[NYAPRS Enews] Study: Supported Education for Adults With Psychiatric Disabilities

[Harvey Rosenthal]

Supported Education for Adults With Psychiatric Disabilities

Sharon A. Gutman, Ph.D., O.T.R.    Psychiatric Services   March 2008

 

The Bridge Program is a supported education service for adults with
psychiatric disabilities who wish to pursue postsecondary education or
employment. Because the onset of psychiatric disability commonly occurs
in late adolescence and early adulthood, many people with psychiatric
disability have difficulty completing high school and entering
postsecondary education or employment. Consequently, many possess gaps
in their basic educational knowledge and lack interpersonal skills
needed to succeed in the student or worker role. 

 

The Bridge Program consists of 12 classroom-lab modules, each lasting
two hours. They include training programs, degrees, and work options;
study skills; time management skills; effective reading skills; basic
writing skills; basic computer skills; introduction to Internet skills;
basic math skills; library resources; public speaking strategies;
professional behaviors and social skills; and stress management tools.
An hour of one-on-one mentoring follows each two-hour module. Mentors
help participants to explore available educational and job training
programs, complete application forms for specific schools or training,
complete financial aid forms, study for the GED or school or job
placement tests, and use customized compensatory strategies to enhance
school and work performance. The program is held twice weekly over a
six-week period. Participants who complete the program and become
actively engaged in school or vocational pursuit are offered an
additional six weeks of mentoring to facilitate a successful transition
to the student or worker role. 

 

To participate in the program, individuals must possess a tenth-grade
reading and writing level and be fluent in English. Individuals having
an active substance use disorder are ineligible to participate until
they can demonstrate six consecutive months of sobriety. 

 

The program was tested for effectiveness with 38 participants who were
randomized to an experimental (21 participants) or control group (17
participants). The experimental group attended the 12-session Bridge
Program and received treatment as usual at their mental health
facilities. Control group participants received only treatment as usual
at their mental health facilities during the six-week study. The Bridge
Program was implemented in the occupational therapy program at Columbia
University; both faculty and graduate-level occupational therapy
students participated as instructors and mentors. Data were collected
before and after the program, with follow-up at one month and six
months. 

 

Recruitment occurred at three outpatient mental health facilities in the
New York metropolitan area. The participants, 22 men and 16 women,
ranged in age from 19 to 55. Most participants were Hispanic (15
participants, or 39%), African American (14 participants, or 37%), or
Caucasian (eight participants, or 21%). Psychiatric diagnoses included
schizophrenia (16 participants, or 42%), schizoaffective disorder (11
participants, or 29%), bipolar disorder (six participants, or 16%), and
depression (five participants, or 13%). The highest education level
achieved for most participants was a high school diploma or GED (22
participants, or 58%). Eight participants (21%) completed some college.
Another eight participants (21%) did not complete high school. No
participants were currently employed. 

 

Sixteen (76%) of the 21 experimental group participants completed the
Bridge Program. At a six-month follow-up, ten of these 16 participants
(63%) had enrolled in some form of educational program or job training,
had obtained employment, or were in the process of applying to a
specific program in the next year. Only one of 17 control group
participants (6%) reported being involved in school or work; he was
involved in school coursework. 

 

The results suggest that the program helped participants to increase
their skill level in basic academic areas, improve professional
behaviors and social skills needed for school and work settings, and
gain confidence to test their skills in the larger community. Factors
that correlated with success in the program included adherence to a
medication routine (r=.70, p.001), possession of a stable residence
(r=.64, p<.001), and motivation to attend the program regularly (r=.84,
p.001). Diagnosis, prior educational level, number of hospitalizations
in the past five years, age of illness onset, and parental education
level had no relationship to success in the program. Data collection at
a one year follow-up is planned. 

 

   Footnotes 

Dr. Gutman is an occupational therapist and an associate professor
affiliated with Programs in Occupational Therapy, Columbia University,
710 W. 168th St., NI-8, New York, NY 10032 (e-mail:
sg2422 at columbia.edu). 

 

 

 

 

 

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