October 9, 2009
SE pioneer Gary Bond provides an update on research, evidence for supported employment
Indianapolis, IN—The Center for Evidence-Based Practices at Case Western Reserve University was pleased to welcome back one of its long-time friends, Gary Bond, PhD, Chancellor's Professor Emeritus of Psychology at Indiana University-Purdue University Indianapolis. Dr. Bond was a keynote speaker at the Annual Ohio Supported Employment Conference 2009, which was held in Columbus in March.
Dr. Bond has been a pioneer in the field of evidence-based practices (EBPs) for people with severe mental illness. His research has focused primarily on the Supported Employment (SE) and Assertive Community Treatment (ACT) models. He also develops and evaluates "fidelity scales," which are standardized measures for assessing how well service models are being implemented. In a career spanning over 30 years, he has collaborated on numerous studies and has published widely.
THE KEYNOTE ADDRESS
"The chance of consumers getting a job is at least twice as high if they receive evidence-based Supported Employment services. ... The evidence for SE is stronger than any other psychosocial intervention for people with severe mental illness."
— Gary Bond, PhD
During his keynote plenary at the Ohio SE Conference 2009, Dr. Bond spoke about national studies which illustrate that people with severe mental illness are more likely to find and keep a competitive job of their choice in their community when service providers utilize the principles and practices of the evidence-based SE model. Dr. Bond highlighted the following evidence:
- Only about 5 percent of people with severe mental illness get the services they want.
- The chance of consumers getting a job is at least twice as high if they receive evidence-based Supported Employment services.
- After ten years, nearly half of the people in the studies who received SE services were still working.
- Consumers who were employed had better control of symptoms and higher self-esteem.
- Research shows that SE is effective not only in the United States but also in Canada, Europe, Japan, Australia, and Hong Kong.
- SE is effective with many different cultural groups.
- The evidence for SE is stronger than any other psychosocial intervention for people with severe mental illness.
Dr. Bond sat down with us after his presentation to provide an overview of his plenary, to share a little history of how he happened into the field of mental-health-services research, and to share success stories and a look into the future of Supported Employment.
1.) SE Research Plenary, Part 1 (1m 45s)
presentation covered several topics: increasing access to SE among
beneficiaries of SSDI; decreasing dependence of consumers upon social
systems; and possible new SE funding sources from the U.S. Dept. of
Labor and Social Security Administration; among others.
2.) SE Research Plenary, Part 2 (2m 38s)
Some initial findings
from the national 10-state J&J-Dartmouth Community Mental Health
Program; some encouraging impressions from The Mental Health Treatment
Study—a national 23-site Social Security project (see sidebar in right
column); SE could be augmented with cognitive-rehabilitation
3.) Cognitive Rehabilitation Strategies, Part 1 (1m 49s)
There is emerging research on this systematic method to help improve job
retention. First, service providers help consumers identify cognitive
tasks they struggle with—e.g., attention, memory, judgment, interpreting
non-verbal social signals. Then, consumers learn and utilize coping
mechanisms for each.
4.) Cognitive Rehabilitation Strategies, Part 2 (1m 24s)
Research at Duke University has found that people with schizophrenia
tend to be less capable of reading the emotions of others. However,
there are interventions to help people develop this skill, so consumers
may become more attuned to the verbal and non-verbal signals exhibited
by co-workers, supervisors, and others.
5.) Personal Transformations (1m 31s)
Bond tells a story
about a service provider who did not recognize several consumers whom he
had met while they were in a psychiatric hospital. After discharge,
they found jobs via Supported Employment services and their physical
appearances changed dramatically. They seemed more vibrant, more
attentive, more engaged socially.
6.) Advice for Implementation (1m)
Some successful implementation "factors" identified in research studies:
have positive attitudes and hopefulness that consumers can work and
shall recover; hire team leaders and program managers who are committed
to SE; and find adequate and sometimes innovative funding sources.
7.) Zero Exclusion, Almost (2m 28s)
Research suggests that organizations which are committed to SE
embrace its principles and practices. However, in a larger "systems"
context, this is not the case. For instance, some voc rehab counselors
tend to maintain a strongly held prejudice that some consumers are not
capable of succeeding in competitive jobs.
8.) Early Intervention (2m 31s)|
Early intervention for people with early-onset psychosis will hopefully
some day include Supported Employment as well as Supported Education,
making holistic recovery a part of the fundamental policy discussion on a
local, national, and international level. Learn more about the new SE
fidelity scale and the implementation of SE overseas.
9.) Supported Education (1m 25s)
Supported Education works much in the same way as Supported Employment,
tapping into "consumer choice"—and hope for the future—while providing
various support services along the way. The model is having success in
Kansas and Washington. Learn about some prominent names in Supported
10.) The Early Days: A New Career Path (2m 27s)
Gary Bond began his professional career some 30 years ago as a
mathematics major and came into the world of mental-health-services
research serendipitously one day in Chicago, when a student of his told
him about a job at Thresholds, a provider agency. Bond also finds
inspiration from his sister, who has schizophrenia.
11.) A Success Story In His Family (2m 16s)
With his sister on her own recovery journey, Gary Bond has seen
first-hand how work helps accelerate and sustain recovery. It has helped
improve her demeanor and her sense of what she brings to the world.
THE NATIONAL SCENE
Supported Employment, the evidence-based practice, was created by researchers Deborah R. Becker, MEd, CRC, and Robert E. Drake, MD, PhD, and their colleagues at the New Hampshire-Dartmouth Psychiatric Research Center at Dartmouth Medical School.
They have provided leadership for national implementation of SE via the Johnson & Johnson-Dartmouth Community Mental Health Program. The State of Ohio—and the Center for EBPs at Case, through its Ohio SE Coordinating Center of Excellence—is participating in this national initiative.
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