Glossary of terms used in SE-IPS
Agency intake: Most mental health agencies have an intake process (sometimes referred to as a mental health assessment) that is administered when a person begins receiving mental health services. At some agencies, the intake/assessment is updated on an annual basis.
Assertive Community Treatment (ACT): Refers to a highly integrated team approach for delivering community mental health services to people with severe mental illness. Services are characterized by shared caseloads, community-based services, and a focus on assistance with daily living skills.
Benefits planning: Refers to helping a person review all of his or her benefits (e.g. Social Security benefits, medical benefits, food stamps, housing subsidies, Veteran’s Administration benefits, etc.) and determine the impact of earned income upon those benefits. Depending upon the preferences of the person, benefits planning may have the goal of helping someone exit the benefits system because she will support herself entirely through working. Also called work incentives planning.
Career profile: Refers to a document (previously called a vocational profile) in which the employment specialist records job preferences, work history, education history, strengths, legal history, and other information pertinent to a person’s employment or education goals.
Community-based services: This refers to meeting with people at their workplaces, homes, libraries, coffee shops, etc., based upon each person’s preference. Employment specialists also spend part of each week meeting with employers at their businesses. In IPS, employment specialists spend at least 65% of their time away from their offices.
Competitive employment: Jobs that anyone can apply for rather than jobs created specifically for people with disabilities. These jobs pay at least minimum wage (or clients receive the same pay as their colleagues who have similar duties). The jobs do not have artificial time limits imposed by the social service agency. IPS programs focus on competitive jobs.
Co-occurring disorders: Sometimes referred to as dual diagnosis. Refers to coexisting severe mental illnesses and substance use disorders.
Disclosure: Refers to disclosing information about one’s disability in the workplace. Some people choose to share information about their disabilities in order to ask for job accommodations (such as the support of an employment specialist) or because they are proud of having overcome barriers in order to return to work.
Employment specialist: The practitioner who helps people find work related to their preferences, and provides job supports to working people. IPS teams are comprised of employment specialists and an IPS supervisor.
Enclaves: Also referred to as “work crews.” Typically refers to a group of people who have disabilities and under the supervision of an employee of a vocational rehabilitation program. These positions are not considered to be competitive jobs even when the work is performed in community settings or when the wages are at, or above, minimum wage.
Evidence-based practice: Evidence-based practices refer to well-defined practices that have been demonstrated to be effective through multiple research studies. Research for IPS supported employment has been conducted in urban and rural settings, as well as national and international programs. Programs with good fidelity to IPS supported employment have better outcomes than programs with poor fidelity to supported employment. For more information about the evidence for IPS, go to http://sites.dartmouth.edu/ips, select “About IPS.”
Family: In IPS, practitioners are encouraged to ask people if they would like to include family members in their employment plans. The family may refer to parents, siblings, children, good friends, life partners, AA sponsors, or others identified by the person served.
Fidelity: A fidelity scale is a tool to measure the level of implementation of an evidence-based practice (EBP). The Supported Employment Fidelity Scale defines the critical ingredients of IPS supported employment in order to differentiate between programs that follow the IPS approach and those that do not. IPS fidelity helps program leaders develop plans for improving IPS services at their agency (see fidelity action plan). To view the fidelity scale, go to http://sites.dartmouth.edu/ips, and select “For Programs.”
Fidelity action plan: A written plan that outlines steps to improve fidelity to the IPS supported employment model. Plans include specific steps to be taken, a person(s) responsible, and target dates. Typically, fidelity action plans are developed after fidelity reviewers visit the program, score the fidelity scale, and provide a report with suggestions to improve services.
Field mentoring: Side-by-side coaching with practitioners as they perform their work. For instance, a supervisor might meet with an employment specialist and job seeker who are working on the career profile to model or observe the employment specialist’s interviewing skills. IPS supported employment supervisors also go with employment specialists to demonstrate meeting with employers to learn about their businesses and suggest potential job candidates.
Individual Placement and Support (IPS): IPS is a specific type of supported employment service that has been well researched and is carefully defined in a 25-item fidelity scale. The outcome of this service is competitive employment for people who wish to work.
Integrated services: In IPS, mental health practitioners and employment specialists meet weekly to brainstorm ways to support people’s employment and education goals. Another way that IPS uses integrated services is to meet frequently with Vocational Rehabilitation counselors to ensure that services are well coordinated.
Job accommodations: A worker who has a disability might request an accommodation that would permit her to work successfully in spite of some effect from the disability. For example, a person who had cognitive problems might ask if his employment specialist could help him learn new job duties. A person who began experiencing psychiatric symptoms might ask for a few days off so that she could try to manage the symptoms with a medication change. A person who found he had problems working with the public might ask to be switched to a position where he could work alone. Employers in the U.S. are not bound to agree to accommodations, but many are willing to do so if it is not too disruptive or costly to the business.
Job readiness groups: These groups may vary from one setting to another but typically focus on teaching people about the world of work; the importance of punctuality, proper grooming, managing symptoms in relationship to a job, etc. Groups that precede a job search are not part of IPS supported employment. In fact, IPS practitioners do not usually facilitate groups because they spend their time meeting individually with people and perform their jobs away from the office.
Job tryouts: See “situational assessments.”
Mental health treatment team (or multidisciplinary team): A group of mental health practitioners such as counselors, case managers, nurses, medication prescribers, substance abuse counselors, or others. When IPS is present, employment specialists are part of the mental health treatment team. Teams may also include other disciplines such as Vocational Rehabilitation counselors or housing specialists.
Multidisciplinary team: See “mental health treatment team.”
Peers: Refers to a person with lived experience of mental illness who is hired to be part of the mental health treatment team or IPS unit. This person talks with program clients about his experiences with mental illness, substance use disorders, legal history, or other issues, and how he overcame those barriers to be able to work and pursue other life goals. Some IPS programs hire peers to provide encouragement for working and job supports. Other IPS programs hire employment specialists who also happen to have a lived experience of mental illness. These employment specialists have the same responsibilities as their colleagues on the team, but they also sometimes share their own experiences in order to encourage others.
Randomized controlled trial (RCT): A type of research design that is regarded as the gold standard in medical research. People who participate in these research trials are randomly assigned to either the treatment or control group. The purpose of these trials is to study the efficacy of a treatment or intervention.
Rapid job search: Within 30 days of entering an IPS program (on average), the job seeker and/or employment specialist has in-person contact with employers. Some people who participate in IPS services may wish to move more slowly, and in these cases, employment specialists follow the preferences of their clients.
Sheltered employment: These workplaces hire people with disabilities to complete contracts for other businesses, for example, people with disabilities may be paid a piece rate to assemble garden hose spigots for a company that makes garden hoses. Sheltered employment is not consistent with IPS supported employment.
Situational assessments (“job tryouts”): Short-term work assignments that occur at an agency or in a regular business. The purpose of the assessment is to evaluate work behaviors such as attendance, ability to persist at a task, social skills and so forth. These assessments may also evaluate the person’s ability to perform a particular type of work. Situational assessments are not consistent with IPS supported employment.
Steering committees: Sometimes referred to as advisory committees or leadership teams. Agencies gather together stakeholders for IPS supported employment to discuss implementation efforts and to develop goals for better implementation. Advisory committees may include the IPS supervisor, clients, family members, Vocational Rehabilitation representatives, agency administrators, area chamber of commerce representatives, local colleges and GED programs, etc. For more information about steering committees, go to http://sites.dartmouth.edu/ips and select “For Programs.”
Supported education: There are many models of supported education, but in general the purpose of these programs is to help people successfully complete education programs such as college degrees, high school degrees, high school equivalency programs, and vocational training programs that are open to the general public. IPS programs may provide education supports to people who have education goals that are connected to their career goals.
Supported employment: Supported employment is a term used to describe employment programs that help people with disabilities find and keep jobs. These programs typically provide long-term job supports. IPS supported employment meets this definition, but is more specific in that it is also defined by a 25-item fidelity scale and is an evidence-based practice.
Transitional employment: Some social service agencies work with employers to secure positions that the agency will staff. For example, an agency might make an agreement with a local store so that a client worker will clean the store each day. The store would pay the social service agency for the work, and the agency would pay the client. Agencies typically offer these positions to their clients for a limited time period, such as six months. When the person has fulfilled his or her time commitment, the job is offered to another client of the agency. This is not consistent with IPS supported employment.
Vocational evaluation: Usually refers to a battery of tests and work samples that measure academic levels, manual dexterity, short and long-term recall, the range of motion, vocational interests, ability to sort items, etc. These standardized tests are not consistent with IPS supported employment, which uses a rapid job search instead.
Vocational Rehabilitation (VR): In the U.S., each state, as well as the District of Columbia and U.S. Territories, supports a division of Vocational Rehabilitation that has offices throughout the state to provide employment services for people with disabilities. The focus of Vocational Rehabilitation is to help people find gainful employment related to each person’s “strengths, resources, priorities, concerns, abilities, capacities, interests, and informed choice.” Vocational Rehabilitation counselors work collaboratively with IPS programs. Vocational Rehabilitation counselors provide expertise about disabilities and jobs, and sometimes provide resources such as money to pay for work clothing or education. They also participate in employment planning for each person who is referred for Vocational Rehabilitation services.
Vocational unit: The team of employment specialists and supervisor that form the IPS team.
Work incentives: Special rules that make it possible for people with disabilities receiving Social Security or Supplemental Security Income (SSI) to work and still receive monthly payments and Medicare or Medicaid. When people receive information about how their financial benefits may be affected by earned income, this is referred to as work incentives planning or benefits planning. For more information go to www.socialsecurity.gov