CKC - Clubhuis KennisCentrum -TE Transitional Employment

TE Transitional Employment

Created: 2013-11-26 Last modified: 2013-11-26 Published: 2013-11-26

The Most Supported Employment of Supported Employment

By Ralph Bilby.

“Transitional Employment is itself a form of supported employment, in fact the most supported of all variations”.

It will come as no surprise to any of you when I say that clubhouse- based transitional Employment, even after forty years, is still under considerable attack, primarily from competing Supported Employment models in the United States. There are also, frankly, clubhouse people who question why the Standards should mandate TE when it is more difficult to do than permanent placements with fewer supports. The one line write-offs that typify what SE people sometimes have to say about us are of course irritating, but I do believe that more thoughtful discussion of the issues in healthy.

The beginning of that discussion should note that Transitional Employment is itself a form of Supported Employment, in fact the most supported of all variations. As all vocational models seek the support the client, a definition of SE rests primarily on support for both the member and the employer, which in TE includes training, absence coverage (which is unique to Clubhouse-based TE) and expeditious problem solving.

So the not uncommon belief that clubhouses are somehow opposed to Supported Employment is simply false. There is currently, in fact, a proposal being considered by the ICCD Standards Review Committee to write Supported Employment into the language of Standards 20 and 21 on Independent Employment. Whether or not the proposed language is accepted, I personally think that it is inevitable that the standards will eventually include a recognition of SE as an acceptable variation, modified by clubhouse values, of time unlimited employment.

If, then, clubhouses accept and practice Supported Employment, what is rational for building staff intensive TE opportunities as the centrepiece of a clubhouse employment system? That, of course, is a very good question.

The arguments for TE will be familiar to many of you, but they are well worth a brief review. In comparison to indefinite Supported Employment placements, TE allows members to explore work with various employers and in different jobs, so that when they do look for more permanent work, their decisions can be based on a broader experience and more informed choice. Those multiple, diversified work experiences also allow members to struggle with vocational problems and build on strengths so that they are in a better position to succeed when they move on to more independent work. TE also provides members seeking their own job a recent work history with current references, making them more competitive-and less dependent on an ‘act of faith’ by interviewers regarding their work ethics and abilities.

But for me the real heart of any argument for TE centres on its features which promote inclusiveness. Although they make claims of inclusiveness, other American Supported Employment models, excepting PACT programs, either outright screen for vocational success, or only accept clients who declare themselves ready for employment. Standards-driven clubhouses, on the other hand, are committed to long term work with members at all levels of vocational development and interest. Let us look briefly at how that works.

When all staff are involved in TE, employment becomes an ethic that spans the entire program. Everyone appreciates how difficult it is to do, as well as what a victory it is for the members to work. And perhaps most important of all, clubhouse relationships are often the strongest encouragement for members to try work – members who would not otherwise seek placements on their own initiative, but become willing because they have developed relationships with clubhouse people who truly believe in and support them. I have seen this happen time after time. And that of course is a major distinction between clubhouse employment and virtually all other community-based Supported Employment models, including PACT programs.

Our relationships with TE employers also foster inclusiveness. There is certainly no other community-based vocational strategy which gives programs this degree of discretion in selecting who will be given opportunities to go to work. One reason for that is that TE employers become, with experience and support from the clubhouse, progressively more adept at working with members with vocational problems. But we also earn the right to choose members, a significant number of whom will not be successful, by training, absence coverage, and problem solving subsidies that Transitional Employment provides to employers. We ask our employers to take risks, but we provide the safety net that makes it possible for them to do this.

But let’s go back to that great distinction between clubhouses and other community-based vocational models; that we do not screen for work readiness in our intake process. Consider what the Standards say on the issue. They address placements as a “…right of membership…,” and state that “the desire to work is the single most important factor determining placement opportunity.” They say that “…regardless of failure…placement opportunities will continue to be made available.” That seems pretty clear, but in fact there is a considerable disparity in clubhouse practices over how members are selected for TE.

We would all agree that placement selection decisions should not be made competitively. Competitive decisions, of course, are our goal when hiring staff, to ensure that we find the strongest candidate. But not with TE. The unique level of program supports required by TE (particularly training and absence coverage) is only justified if a substantial number of members on TE are not yet “vocationally ready” and are still struggling with work. In other words, that placements are being used for rehabilitation.

The whole selection process is complicated, of course, by sometimes less that optimal TE situations, the understandable desire to keep the good workers working, and, we need to face it, often a shortage of placements. I don’t see perfect solution. In my view, though, staff advocating for the members with whom they work is the process I find least problematic. Members being asked to compete against one another is the process I find post problematic. Even thoughtful TE ‘interviews’ can be risky, since people are seldom at their best when unemployed. If a member doesn’t have natural staff advocates, it is the clear responsibility of clubhouse leadership to provide them. We talk about “some failure being necessary for growth,” but we don’t always act on that considerable wisdom. Ultimately, the ethics of the Standards should be our guide. But every clubhouse should be monitoring itself to insure that there are a good number of members being chosen for placements who are not strongest candidates.

Let us consider the next issue of absence coverage, which is one of the model’s most famous features. In fact, the omission of absence coverage is the principal reason that “TE” has failed when replicated by free standing vocational programs. A commitment to the employer that we will ensure that the job is done no matter what is, of course, a difficult commitment for vocational practitioners, as absenteeism is a fairly common problem for people with mental illnesses who have been out of work for some time. Although there are a number of solutions to meeting our absence coverage commitment besides staff time, one thing is certain. If a TE program doesn’t cover its absences, then the problem falls directly on the shoulders of the employer, thus discouraging them from taking a chance on people with greater than normal work adjustment problems.

So is the case fully made that TE as the middle ground of vocational rehabilitation is stronger than free standing Supported Employment Programs doing only time-unlimited placements? I won’t presume to make that claim, which is in part a research issue. But I can tell you from the conversations I have had over the years with Supported Employment people, that they would all jump at the chance to be fed by a good TE program – to be working with people who have tried a variety of jobs, who have moved forward in overcoming adjustment problems and developing successful work habits, and who have current references. In the clubhouse we don’t need to screen for people in those situations. We create them.

I think that hands down we have the right model – for community, inclusion, support, and the ambitious pursuit of opportunities across the full spectrum of members’ lives. I believe a fair evaluation of current and future research will show us to be at least equal to competing models in most dimensions, and dramatically stronger in ways our members declare to be important.

The ICCD certification (accreditation) process doesn’t just get us licensure, it gets us clubhouse that literally leap forward in the quality of their programs and opportunity systems. This great gathering is yet another confirmation of the vitality and power of this extraordinary movement. But our greatest strength is in our shared values and vision, manifest by the International Standards for Clubhouse Programs, and in our union through the now 192 clubhouses united through the ICCD.

Ralph Bilby is on the staff of the International Centre for Clubhouse Development.

Before joining the ICCD, Ralph was the Director of Employment at Fountain House in New York City. 

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