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      Practices and roles of Irish occupational therapists’ with adults with intellectual disabilities who access supported employment services

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          Abstract

          Purpose

          Work is good for one’s health and well-being. Work for people with disabilities should be encouraged because it is therapeutic and improves participation in the society, leading to better health outcomes. It develops interpersonal relationships and enhances life quality. Work is an aspiration for many people with intellectual disability. Within research literature, there appears to be a lack of research into the experience of occupational therapists in Ireland who refer adults with intellectual disabilities to supported employment services. The purpose of this paper was to explore the experience of Irish occupational therapists who refer adults with intellectual disabilities to supported employment services.

          Design/methodology/approach

          Semi-structured, in-depth interviews were conducted with four occupational therapists recruited through the Association of Occupational Therapists of Ireland (AOTI). Data were analysed using thematic analysis.

          Findings

          Themes that emerged were as follows: occupational therapy participants did not directly refer adults to supported employment but received referrals; occupational therapy roles included assessments, task analysis and development of client’s skills are major components of current practice; pragmatics involved factors that facilitate and challenge; and future roles.

          Originality/value

          This paper contributes to occupational therapy practice knowledge by providing a perspective on supported employment in Ireland. Occupational therapists should continue to work in the area of supported employment to support social inclusion and enable participation. Further research with occupational therapists working in this field is required to inform practice.

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          Most cited references 57

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          Using thematic analysis in psychology

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            An update on randomized controlled trials of evidence-based supported employment.

            The Individual Placement and Support (IPS) model of supported employment for clients with severe mental illness has been described as a standardization of evidence-based supported employment. Although several reviews on the literature on its effectiveness have been conducted, the completion of several new studies suggests an updated review is warranted. We conducted a comprehensive literature search for randomized controlled trials of IPS, limiting our review to programs with high-fidelity IPS programs, locating 11 studies. We examined the following competitive employment outcomes: employment rates, days to first job, annualized weeks worked, and job tenure in longest job held during the follow-up period. Across the 11 studies, the competitive employment rate was 61% for IPS compared to 23% for controls. About two-thirds of those who obtained competitive employment worked 20 hours or more per week. Among those who obtained a competitive job, IPS participants obtained their first job nearly 10 weeks earlier than did controls. Among IPS participants who obtained competitive work, duration of employment after the start of the first job averaged 24.2 weeks per year, or 47% of the 52-week year. The current review is consistent with earlier reviews, although the evidence for high-fidelity IPS appears to be somewhat stronger here than in reviews evaluating studies with more heterogeneity in the supported employment models examined. The number, consistency, and effect sizes of studies of evidence-based supported employment establish it as one of the most robust interventions available for persons with severe mental illness.
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              Implementing supported employment as an evidence-based practice.

              Supported employment for people with severe mental illness is an evidence-based practice, based on converging findings from eight randomized controlled trials and three quasi-experimental studies. The critical ingredients of supported employment have been well described, and a fidelity scale differentiates supported employment programs from other types of vocational services. The effectiveness of supported employment appears to be generalizable across a broad range of client characteristics and community settings. More research is needed on long-term outcomes and on cost-effectiveness. Access to supported employment programs remains a problem, despite their increasing use throughout the United States. The authors discuss barriers to implementation and strategies for overcoming them based on successful experiences in several states.
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                Author and article information

                Affiliations
                Department of Occupational Science and Occupational Therapy, University College Cork – National University of Ireland , Ireland
                Department of Occupational Therapy, Bethlehem University , Bethlehem, Palestine
                Author notes
                Patrick Joseph Hynes can be contacted at: patrick.hynes@ucc.ie
                Contributors
                Journal
                IJOT
                10.1108/IJOT
                Irish Journal of Occupational Therapy
                IJOT
                Emerald Publishing
                2398-8819
                04 September 2017
                : 45
                : 2
                : 78-91
                597898 10.1108/IJOT-06-2017-0016 IJOT-06-2017-0016.pdf IJOT-06-2017-0016
                © Patrick Joseph Hynes and Alia Harb.
                Counts
                Figures: 0, Tables: 0, Equations: 0, References: 70, Pages: 14, Words: 7613
                Product
                Categories
                research-article, Research Paper
                cat-HSC, Health & social care
                cat-HEDU, Health education
                Custom metadata
                Yes
                Yes
                JOURNAL
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