach people basic work skills. It was a traditional vocational-rehabilitation approach: train people in a workshop removed from everyday life and assess their abilities before helping them find a job in the community. There was a man in the program who had been diagnosed with schizophrenia whose thoughts and speech were so disorganized that he could barely manage his tasks in the shop. Steve and his colleagues were convinced this man would never work a regular job.

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2.) Service Providers and Family Members Might Block Recovery (2m, 39s)

One day, the agency decided to implement an early version of the evidence-based Supported Employment (SE) model. The model insisted that service providers help anyone who expressed an interest in work find a job of his or her choice in the community as quickly as possible—with rapid-job search and placement services. The man with schizophrenia wanted to work in a local grocery store. His family members and service providers were skeptical, but they proceeded. Ultimately, the man proved them all wrong, creating a track-record of reliability for more than seven years.

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3.) Job Coaching and Follow-Along Services Support the Desire to Work (2m, 56s)

With the help of a job coach, the man learned to manage his disorganized thoughts enough to organize and maintain the cheese wall—a mosaic of specialty cheeses—at the store. He then pursued and learned other jobs at the store on his own, honoring his own interests and desire to keep challenging himself. The result was not defeat, but feelings of accomplishment and pride.

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4.) The Suspension of Disbelief (2m, 42s)

Shober is not afraid to reflect openly upon this story and his role in it. He admits that he and his colleagues made a big error in judgment, but they all learned an important lesson, which he shares with others whenever he gets the chance. It is this: when you expect nothing from someone, that’s what you get; but when you expect good things from them and for them, you will witness results you never imagined possible. Sometimes, people need to see that someone else believes in them—their hopes, their dreams, their abilities. It gives them the permission and assurance to believe in themselves.

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5.) Sign Off (0m, 44s)

This audio eConsult is a production of the Center for Evidence-Based Practices at Case Western Reserve University—a partnership of the Mandel School of Applied Social Sciences at Case and the Department of Psychiatry at the Case School of Medicine.

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CONTINUE ON TO . . .

Get a list of all Benefits Planning eConsults.

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Matthew K. Weiland, MA, is senior writer and producer and Paul M. Kubek, MA, is director of communications at the Center for Evidence-Based Practices at Case Western Reserve University—a partnership of the Mandel School of Applied Social Sciences at Case and the Department of Psychiatry at the Case School of Medicine.