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The Rotterdam Supported Education Program: an integration of services

The Rotterdam Supported Education Program: an integration of services. USPRA Conference Phoenix, June 200 6 Lies Korevaar Anne Sullivan. Learning Objectives.

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The Rotterdam Supported Education Program: an integration of services

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  1. The Rotterdam Supported Education Program: an integration of services USPRA Conference Phoenix, June 2006 Lies Korevaar Anne Sullivan

  2. Learning Objectives • The participants will have increased knowledge in a Supported Education program with integrated services (classroom model, on-site support model and mobile support model) • The participants will have increased knowledge of a SEd activity (disclosing) Hanze University Groningen, Research Department of Rehabilitation

  3. Overview 1. Location of the SEd programme 2. Who are served by the Supported Education programme? 3. Principles of Supported Education? 4. The Rotterdam Supported Education programme 5. Outcomes 6. New Activities, Products & Services that came out of the 1st SEd programme 7. Excercise 8. Summary Hanze University Groningen, Research Department of Rehabilitation

  4. Hanze University Groningen, Research Department of Rehabilitation

  5. Hanze University Groningen, Research Department of Rehabilitation

  6. Hanze University Groningen, Research Department of Rehabilitation

  7. Hanze University Groningen, Research Department of Rehabilitation

  8. Hanze University Groningen, Research Department of Rehabilitation

  9. Hanze University Groningen, Research Department of Rehabilitation

  10. Hanze University Groningen, Research Department of Rehabilitation

  11. Setting of the SEd programme The Netherlands 16.000.000 citizens Rotterdam 650.000 citizens Biggest port in the world 165 different nationalities Community College ROC Zadkine 33.000 students 1.800 professors/lectures 70 locations Hanze University Groningen, Research Department of Rehabilitation

  12. WHO ARE SERVED BY THEROTTERDAM SEd PROGRAM? Hanze University Groningen, Research Department of Rehabilitation

  13. “SUPPORTED EDUCATION PARTICIPANTS” (YOUNG) ADULTS WITH LONGTERM AND SEVERE PSYCHIATRIC DISABILITIES THAT HINDERS THEM IN FULFILLING THE STUDENT ROLE Hanze University Groningen, Research Department of Rehabilitation

  14. People with chronical diseases and disabilities belong to the most disadvantaged group of people in our society. (Rapportage Gehandicapten 2002) Hanze University Groningen, Research Department of Rehabilitation

  15. EINSTEIN Hanze University Groningen, Research Department of Rehabilitation

  16. Eligibility requirements • 16 years of age or over • Be willing to use an educational (group) environment to develop and utilize an educational plan • Have experienced a severe disability due to mental illness of at least one year Hanze University Groningen, Research Department of Rehabilitation

  17. Characteristics of the Participants (N = 45) • Sex: Female 51% Male 49% • Age (years): Mean 30.6 Range 17-51 • Marital Status: Single 80% Married 20% Hanze University Groningen, Research Department of Rehabilitation

  18. Characteristics of the Participants (N = 45) • Diagnosis Category: • Schizophrenia 31% • Affective disorder 18% • Personality disorder 24% • Other 24% • Unknown 3% • Years of contact with mental health: Mean 6.5 years Range 1-24 years • Psychotropic medication: Yes 80% No 20% Hanze University Groningen, Research Department of Rehabilitation

  19. Characteristics of the Participants (N = 65) • Living Situation: Alone 42% With family 31% Sheltered/clinic 24% Other 3% • Education: Primary education 31% Secondary education 53% Tertiary education 16% Hanze University Groningen, Research Department of Rehabilitation

  20. Comparison with SEd participants in the USA Hanze University Groningen, Research Department of Rehabilitation

  21. PRINCIPLES OF SUPPORTED EDUCATION Hanze University Groningen, Research Department of Rehabilitation

  22. THREE ASPECTSOFCARE Safety, Health & Stability Problem- oriented Environmentally oriented Support (Care) Treatment (Cure) Developmentally oriented Rehabilitation Hanze University Groningen, Research Department of Rehabilitation

  23. Traditional treatment plan • Medication (management) • Day-night rhythm • Personal hygiene • Financial problems • Cleaning the room • Return to or remain at school Hanze University Groningen, Research Department of Rehabilitation

  24. Rehabilitation / Treatment plan • Return to or remain at school • Medication (management) • Day-night rhythm • Personal hygiene • Financial problems • (Cleaning the room) Hanze University Groningen, Research Department of Rehabilitation

  25. Supported Education principle Student role + Educational setting of preference Skills + Support Success + Satisfaction Hanze University Groningen, Research Department of Rehabilitation

  26. SEd: the link between psychiatry and community Psychiatry PSR / SEd Community Living Working Patient =>Client/consumer =>Citizen =>Learning => Student Socializing Hanze University Groningen, Research Department of Rehabilitation

  27. Einstein or 3 women Hanze University Groningen, Research Department of Rehabilitation

  28. THE ROTTERDAM SUPPORTED EDUCATION PROGRAMME Hanze University Groningen, Research Department of Rehabilitation

  29. Aim of the Project To develop, implement, and evaluate a Supported Education programme within the Zadkine College in Rotterdam, based on the Choose-Get-Keep model Hanze University Groningen, Research Department of Rehabilitation

  30. Orientation & intake ‘Choose’ + ‘Get’ Group Classroom IMPULSE Zadkine College ‘Keep’ Individual On-site Support Zadkine College Support Service Mobile Support MH-org. Rehab. Center Hanze University Groningen, Research Department of Rehabilitation

  31. Service 1: Preparation Class • Duration: 16 weeks • Frequency: 2 days per week for 6 hours • Participants: (young)adults who do not yet know what kind of education they prefer • Subjects include: • Orientation to college locations and services • Identifying Personal Criteria • Setting an overall educational goal • Academic & Social Skills building • Development of coping strategies • Resource Assessment & Coordination Hanze University Groningen, Research Department of Rehabilitation

  32. Service 2: On Site and Mobile Support • Duration: As long as needed and wanted • Supports includes: • Emotional Support • Academic & Social Skills building • Advocacy with faculty for accommodations • Assistance with financial aid application • Peer Support Group • Development of coping strategies • Resource Assessment & Coordination Hanze University Groningen, Research Department of Rehabilitation

  33. OUTCOMES Hanze University Groningen, Research Department of Rehabilitation

  34. Outcomes 1 PREPARATION CLASS: 45 students started the Impulse course 30 of the 45 students completed the course (66%) 26 of the 30 set an Educational Goal 20 of the 26 students continued with regular education together with “regular” students Hanze University Groningen, Research Department of Rehabilitation

  35. Outcomes 2* PREPARATION CLASS: Drop-outs No significant differences on sociodemographic characteristics No negative consequences on daily functioning Measurement of Guidance Impact (MGI) Decision making p .003 Opportunity awareness p .000 Self awareness p .000 Transitional skills p .000 MGI Total score p .000 Self-esteem (Rosenberg) p .035 Quality of Life ns Symptoms (SCL-10) ns * Given the limitations of the research design (n= 26; no control group) Hanze University Groningen, Research Department of Rehabilitation

  36. Outcomes 3 • ON-SITE & MOBILE SUPPORT: After 1 year full time education 17 of 20 students were still at college (= 38% of the 45) Most common problems: • Coping with stress • Disclosing the disability • Requesting support / modifications • Responding to feedback • Insecurity about social contacts and collaboration with fellow-students / professors • Internship (requires another role) Hanze University Groningen, Research Department of Rehabilitation

  37. INTEGRATION OF SERVICES Hanze University Groningen, Research Department of Rehabilitation

  38. Orientation Intake ‘CHOOSE’ ‘GET’ ‘KEEP’ INDIVIDUAL GROUP INDIVIDUAL INDIVIDUAL ZADKINE COLLEGE ANOTHER COLLEGE MOBILE S ON-SITE S ON-SITE S MOBILE S ON-SITE S REHAB CENTER/ Mental Health settings ON-SITE SUPPORT SERVICE Supp Ed CLASS-ROOM IMPULSE ‘GET’ REHAB CENTER and other Mental Health Settings ON-SITE SUPPORT SERVICE Supp Ed ON-SITE SUPPORT SERVICE ZADKINE COLLEGE ON-SITE SUPPORT or MOBILE SUPPORT ‘GET’ ‘GET’ ‘KEEP’ ‘KEEP’ ‘KEEP’ ‘KEEP’ another LIFE AREA than EDUCATION ‘KEEP’ includes also PEER GROUP SUPPORT Hanze University Groningen, Research Department of Rehabilitation

  39. 3 WOMEN or Einstein Hanze University Groningen, Research Department of Rehabilitation

  40. SEd activities in the Netherlands 2002-2005 • SEd initiatives and programmes in ± 20-25 cities or regions (Study Buddy Project) • Three national SEd conferences • Website www.begeleidleren.nl (Begeleid Leren = Supported Education), developed by a consumer runn programme • ± 15 articles in journals; 2x a special issue in Passage, Journal of Rehabilitation, ± 30 presentations & workshops • Dissertation about SEd (in Dutch, English summary) • Interest from and contacts with other (European) countries: Belgium, England, Norway, Portugal, Sweden, Czech, Australia, New Zealand, South Africa • Studying with Support Project 2004-2005 (see next slides) Hanze University Groningen, Research Department of Rehabilitation

  41. Overview products 1 Brochures: • Successful studying with psychiatric disabilities, Experiences of students 2. Successful studying with ADHD 3. Successful studying with a borderline personality disorder 4. Successful studying with a mood disorder 5. Successful studying with an eating disorder 6. Successful studying with schizophrenia Hanze University Groningen, Research Department of Rehabilitation

  42. Overview products 2 Skills brochures: 7. “To tell or not to tell?”. Selfdisclosure about your psychiatric background 8. “When it becomes too much”. Coping with stress 9. “How to be on time?”. Requiring support 10. “Who is going to adapt?”. Requiring modifications 11. “How to respond adequately?”. Responding to feedback Hanze University Groningen, Research Department of Rehabilitation

  43. Stigmatizing Dilemma: do I tell or do I not tell others about my psychiatric disability? Some important aspects: • Do I benefit from disclosing my disability? • Who do I tell and why? • What, if people find out? • What do they think of me? Hanze University Groningen, Research Department of Rehabilitation

  44. Disclosure "Disclosing your psychiatric disability" means that you tell someone about your psychiatric condition in the present and/or in the past. To prepare yourself whether to tell about your psychiatric disabilitiy, consider the following: Steps: • Whether to Tell • What to Tell • Who to Tell • When to Tell • How to Tell Hanze University Groningen, Research Department of Rehabilitation

  45. Exercise Step 1: Identify Whether to Tell • Identify benefits • Identify risks • Compare the balance Hand outs Hanze University Groningen, Research Department of Rehabilitation

  46. Conclusion Disclosing is a personal decision – the student with a psychiatric disability him-/herself is the only one who can make it, taking in account his/her own situation and circumstances Hanze University Groningen, Research Department of Rehabilitation

  47. Overview products 3 Peer support group: 12a. “Studying with mutual support”. Manual for starting and performing a Peer Support Group 12b. Research rapport Hanze University Groningen, Research Department of Rehabilitation

  48. Overview products 4 Information: 13. “Where to go to get support?” A guide for students in Groningen with psychiatric problems and disabilities Workshops for Educational Staff: 14. “How do I recognize that students have mental problems?” 15. “What kind of support do students with psychiatric disabilities need?” Hanze University Groningen, Research Department of Rehabilitation

  49. www.begeleidleren.nl Hanze University Groningen, Research Department of Rehabilitation

  50. SEd plans in the Netherlands2006 - 2010 • Implementation of SEd programmes in other cities & regions • SEd handbook (in Dutch) • The fourth national SEd Conference in Spring 2007 • The First World Conference on Supported Education in 2008 in Amsterdam • Develop new SEd information and skills brochures • Develop Fidelity Scale for SEd and a SEd Toolkit for implementation • More research (multi site RCT) on SEd • Starting a National & European Network on SEd • September 2006: Project for Students with Autism in Higher Education Hanze University Groningen, Research Department of Rehabilitation

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