thinking skills for work program (tsw) -...
TRANSCRIPT
THINKING SKILLS FOR
WORK PROGRAM (TSW)Presented by Matthew Angell & Meriah Brown
MATTHEW ANGELL
Supported Employment Coordinator at the Mental
Health Association of South Central Kansas
MERIAH BROWN, B.A.
Employment Training Specialist/Cognitive
Remediation Specialist at the Mental Health
Association of South Central Kansas
Mission: The Mission of the Mental Health Association is to
empower and assist youth, families and adults in our community
to achieve optimal mental health and wellness through
education, advocacy, and service.
Our Vision is achievement of a just, humane, and healthy society
where all people are treated with respect, dignity, and the
opportunity to achieve their full potential free from stigma and
prejudice.
Other sites in Paris, Toronto, Tokyo, Copenhagen, Oslo, and Melbourne.
THE MISSING LINK TO LONG-TERM
EMPLOYMENT SUCCESS
Who all in here is involved with Supported Employment?
What do you see as being a barrier to long-term employment
success?
Inability to maintain long-term job retention
Motivation for job searching would reduce after job loss,
negative barriers, and/or mental health obstacles
Implementation of Thinking Skills for Work (TSW)
To offer additional support and improvements for individuals who
have low retention rates and job loss
INTRODUCTION TO THINKING SKILLS
FOR WORK (TSW)
Cognitive enhancement program that targets improving cognitive functioning through computerized cognitive practice, strategy coaching, and teaching coping/ compensatory strategies
Fully integrated with Supported Employment and Case Management services
Implemented by a Cognitive Specialist (CS) who is a member of the treatment team
Follow-along CS consultation and support with individual and the treatment team
WHY IS TSW IMPORTANT?
Statistics show that with Thinking Skills for Work, individuals with
Mental Illness are able to maintain employment for longer
periods of time, as well as increasing their skills in other aspects of
their lives.
TSW is important for assisting individuals with Mental Illness
achieve employment goals. TSW also assists the individual
improve other areas of their daily lives to enhance his or her
recovery.
COMPONENTS OF TSW
Assessment: Determine individuals cognitive strengths and weaknesses
Cognitive Skills Training: 24 sessions of computerized cognitive practice using Cogpack software
Training in Coping/Compensatory Strategies: Primary aim is to reduce interference caused by cognitive challenges
Job Search Planning: Work with Employment Specialist to identify need for cognitive coping strategies
Job Support Consultation: Ongoing consultation regarding individually tailoring of specific compensatory strategies based on the individual’s needs and job demands
COGPACK- COMPUTER BASED
COGNITIVE PRACTICE
Curriculum-based program to guide cognitive practice
• 24 sessions, curriculum based, manualized program delivered twice
weekly
• Curriculum has demonstrated efficacy in improving cognitive skills in
persons with SMI
• Designed to provide practice of the broad range of cognitive
functioning
• Uses commercially available software developed for persons with
psychiatric illness (Cogpack)
• Audiovisual presentation with contextualized formats
• Provides information regarding the speed and accuracy of task
performance
This is an example of one of
the cognitive exercises that
is in the curriculum, called
Labyrinths.
STRATEGY COACHING
Remedial task practice that is supplemented with suggestions from
the CS of more efficient task approaches to improve performance
For example:
Categorizing to enhance encoding of new material
Food items with food items or non food items with non food items
COGPACK- COMPUTER BASED
COGNITIVE PRACTICE
• Participants taught to record exercise performance and
track progress of their performance
• Facilitated practice by a Cognitive Specialist providing
strategy coaching
• Cognitive Specialist makes linkages between cognitive
exercises and work tasks that may be encountered in the
type of job the individual is looking for
EXAMPLE OF THE RECORDING FORM
Data Recording Form Sessions 1
1)- Comparisons (Attention)
subtest b: # Correct: ________
Average working time per task: ________ sec.
2)- Memory (Verbal Memory)
subtest p, variant e: # Correct: ________
Correctness in percent totals: ________
3) Labyrinths (Speed/Planning)
subtest a: # Correct: ________
Average working time per task: ________ sec.
Another example
of one of the
exercises in the
Cogpack.
Yet another
example of a
Cogpack exercise.
COPING/COMPENSATORY
STRATEGIES: GROUP
• 12 session, manualized curriculum delivered individually or in groups
• Handouts for participants with checklists and homework assignments
• Topics address coping with persistent cognitive difficulties that interfere with work attainment
• Coping with problems with attention, planning, problem solving, and memory
• Additional topics include developing a routine and challenging negative thinking
COPING WITH ATTENTION
DIFFICULTIES: GROUP EXAMPLE
• Reduce distractors in the environment
• Provide cues for tasks or steps
• Schedule regular rest breaks and gradually increase duration of
work periods
• Teach self-management strategies (e.g., verbalizing tasks out loud)
• Repeating back what is heard to ensure attention/concentration
• Nancy found it helpful to say out loud the steps of the Xeroxing and filing task, such as ‘Put the paper on the plate, put down the lid, press the “copy” button…’ and so on. Eventually she was able to think the steps without saying them.“
TSW PROGRAM TREATED AS WORK
1- Timeliness, dress, and demeanor
2- Social responsiveness
3- Problem recognition
4- Asking for help
5- Use of suggested strategies
6- Frustration
7- Cognitive effort and fatigue
AFFIRMATIONS
Jane: “This group brought out that to need to pay attention to more than what's in front of me, especially when I am driving.”
Trever: “I like it. It’s definitely working on stuff that I have been wanting to work on. Its nice to have someone to help me out. And I definitely think it will help when I start working too.”
Pepper: “I like it, I think it is the best job thing ever. I really do. It got me a job, I have been able to calm down more, when I get frustrated I learn to take a deep breath, and leave the room for 5-10 minutes if I need to calm down. The Cognitive Specialist has helped me with my memory and cognitive skills to help me work things out on my own!”
MHA RESULTS WITH TSW THUS FAR
Individuals who have a history of noncompliance with
maintaining appointments have increased participation and
frequently meet with CS
Individuals state that they enjoy coming to class and
participating in group
We currently have 39 clients who are enrolled in the TSW, 6 are
close to graduation, 5 are past the half way point, and 21 are still
working on lab in between dealing with increased mental health
symptoms and working.
MHA RESULTS CONTINUED…
We have seen a _25___ % increase in the clients served by the
Supported Employment department due to the interest in the
TSW Program.
We have been able to assist _11___ clients with obtaining
competitive employment in the respective jobs that clients want,
while involved with TSW.
Projected outcomes
REFERENCES
Susan R. McGurk, Ph.D.
Center for Psychiatric Rehabilitation
Boston University
Pictured:
Matthew Angell, Supported
Employment Coordinator
Susan McGurk, Ph.D.
Kristina Fouquet, LSMW, Director
of Adult Services
Meriah Brown, Employment
Training Specialist/Cognitive
Specialist
Carol Manning, APRN, President
and CEO
Thank you!