fINAL REPORT

EEE4all

10-02-2017

Authors

Aart, Joyce NLBerwaerts, Sieben BEBoehlé, Evelien NLBöttcher, Sandra DEBuyck, Birgit BEDaniels, Istvan BEHuntjes, Chayenne NLMaggen, Jana BEMoes, Lotte NLVogels, Lonneke NLWoensel, Naomi NL

Table of ContentsDedications................................................................................3Abstract.....................................................................................41. Introduction..........................................................................51.1 Who are we?.............................................................................................................................51.2 What is the assignment?...........................................................................................................51.3 What can the reader find in the document?.............................................................................5

2. Methods...............................................................................52.1 What is supported employment?..............................................................................................62.2 What are the basic emotions?...................................................................................................62.3 What are the best practices that show successful elements to train employees in supported employment?.........................................................................................................................................72.4 Which competences does a job coach need to train people with a mental disability?.............72.5 Which relaxing techniques can be used to make a group of people with a mental disability feel comfortable?...................................................................................................................................72.6 What verbal and non-verbal manners are there to communicate with people with a mental disability in order to understand each other?........................................................................................8

3. Results.................................................................................83.1 Background information............................................................................................................8

What is Platform Begeleid Werken?..................................................................................................8What do they do?..............................................................................................................................8What is their vision?..........................................................................................................................8What is their mission?.......................................................................................................................9What is the problem (of the assignment)?.........................................................................................9Definition of the population light/moderate/severe/deep mental handicap.....................................9

3.2 What is supported employment?............................................................................................103.3 What are the basic emotions?.................................................................................................113.4 What are the best practices that show successful elements to train employees in supported employment?.......................................................................................................................................123.5 Which competences does a job coach need to train people with a mental disability?...........123.6 Which relaxing techniques can be used to make a group of people with a mental disability feel comfortable?.................................................................................................................................123.7 What verbal and non-verbal manners are there to communicate with people with a mental disability in order to understand each other?......................................................................................13

4. Discussion..........................................................................145. Conclusion..........................................................................156. References.........................................................................167. Appendix (other document).................................................18

2

Dedications

For all the tutors, guiding us with their expertise.The job coaches for their expertise in the work field and support on the ‘trainingsdag’.For The Zuyd University and PXL University for the accommodation and material.For group 2 for the collaboration during the process.

3

AbstractSay it with emotionsBy: Group 1Supported by: Loeka Vanderborcht, Marike Hendrickx, Els Peters, Lisa Basile

Introduction: During the assignment there had to be given an answer to the following question: How can we train coaches and employees with a mental disability in supported employment? To give an answer to this question there were 3 subtasks to be done:The first subtask was to identify/find best practices that show successful elements to train coaches in supported employment. The second was to identify/find best practices that show successful elements to train employees in supported employment. The last one was to design a training program for employees in supported employment, given by the coaches.

Aim: The aim of this study is to organize a ‘vormingsdag’ for people with a mental disability. The purpose of the ‘vormingsdag’ is to train the employees to cope with their emotions at work.

Method: This assignment is based on a literature study. There is this question from the work field ‘begeleid werken’ and they experience problems with the theme emotions at the workplace of people with a mental disability. To get some good research questions we have used the main question from the student handbook. From this question diverse sub questions are made. For these sub questions several PICO’s are made. These PICO’s resulted in some search terms and research questions. After this the literature study started.For the information and specific examples about the people with a mental disability and how they cope with their emotions at work, there has been a semi structured interview with two job coaches.

Results: Supported employment means that a person with a mental disability can work with guidance in a regular workplace. This kind of employment is unpaid and the employees will do subtasks in an work area that they like.

A commonly-held life, posits there are six basic emotions which are universally recognized and interpreted through specific facial expressions, regardless of language or culture. These are: happiness, sadness, fear, anger, surprise and disgust. These basic emotions are basic emotions because of their characteristics.

The best way to train employees is to put them in a right workplace, like the right activities, the way the activities will be offered and the right work environment. Further the likert-scale in combination with pictures or short text is very useful in this target group.

The job coaches need to have a few competences to support people with a mental disability. They have to be specialized in guiding this target group.

Good communication is very important to relax people. Also relaxation interventions like meditation and muscle relaxation are efficient.

The way how you communicate with people with mental disability is very important. While you use verbal communication you also need to be aware of your own body language (non-verbal).

Conclusion: The conclusion is about the different topics we searched literature for.

4

Search terms: a mental disability, Supported employment, Emotions, Job coach, Relaxation, Communication (verbal and non-verbal)

1. Introduction

1.1 Who are we?We are 11 students who are studying Occupational Therapy. We all follow the module EEE4ALL (Euro Education Employability for all). We have an international group with students from 3 different countries: 6 students from the Netherlands, 4 students from Belgium and one student from Germany.

1.2 What is the assignment?During the assignment there had to be given an answer to the following question: How can we train coaches and employees with a mental disability in supported employment? To give an answer to this question there were 3 subtasks to be done:The first subtask was to identify/find best practices that show successful elements to train coaches in supported employment. The second was to identify/find best practices that show successful elements to train employees in supported employment. The last one was to design a training program for employees in supported employment, given by the coaches.

1.3 What can the reader find in the document?In this document you can find the background information related to the task and the methods used to complete the task. Also the results, the discussion and conclusion are discussed in the report. At the end there are some references that have been used and also the products that are made.

2. MethodsThis assignment is based on a literature study. There is this question from the work field ‘begeleid werken’ and they experience problems with the theme emotions on the workplace of people with a mental disability. To get some good research questions we have used the main question from the student handbook. From this questions there diverse sub questions are made. For these sub questions several PICOs (problem, intervention, co-intervention and outcome)are made. A PICO is an aid to clarify the research question and for each subject one is made. These PICOs resulted in some search terms and research questions, after this the literature study started.

Research question: How can we train coaches and employees with a mental disability in supported employment?Sub questions: - What is supported employment?

What are the obstacles in supported employment? Does it make sense to work with emotions in supported employment?

- Question about emotion- What are successful elements to train employees?- What are successful elements to train job coaches?- Which relaxing techniques can be used to make a group of people with a mental disability feel

comfortable?- How do you communicate with people with a mental disability on different levels?

At first we searched in Google and google scholar about information of people with a mental disability and our theme Emotions. After this we searched in books, articles, journals and different

5

evidence based databases like Pubmed, Springerlink, Bohn Stafleu, CINAHL, OT seeker, Psychology and Behavioural Sciences Collection and Science direct.

Inclusion criteria:

There has been a selected procedure to search for the articles. Articles are not older than 10 years Use of free terms and MeSH terms Full texts are available Reputable databases (PubMed, SpringerLink, Zuyd Library, CINAHL, Psychological and

Behavioral Sciences Collection …) Three languages: Dutch, German or English

For more information and specific examples about people with a mental disability and how they cope with their emotions at work, we have conducted a semi-structured interview with two job coaches.

2.1 What is supported employment?

P People/employees with a mental disability

I Supported employment

C No supported employment

O Obstacles, effectiveness of supported employment

Research question: What is supported employment?Sub questions:

- What are obstacles in supported employment?- Does it make sense to work with emotions?

Search terms: people with a mental disability, supported employment, barriers, obstacles, challenges, mental health, workplace, a mental disability, mental illness, effectiveness, coping with emotions, adults

2.2 What are the basic emotions?

P People/employees with a mental disability

I Training in coping in emotions

C No training

O Better cope with emotions in work field

Research question: What are the basic emotions?

Search term: basic emotions, people/employees with a mental disability, coping with emotions, training in coping in emotions, emotions in the work field, interventions for coping with emotions

6

2.3 What are the best practices that show successful elements to train employees in supported employment?

P People with a mental disability

I Training in supported employment

C No training, no intervention

O There are no problems in the work place, they receive compliments from

colleagues

Research question: What are the best practices that show successful elements to train employees in supported employment?

Search terms:Mentally handicapped employees, employees with a mental handicap, employees with low IQ, mentally impaired employees, mentally disabled employees, employees with a mental disability, learning methods, ways to learn, ways to learn new information, teaching methods, training methods, practices, supported employment, learned new information, understanding and successfully trained.

2.4 Which competences does a job coach need to train people with a mental disability?

P Job coaches

I Training people with a mental disability

C No training

O Job coaches have the right competences to train people with a mental disability

Research question: Which competences does a job coach need to train people with a mental disability?

Search terms:Training, job coaches, job for people with a mental disability , practice based evidence, people with a mental disability 2.5 Which relaxing techniques can be used to make a group of people with a mental

disability feel comfortable?

P A group of people with a mental disability

I Relaxing techniques

7

C No relaxing techniques

O A group that is feeling comfortable

Research question: which relaxing techniques can be used to make a group of people with a mental disability feel comfortable?

Search terms:Relaxation techniques, mental disability, mental handicap, comfortable, mental disability, relaxing, calm down, tranquilize

2.6 What verbal and non-verbal manners are there to communicate with people with a mental disability in order to understand each other?

P People with a mental disability

I Manners to communicate verbally and non-verbally

C No attention to verbal and non-verbal communication

O Understanding each other

Research question: What verbal and non-verbal manners are there to communicate with people with a mental disability in order to understand each other?

Search terms:People with a mental disability, mentally handicapped people, people with a mental handicap, people with low IQ, mentally impaired people, mentally disabled people, people with a mental disability, methods to communicate verbally and non-verbally, ways to communicate verbal and non-verbal, communication on different levels, understand each other, work together.

3. Results 3.1 Background informationWhat is Platform Begeleid Werken?Supported employment is when a person with a disability works at an ordinary workplace. They work at this place with guidance. The person with a disability goes to work on a regular basis; every week the same working days. The tasks can be very different per person. The work places vary from a bakery to a farm for example. Most people don’t perform complicated tasks, but they do subtasks. The work is unpaid so it is very important that they like their jobs.

What do they do?The person with a disability can go to work thanks to the job coach. He/she guides the person with a disability to his job. Every question the employee has, he can ask to the job coach. There will be a continuous cooperation between the employee, the employer and the job coach.

8

What is their vision?Everyone has the right to work, this counts for people with a mental disability as well. If people with a disability can go to work, this will increase their self-esteem. For them it matters that they like their jobs, money is not important.By a step-by-step plan the people with a mental disability will be led to the labour market. The first step is the intake. In this intake will be searched for work activities the person likes. In the second step they will look for interests and capabilities. They will be also make an individual file. After that the job coach will look for a suitable workplace. He/she is going to introduce the person with a mental disability and then they make some agreements.When he/she is finally settled at the workplace, the job coach will train and coach when needed.

What is their mission?They want to work in a client-centred way to answer the specific question of the people with a mental disability. Supported employment wants to improve the quality of life. They also aspire empowerment and inclusion. Thanks to supported employment, the people with a mental disability increase their social network.

What is the problem (of the assignment)?During a meeting with the job coaches they told us that the people with a mental disability find it hard to express their emotions. Also the recognition of emotions is difficult for them. So we got the task to design a training day for them. We will do this with using the 6 social emotions: sad, happy, angry, scared, surprised and disgusted.

Definition of the population light/moderate/severe/deep mental handicapThere are several definitions of a mental disability. These are 2 examples:

‘Mental disability refers to disability characterized by significant limitations in the mental functioning (reasoning, learning, problem solving) and in the adaptive behaviour as expressed in conceptual, social and practical skills. This disability originates before the age of 18.’ (American Association on Intellectual and Developmental Disabilities, 2013)

‘A mental handicap is a general or specific mental disability, resulting directly from injury to the brain or from abnormal neurological development’. (Collins, 2016)

In the DSM-IV (general recognized diagnostic manual), the a mental disability are distinguished on four levels: light, moderate, severe and deep.

LightThese people have an IQ of 50 till 70 (Carehouse, 2013).Details (Healthyplace: American's Mental Health Channel, 2000-2015):

Slower than typical in all developmental areas; No unusual physical characteristics; Able to learn practical life skills; Attains reading and math skills up to grade level 3 to 6; Able to blend in socially; Functions in daily life.

ModerateThese people have an IQ of 35 till 50 (Carehouse, 2013).Details (Healthyplace: American's Mental Health Channel, 2000-2015):

Noticeable developmental delays (i.e. speech, motor skills);

9

May have physical signs of impairment; Can communicate in basic, simple ways; Able to learn basic health and safety skills; Can complete self-care activities; Can travel alone to nearby, familiar places.

SevereThese people have an IQ of 20 till 35. They also have a minimum communicative behaviour, a weak motor development and need for constant supervision (Carehouse, 2013).Details (Healthyplace: American's Mental Health Channel, 2000-2015):

Considerable delays in development; Understands speech, but little ability to communicate; Able to learn daily routines; May learn very simple self-care; Reduction in motor area; Need direct supervision in social situations; Verbal limitation, passive language is better developed than the active language; Self-reliance: ranges from full independence to total dependence.

Deep These people have an IQ of less than 20. The people who suffer in on this, need structuring environment, sensory stimulation and constant supervision. The development level is no more than a 2-year (Carehouse, 2013).There are different subgroups (Healthyplace: American's Mental Health Channel, 2000-2015):

Serious physical deviations; Significant developmental delays in all areas; Obvious physical and congenital abnormalities; Requires close supervision; Requires attendant to help in self-care activities; May respond to physical and social activities; Not capable of independent living; Individuals who can’t express verbally; Some can’t eat alone.

3.2 What is supported employment?We’ve found 31 articles about our main and sub-questions. From these 31 articles, there were 7 articles who were relevant. The relevant articles were RCT’s. we’ve searched in the following.

What is Supported employment?Definition supported employment: Employees with a mental disability must cooperate on an ordinary workplace. They work with guidance of a job coach. The people with a mental disability work at fixed times during the week. They must perform subtasks at their workplace. The subtasks are tasks that the employee can do and like to do. Supported employment is no paid work (Burns, et al., 2007).

What are the obstacles in supported employment?There are some obstacles in implementing supported employment for people with severe a mental disability. The most consistently noted individual predictors of success in achieving open employment are: motivation, self- efficacy and previous employment history. Attitudinal and structure factors provide more significant barriers. Clinicians and vocational workers may be protective of their patience and avoid rapid job placement for fear of placing to much stress on them (Boardman & Rinaldi, 2013).

10

Does it make sense to work with emotions?Mental health and emotion problems in people with a mental disability. There has been a general lack of regard for the mental health needs of people with a mental disability. The people in this population have higher levels of unmet needs and receive less effective treatment for their mental health and emotional problems. There is a lack of knowledge and awareness of mental health and emotional problems experienced by people with a mental disability (Taylor, Williams, Hastings, & Hatton, 2013).Sixty-seven subjects with mild or moderate a mental disability were assessed on a variety of measure of emotion. All these measures were self- report measures and all of the data is based on reports by the subjects' themselves. The battery included the Zung Self-Rating Anxiety Scale, the Zung Depression Inventory, the General Health Questionnaire and the Eysenck-Withers Personality Test. The results reveal an impressive amount of convergent validity in the subjects' emotional systems (Lindsay, Michie, Baty, Smith, & Miller, 2008).

3.3 What are the basic emotions?We were searching for background information about emotions. We found articles about emotions from the authors Hopkins and Ekman with a high-quality level. We searched for the articles in Google Scholar.

A commonly-held life, posits there are six basic emotions which are universally recognized and interpreted through specific facial expressions, regardless of language or culture. These are: happiness, sadness, fear, anger, surprise and disgust. These basic emotions are basic emotions because of their characteristics. Paul Ekman has made this checklist and it is worldly used as a tool for establishing emotions (Sabini & Silver, 2005). Every emotions has to have the following criteria to be called a basic emotion;

(Sabini & Silver, 2005)

However, new research published in the journal Current Biology by scientists at the University of Glasgow has challenged this view, and suggested that there are only four basic emotions. (Universityof Glasgow, 2014)

Glasgow scientist studied people’s facial expressions, and the emotions they signal, by showing people computer-generated facial animations. They asked the observers to characterize the faces based on those six emotions, and found that anger and disgust looked very similar to the observers in

11

the early stages, as did fear and surprise. For example, both anger and disgust share a wrinkled nose, and both surprise and fear share raised eyebrows.

The distinction between anger and disgust and between surprise and fear, is socially, not biologically based. This leaves us with four ‘basic’ emotions’, according to this study: happy, sad, afraid/surprised and angry/disgusted. (University of Glasgow, 2014)

3.4 What are the best practices that show successful elements to train employees in supported employment?

Searching for this question resulted in 15 articles. 5 were relevant according their level of evidence; 4 systematic reviews and 1 book. They were not older than 10 years to ensure modern and recent evidence. After analysis of research data 2 articles were removed due to the lack of a full text. The end product concluded in 3 articles critically reviewed.

Successfully training employees requires a behavioural change. This can be reached with a behavioural change model. The six steps model of Balm (Balm, 2002) and the ASE-model is a well-received way to make this happen (Vliet, 2016). Education alone does not help, it also needs rewards and feedback with the education (Torrey, et al., 2001). It is also important to take in mind when training people with a mental disability, that the focus of the training is very important. When you train people with a long distance to the labour market you need to make sure that your training uses specific tasks within the work floor (Department for Work & Pensions, 2013).

We found a guideline in an article for training working people in the GGz/mental healthcare. It also stated that the used training program worked (Cappelle, 2016). The guideline from Leigh was used to make the training day, this book states methods to train people and also gives ways to form a training with those methods incorporated in it. Below is a short summary of the book.

Training people in groups has all sorts of benefits: it disseminates information to a large number of people all at once and it allows interactive learning exercises. In order for a training session to be effective, however, the trainer must develop a course of action that will engage the group and hold their interest. Leigh breaks down each stage of designing and developing a successful training course and all the skills essential to effective group training, with concise chapter summaries and trainer tips to reinforce each concept (Leigh, 2006).

3.5 Which competences does a job coach need to train people with a mental disability?These are the following competences for the job coaches (BegeleidWerken):

- Recruitment - Intake (general and for the administration)- More specialized intake (screening, diagnosing, tests)- Job finding - Deciding the process - File management- Follow-up and providing feedback- Social and mental coaching- Guiding towards the workplace - Contact the employer- Conciliation - Aftercare for dropout - Aftercare for the employer

12

3.6 Which relaxing techniques can be used to make a group of people with a mental disability feel comfortable?

Searching for this question resulted in 5 articles. After reading there were 3 relevant articles. It were 2 reviews and 1 randomised controlled trial. One was older than 10 years because there was lack of literature.

Therapists use relaxation interventions such as meditation, muscle relaxation abdominal breathing and guided imagery. These methods reduce stress and depression. They can also use the following interventions to relax the group (Lubna Bte , Klainin-Yobas, & Torres, 2014): Playing relaxing music; A room with blacked out windows; Friendly vocalization; Soft touch; Laughter; Overall positive responsiveness.

There can be used friendly vocalization, soft touch, laughter and overall positive responsiveness as a way to relax the group. This because it is the most suitable way for the target group and situation where will be worked in. These intervention will be implement in the big group, as well as in the small groups (William, 2001).

Things like screaming, aggression to others, leaving, pulling away and overall negative responsiveness can have a negative effect for feeling comfortable (William, 2001).

3.7 What verbal and non-verbal manners are there to communicate with people with a mental disability in order to understand each other?

For literature about communication, we used the book ‘Group Trainer Handbook: designing and delivering training for groups (2006)’ of Leigh. We used this book because there was a lot of information about the verbal-and non-verbal communication.

Non-verbal communicationThe simplest and most effective way of demonstrating you are friendly and approachable is by smiling. This should be a natural relaxed smile, not a nervous giggle. The less relaxed you feel, the more important smiling becomes.

Being self-assured isn’t the same thing as being conceited. Nothing that you say or do should make the group feel inhibited, embarrassed or patronized.

When course participants attend a course they generally gave formed some opinion of what they expect to see. Your appearance will form an integral part of this expectation.

Understanding a messageIn normal conversations, your hands might not merit a second thought but somehow in making a presentation your hands suddenly seem to acquire the capacity to move independently of the rest of your mind or body. It is important that you reduce temptation by keeping jewellery to a minimum, if you’re conscious of being a ‘fiddler’.

If you are standing in front of a group, it is very difficult to convey an impression of controlled confidence if you are standing cross-legged and wobbling from side-to-side.

13

Verbal communicationVoice ToneWhat we hear when we talk is different from the sound received by others. This is because of the sound vibrates through the air passages connecting the mouth and ears (Leigh, 2006).

Voice SpeedSpeaking fast can convey and excited or agitated feel. If you’ve ever experienced someone speaking at a speed that is incongruent with the content of what they’re saying, you know how this can stand out (Communication Skills Activites, 2012).

Voice VolumeThis can range from a whisper to a scream and everything in between. A very quiet voice can represent that you’re sharing something you don’t want overheard, it can represent that you’re depressed. A very loud voice can express great joy (Communication Skills Activites, 2012).

During the training day, it’s important to you think about your voice volume when you’re talking.

VocabularyAs a verbal communicator, your words are your toolbox, palette and your set of ingredients. The more diverse your vocabulary, the more effective you can be in expressing yourself to others (Communication Skills Activites, 2012).

4. Discussion

During the project, we have come across some obstacles. A first we had to adjust to cultural differences due to the fact that all participants came from different countries. The way of working, learning, writing, etc. … differed and we had to agree on a similar way of working.Furthermore the assignment wasn’t very clear and we have approached this in the wrong way. Therefore at one point we had to start all over again. It would be more effective if we have had a meeting face-to-face before the start of the project to clarify what was expected from us.In addition the way of communicating using BlueJeans was sometimes a challenge due to technical issues.

‘Vormingsdag’The participants were very happy because they have learned more about emotions and how to react in different (work) situations. Also they have learned that it is possible to experience more emotions in one situation and that everyone can react in a different way. They liked the interactive way of working so they could stay focused.We had a standard script for the day but we had to be flexible to fit the special needs in each group. We appreciated the support and experience of the job coaches during the day. They have helped us a lot to learn more about dealing with people with a mental disability.For future practice, we will take in mind to take more initiative for this target group. They need a lot of structure and guidance to feel comfortable and to be able to understand what we expect from them.

Literature searchWe have done a literature search to collect more information about the topics of the assignment. In the beginning we had a lot of articles because our search strategy was not good. We used PICO-

14

questions in the wrong way and too broad in order to find the relevant literature. After the intervention of one of our tutors we were able to focus on the right search items. There was a lot of literature about emotions and our target group, however it was difficult to found recent literature about emotions in regarding to people with a mental disability. In future practice we will try to have a better view of the assignment before the start of the project. Therefore we avoid losing time by searching for the wrong literature and prevent getting frustrated and demotivated. An improvement would be to have more practical guidance especially in the beginning.

5. ConclusionSupported employmentLiterature studies we’ve found, shows that Individual Placement and Support (IPS) is one of the most effective practice, Platform Begeleid Werken also use this method to place people with a far distance to the labour market. Out of the interview with the job coaches can be suggested that the tasks in supported employment can be very different. The way of guidance depends on the disability and the level of intelligence.

Basic emotionsThere is a difference between the four biological emotions and the six social emotions. We used the six social emotions. Feeling an emotion is a response to a situation. Out of the interview we can suggested that there isn’t one good way to react on a situation. This compares with the literature we found.

What are the best practices that show successful elements to train employees in supported employment?Different literature studies show that Individual Placement and Support (IPS) is one of the best and most effective best practices. Successfully training employees requires a behavioural change. This can be reached with a behavioural change model: the six steps model of Balm and the ASE-model. These models are a well-received way to make this happen.

Which competences does a job coach need to train people with a mental disability?A job coach need a lot of competences to train people with a mental disability. Begeleid Werken made a list with the competences in the book ‘Aan de slag’. Some of the competences are: recruitment, intake, job finding, conciliation, etc. You can find the other competences in this document (point 3.5, page 12). Out of the interview can be suggested that it’s also important to be calm in every situation and always be available for the employees.

Which relaxing techniques can be used to make a group of people with a mental disability feel comfortable?To relax a group of people with a mental disability, you can use some techniques like playing relaxing music, friendly vocalization, soft touch and overall positive responsiveness. You can use these interventions in big groups, but also in small groups. Another conclusion that has a negative influence on relaxing the group is screaming, leaving and overall negative responsiveness.

What verbal and non-verbal manners are there to communicate with people with mental disabilities in order to understand each other?Literature studies show that the simplest and most effective way to communicate non-verbal is to be friendly, approachable, authoritative and confident. There has to be a balance between the following three areas: slowly scanning the entire audience, focusing on particular areas your audience and looking at individual members of the audience for about five second per person. The most effective way to communicate verbal is to think about your voice tone, voice speed, voice volume and

15

vocabulary. Out of the interview can be suggested that it is important to think about the way you communicate non-verbal and verbal; this compares with the literature studies we’ve found.

6. References

American Association on Intellectual and Developmental Disabilities. (2013). Frequently Asked Questions on Intellectual Disability. Opgehaald van https://aaidd.org/intellectual-disability/definition/faqs-on-intellectual-disability#.WEPwiELvNyY

Balm, M. (2002). Exercise Therapy and Behavioural Change. Purdue University Press: West Lafayette.

BegeleidWerken. (sd). Aan de slag. Leuven: Mario Vanhaeren, MAGDA.

Boardman, J., & Rinaldi, M. ( 2013). Difficulties in implementing supported employment for people with severe mental health problems. The british journal of Psychiatry, 247.

Burns, T., Catty , J., Becker, T., Drake, R. E., Fioritti, A., Knapp, M., . . . Wiersma, D. (2007, September 29). The eff ectiveness of supported employment for people with svere mantal illness: a randomised controlled trail. The Lancet.

Cappelle, F. v. (2016). Externe duurzame inzetbaarheid bij GGZ-werknemers. Utrecht: Universiteit Utrecht.

Carehouse. (2013). Opgehaald van Carehouse bouwen aan zelfstandigheid: http://www.carehouse.nl/verstandelijke-beperking

Collins. (2016). Opgehaald van Definition of mental handicap : https://www.collinsdictionary.com/dictionary/english/mental-handicap

Communication Skills Activites. (2012). The elements of Verbal Communication Skills. Opgehaald van http://www.communicationskillsactivities.com/about-us/

Department for Work & Pensions. (2013). What works for whom in helping disabled people into work? Londen: Department for Work & Pensions.

Healthyplace: American's Mental Health Channel. (2000-2015). Opgehaald van Neurodevelopmental Community: http://www.healthyplace.com/neurodevelopmental-disorders/intellectual-disability/mild-moderate-severe-intellectual-disability-differences/

Hogeschool PXL. (2016). Hoorcollege mentale handicap. Hasselt.Hopkins, L. (2014). Opgehaald van The Five Key Elements of Non-Verbal Communication in Business:

http://www.frugalmarketing.com/dtb/nonverbal.shtml

Leigh, D. (2006). The Group Trainer Handbook. Kogan Pate Ltd.

16

Lindsay, W. R., Michie, A. M., Baty, F. J., Smith, A. W., & Miller, S. (2008, juni 28). the consistency of reports about feelings and emotions from people with intellectual disability. Opgehaald van www.onlinelibrary.wiley.com: http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2788.1994.tb00348.x/abstract

Lubna Bte , I., Klainin-Yobas, P., & Torres, S. (2014, april). Efficacy of Psychoeducation and Relaxation Interventions on Stress-Related Variables in People With Mental Disorders: A Literature Review. Opgehaald van www.sciencedirect.com: http://www.sciencedirect.com.zuyd.idm.oclc.org/science/article/pii/S088394171300143X

Sabini, J., & Silver, M. (2005). Ekman's basic emotions: Why not love and jealousy? Cognition & Emotion, 693-712.

Taylor, J., Williams, L., Hastings, R. P., & Hatton, C. (2013). psychological therapies for adults with intellectual disabilities. united kingdom: Wiley-Blackwell.

Torrey, W. C., Drake, R. E., Dixon, L., Burns, B. J., Flynn, L., John, A. R., . . . Klatzker, D. (2001). Implementing Evidence-Based Practices for Persons With Severe Mental Illnesses. Psychiatric Services, 45-50.

University of Glasgow. (2014, Februari 3). Written all over your face: humans express four basic emotions rather than six, says new study. Opgehaald van http://www.gla.ac.uk/news/archiveofnews/2014/february/headline_306019_en.html

Vliet, V. v. (2016, December 15). Behavioral change model. Opgehaald van Change Management: http://www.toolshero.com/change-management/behavioral-change-model/

William, R. B. (2001). Effects of four therapy procedures on communication in people with profound intellectual disabilities. Journal of applied research in intellectual disabilities, 110-119.

17

7. Appendix (other document) Global plan Script Presentation ‘coachingsdag’ Invitation Presentation ‘vormingsdag’ Poster Hand-outs Reminder of the day

18