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Psychiatric disabilities: Challenges and training issues for rehabilitation professionals

McReynolds, C.J. & Garske, G.G. (2003). Psychiatric disabilities: Challenges and training issues for rehabilitation professionals. Journal of Rehabilitation, 69(4), 13-18.

Article Summary

Long-term success in the workplace may require more than just vocational counseling for the more than 40 million people in the United States with psychiatric disabilities. These individuals who may have poor social skills, limited interpersonal relationships, and difficulties with living independently must first resolve psychosocial and emotional issues before dealing with vocational ones. While the disabilities themselves present numerous challenges to full independent functioning in the community and workplace, the authors suggest that limited training for vocational rehabilitation professionals in working with clients with severe psychiatric disabilities might contribute to the 85% unemployment rate among adults within this population.

The authors share a number of intervention models that have helped individuals with accept their psychiatric disabilities and develop a positive self-image. The Clubhouse Model, developed by the Fountain House in New York, provides interpersonal and occupational training within the context of a community-based support system for individuals with psychiatric disabilities.

Members are able to enhance their self-confidence, improve their work habits, and build up their work experience on entry-level, part-time transitional employment (TE) in the community lasting 3 to 9 months. Supported employment (SE) has also been very effective in helping individuals with psychiatric disabilities find and retain competitive employment. Supported education (SEd), using both the structured classroom and on-site support models, has also been effective in improving employment rates among this population.

Individuals with psychiatric disabilities may not look as though they need special assistance. Often they enter the relationship with rehabilitation professionals having to verify their symptoms. The authors cite studies showing the further intensification of alienation and feelings of low self-worth as individuals attempt to convince service providers that their psychiatric symptoms are real and not delusions. Along with the invisibility of psychiatric illnesses come the stigma and rejection that do not accompany more visible, physical disabilities.

In closing, the authors stress the need to expand training programs for rehabilitation professionals to include the following:
  • Establish academic specialized tracks in psychiatric rehabilitation;
  • Offer special topics courses in psychiatric rehabilitation; and,
  • Incorporate information about psychiatric rehabilitation into existing courses, including psychotropic medications, psychiatric diagnoses, functional limitations, and reasonable accommodations.