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      Development and evaluation of a strength-based method to promote employment of work-disability benefit recipients with multiple problems: a feasibility study

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          Abstract

          Background

          For people with disabilities, chances to find or keep work are negatively affected by multiple problems like lower education, poverty and poor health. Furthermore, although active labour market policies proved to be effective for unemployed in general, success rates are poor for persons who are unemployed due to multiple problems. The present study aims to describe the development of a method as well as professional training to teach its application, and to assess the feasibility of method and training. The Strength-based method (CARm) aims to promote employment of work-disability benefit recipients with multiple problems.

          Methods

          The main principles of the Strength model were redesigned for better applicability in a population of work-disability beneficiaries, resulting in the CARm method. As part of the CARm method, a training module for Labour Experts (LEs) was developed. To assess the new designed method and training, a one-group, pre-post design was used. Data were collected from eight participating LEs, five female and 3 male, aged between 41and 55 years and having 2–17 years working experience. We used self-report questionnaires and a semi-structured discussion meeting after the training sessions with the LEs.

          Results

          Eight labour experts (LEs) from the Dutch Social Security Institute participated in the study. Most LEs felt an improvement in their ability to ascertain developmental needs, opportunities and threats in the client’s situation. Three months after the training, LEs almost unanimously agreed on the statements ‘I expect to use the CARm method more frequently in the future’ and ‘I use the CARm method in daily practice whenever possible’. The overall rating for the training on a scale from 1 to 10 was 7.6 (range 7–9). The overall satisfaction with the trainers was good.

          Conclusions

          The CARm method and training was found to be a feasible approach to facilitate LEs working at the UWV reintegration service to support clients with multiple problems. Sufficient managerial support for participating LEs is a key factor for successful implementation of CARm. Results show that CARm is worth testing for efficacy in a future trial.

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          Most cited references18

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          Uses of strength-based interventions for people with serious mental illness: A critical review.

          For the past 3 decades, mental health practitioners have increasingly adopted aspects and tools of strength-based approaches. Providing strength-based intervention and amplifying strengths relies heavily on effective interpersonal processes.
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            Strengths model case management fidelity scores and client outcomes.

            The study examined the relationship between fidelity of strengths model case management (SMCM) and client outcomes of psychiatric hospitalization, competitive employment, postsecondary education, and independent living. Data were collected over an 18-month period during regularly scheduled fidelity reviews for 14 case management teams representing ten agencies serving an average of 953 clients diagnosed as having a serious mental illness. Time-varying covariate linear growth modeling examined the relationship between fidelity scores and client outcomes. A statistically significant association was found between fidelity scores and psychiatric hospitalization, competitive employment, and postsecondary education. The study results offer promising evidence that higher SMCM fidelity has a positive effect on clients over an 18-month period, thereby providing an effective complement to current mental health treatment.
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              The strengths based approach as a service delivery model for severe mental illness: a meta-analysis of clinical trials

              Background The strengths-based approach is considered a paradigm shift from the deficits- focused service delivery models. The aim of this review was to systematically review randomised controlled trials (RCTs) and quasi experimental studies examining the impact of the strengths-based approach on level of functioning and quality of life as primary outcomes and psychotic symptoms as secondary outcomes in people diagnosed with severe mental illness. Methods This review was conducted in the School of Health Sciences, University of Nottingham, United Kingdom. Participants in the primary studies were adults diagnosed with psychotic disorders. The methodological quality of the included studies was assessed independently by two reviewers using “Consort 2010” checklist for the randomized controlled trials or “TREND” for the quasi-experimental studies. The EPOC checklist was used for data extraction while management of data and meta-analysis were performed using Review Manager software (RevMan version 5.2). Results No significant difference was found between the strengths-based approach and other service delivery models in level of functioning and quality of life. However, a significant effect on symptoms favouring other service delivery models was reported. Conclusion Based upon evidence of moderate quality, this review suggests there is no effect of the strengths-based model of service delivery in level of functioning and quality of life in adults diagnosed with severe mental illness. The number of trials is low; therefore further evidence is required to ascertain the impact of the strengths-based approach in community mental health care. Electronic supplementary material The online version of this article (doi:10.1186/s12888-014-0243-6) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                k.a.brongers@umcg.nl
                l.r.cornelius@umcg.nl
                j.j.l.vdrklink@uvt.nl
                Sandra.brouwer@umcg.nl
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                16 January 2020
                16 January 2020
                2020
                : 20
                : 71
                Affiliations
                [1 ]University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, PO Box 196, 9700 AD Groningen, the Netherlands
                [2 ]Center for Labour Expertise, Nijkerk, The Netherlands
                [3 ]ISNI 0000 0001 0725 5522, GRID grid.491487.7, Dutch Social Security Institute: the Institute for Employee Benefits Schemes (UWV), ; Amsterdam, The Netherlands
                [4 ]ISNI 0000 0004 0435 165X, GRID grid.16872.3a, Research Centre for Insurance Medicine, AMC-UMCG-VU-UWV, , University Medical Centre Amsterdam, ; Amsterdam, The Netherlands
                [5 ]sTilburg University,Tilburg School of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Walfare, Tilbrug, The Netherlands
                Author information
                http://orcid.org/0000-0002-5358-4738
                Article
                8157
                10.1186/s12889-020-8157-3
                6966846
                31948432
                13639dca-97c8-4cf9-98d6-fb0401d2fa75
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 November 2019
                : 3 January 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                disability benefits,multiple problems,return to work,strength,training program
                Public health
                disability benefits, multiple problems, return to work, strength, training program

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