The Rotterdam Supported Education Program: an integration of services USPRA Conference Phoenix, June...

The Rotterdam Supported Education Program:

an integration of servicesUSPRA Conference

Phoenix, June 2006

Lies Korevaar

Anne Sullivan

Hanze University Groningen, Research Department of Rehabilitation

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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)


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Overview1. 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


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Setting of the SEd programmeThe Netherlands16.000.000 citizens

Rotterdam 650.000 citizensBiggest port in the world165 different nationalities

Community College ROC Zadkine33.000 students1.800 professors/lectures70 locations


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WHO ARE SERVED BY THEROTTERDAM SEd PROGRAM?


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“SUPPORTED EDUCATION

PARTICIPANTS”

(YOUNG) ADULTS WITHLONGTERM AND SEVERE PSYCHIATRIC DISABILITIES THAT HINDERS THEM IN FULFILLING THE STUDENT ROLE


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People with chronical diseases and disabilities

belong to the most disadvantaged group of

people in our society. (Rapportage Gehandicapten 2002)


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EINSTEIN


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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


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Characteristics of the Participants (N = 45)

Sex:Female 51%Male 49%

Age (years):Mean 30.6Range 17-51

Marital Status:Single 80%Married 20%


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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 yearsRange 1-24 years

Psychotropic medication:Yes 80%No 20%


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Characteristics of the Participants (N = 65) Living Situation:

Alone 42%

With family 31%

Sheltered/clinic 24%

Other 3%

Education:

Primary education 31%

Secondary education53%

Tertiary education 16%


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Comparison with SEd participants in the USA

Characteristics / Program Impulse n = 45

Cook & Solomon, 1993 n = 125

Mowbray et al, 1996 n = 397

Unger, 1993n = 94

Sexe M VAgeMeanRange

Marital statusSingleMarried

Living SituationAloneWith familyWith othersSheld.+ClinicOther

EducationPrimarySecondary.Tertiairy.Unknown

DiagnosisSchizophreniaMood disorderPersonality disorderOtherUnknown

Mean years of contact with MH

MedicationYesNo

4951

30,617-51

8020

4231-24 3

315316 -

31182424 3

6,5

8020

59% 41%

28,8 24 – 35 (51%)

82% 18%

18% 43% - 39% - - 73% 11% 16%

- - - -

4,6 (No Adm)

88% 12%

48% 52%

36,9 17 - 75

- -

21% 40% 10% 29% -

25% 25% 50% -

- - - -

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- -

50,5% 49,5%

34,6 19 - 58

60% 40%

17,4% 20,7% - 25% 37% - 62% 14% 24%

41,4% 21,4% - 17,3% 20,2%

1,5 (M Y)

92% 8%


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PRINCIPLES OF SUPPORTED EDUCATION


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THRETHREE ASPECTE ASPECTSS OFOF CARECARE

Problem-oriented

Developmentallyoriented

Environmentallyoriented

Treatment(Cure)

Support(Care)

Rehabilitation

Safety, Health & Stability


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Traditional treatment plan1. Medication (management)

2. Day-night rhythm

3. Personal hygiene

4. Financial problems

5. Cleaning the room

6. Return to or remain at school


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Rehabilitation / Treatment plan1. Return to or remain at school

2. Medication (management)

3. Day-night rhythm

4. Personal hygiene

5. Financial problems

6. (Cleaning the room)


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Supported Education principleStudent role +

Educational setting

of preference

Skills + Support

Success + Satisfaction


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SEd: the link between psychiatry and community

Psychiatry PSR / SEd Community

Living

Working

Patient =>Client/consumer =>Citizen => Learning => Student Socializing


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Einstein or 3 women


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THE ROTTERDAM SUPPORTED EDUCATION

PROGRAMME


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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


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Orientation & intake

‘Choose’ +‘Get’

Group

‘Keep’

Individual

On-siteSupport

ZadkineCollege

SupportService

MobileSupport

MH-org.

Rehab.Center

ClassroomIMPULSEZadkineCollege


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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


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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


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OUTCOMES


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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


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Outcomes 2* PREPARATION CLASS:Drop-outs No significant differences on sociodemographic

characteristicsNo negative consequences on daily functioning

Measurement of Guidance Impact (MGI)Decision making p .003Opportunity awareness p .000Self awareness p .000Transitional skills p .000MGI 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)


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Outcomes 3

ON-SITE & MOBILE SUPPORT:After 1 year full time education 17 of 20 students were still atcollege (= 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)


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INTEGRATION OF SERVICES


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another LIFE AREAthan EDUCATION

‘GET’ ‘GET’

‘KEEP’ ‘KEEP’ ‘KEEP’ ‘KEEP’

REHAB CENTER/

Mental Health

settings

ON-SITESUPPORTSERVICE

Supp Ed

CLASS-ROOM

IMPULSE

‘GET’

REHAB CENTER

and other

Mental Health

Settings

ON-SITESUPPORT SERVICE

Supp Ed

ON-SITESUPPORT SERVICE

ZADKINE COLLEGE

ON-SITESUPPORT

or

MOBILESUPPORT

OrientationIntake

‘CHOOSE’ ‘GET’ ‘KEEP’

INDIVIDUAL GROUP INDIVIDUAL INDIVIDUAL

MOBILE S ON-SITE S MOBILE S ON-SITE SZADKINECOLLEGEON-SITE S

ANOTHER COLLEGE

‘KEEP’ includes also PEER GROUP SUPPORT


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3 WOMEN or Einstein


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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)


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Overview products 1Brochures:1. 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


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Overview products 2Skills 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


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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?


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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:

1. Whether to Tell

2. What to Tell

3. Who to Tell

4. When to Tell

5. How to Tell


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Exercise

Step 1: Identify Whether to Tell

a. Identify benefits

b. Identify risks

c. Compare the balance

Hand outs


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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


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Overview products 3

Peer support group:

12a. “Studying with mutual support”. Manual for

starting and performing a Peer Support

Group

12b. Research rapport


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Overview products 4Information: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?”


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www.begeleidleren.nl


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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


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EINSTEIN?


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ALBERT


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Not only runners

move forward,

also they who limp


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Thank you very much for your attention & participation

Lies [email protected]

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