Employment/Education

 

65. Member will increase the number of meetings with his CM in which he is willing to discuss and explore employment goals, from a baseline of 0x/month to a goal of at least 1x/month, and sustain this change for 6 months or until he gets a job, as measured by CM report.

Rehab: CM will help member identify possible reasons for not seeking employment (e.g., concern about loss of SSI benefits, fear of increased responsibility and expectations, etc.). Will work to increase his motivation by helping him identify positive reasons for obtaining employment (e.g., sense of accomplishment, increased self-esteem, contribution to society, respect from others, etc.).

CMS: CM will facilitate linkage to vocational resources and programs offering supported employment in his community, such as EDD and Goodwill Employment WORKS.

CMS: Benefits Specialist will link member with information about SSI work incentives such as the Ticket to Work program and how he can increase his monthly income while minimizing the risk of losing his SSI and/or Medi-Cal benefits.

Group: Group Facilitator(s) will conduct Moving Forward, Sports Talk, and similar groups to encourage peer-to-peer interaction, allow participants to become acclimated to group settings, and help develop greater self-confidence in social situations.

Member will start a journal and write at least one “positive affirmation statement” per day regarding himself, his strengths, and his abilities; and attend at least 1 series of one of the above groups.

66. Member will acquire information about jobs and develop at least 5 job ideas based on his strengths, interests, and values, as measured by information he shares with his CM.  Baseline:  Has never worked and reports having no idea what kind of work he would be good at.

Rehab: CM will use RCCS skill-building exercises "My Identity", "My Strengths", “My Values”, and SOAR (Supportive Choice Making) to increase member’s motivation and help him resolve ambivalence he has about working.

CMS: CM and Employment Specialist will facilitate linkage to employment programs (e.g., EDD, Goodwill Employment WORKS, etc.) or to potential employers directly.

CMS: Benefits Specialist will link member with information about SSI work incentives such as the Ticket to Work program and how he can increase his monthly income while minimizing the risk of losing his SSI and/or Medi-Cal benefits.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce symptoms of thought disorder.

Medication: Nurse will assist with medication management to help member overcome impairments related to lack of med adherence (see CFS 8).

Member will work collaboratively with CM and Employment Specialist to come up with job ideas.

67. Member will be submitting applications, going on interviews, and engaging in structured volunteer work leading to the acquisition of job skills, as evidenced by collateral, evidence provided by member, and report of supervisor.  Baseline: Not submitting applications; engaging in occasional volunteer work with no set schedule, time commitment, or specific duties.

Rehab: CM will work to increase member’s motivation by helping him identify positive reasons for obtaining employment (e.g., sense of accomplishment, greater self-esteem, increased income, etc.). Will provide coaching, modeling, and prompts to help member develop skills for interviewing and for dealing with situations he is likely to encounter in the workplace (fixed schedules, deadlines, specific duties, etc.).

CMS: CM will facilitate linkage to volunteer opportunities and vocational programs offering supported employment, such as EDD and Goodwill Employment WORKS.

CMS: Benefits Specialist will link member with information about SSI work incentives such as the Ticket to Work program and how he can increase his monthly income while minimizing the risk of losing his SSI and/or Medi-Cal benefits.

Group: Group Facilitator(s) will conduct Moving Forward, Sports Talk, and similar groups to encourage peer-to-peer interaction, allow participants to become acclimated to group settings, and help develop greater self-confidence in social situations.

Member will network through acquaintances he has at church and use the internet to look for potential volunteer and P/T work opportunities.

68. Member will increase productive job seeking behavior (searching help wanted ads, following up on leads, and submitting applications) from 0 times per week to a goal of 4 times per week and sustain this change for 3 months, as measured by member self-report.

Rehab: CM will work to increase motivation by helping member identify positive reasons for obtaining employment (e.g., sense of accomplishment, increased self-esteem, contribution to society, respect from others, etc.). Will provide coaching, modeling, and prompts to help member develop skills for interviewing and for dealing with situations he is likely to encounter in the workplace (fixed schedules, deadlines, specific duties, etc.).

CMS: CM will facilitate linkage to volunteer opportunities and vocational programs offering supported employment, such as EDD and Goodwill Employment WORKS.

CMS: Benefits Specialist will link member with information about SSI work incentives such as the Ticket to Work program and how he can increase his monthly income while minimizing the risk of losing his SSI and/or Medi-Cal benefits.

Group: Group Facilitator(s) will conduct Moving Forward, Sports Talk, and similar groups to encourage peer-to-peer interaction, allow participants to become acclimated to group settings, and help develop greater self-confidence in social situations.

Member will network through acquaintances he has at church and use the internet to look for potential volunteer and P/T work opportunities.

69. Member will engage in structured volunteer work at least one day per week and sustain this change for 6 months or until she obtains paid employment, as measured by report of supervisor.  Baseline:  Has not engaged in any work-like activities for at least 10 years.

Rehab: CM will help member identify positive reasons for volunteering (e.g., potential improvement in mood, sense of accomplishment, increased self-esteem, opportunity to make new friends, etc.). Will use modeling and role-play to help member develop more effective communication skills and encourage her to focus on her strengths and achievements.

CMS: CM will facilitate linkage to volunteer opportunities and vocational programs offering supported employment, such as EDD and Goodwill Employment WORKS.

Group: Group Facilitator(s) will conduct Moving Forward group to help participants identify and overcome common barriers to progress.

Member will attend Moving Forward group and inquire about volunteer opportunities at TAO and in the community.

70. Within 6 months member will be engaging in structured, work-like activity (volunteer or paid) that makes use of his strengths, at least 3 days a week; within 12 months, he will have a P/T or F/T job that makes use of his strengths and abilities.  Baseline:  Not working or volunteering.

Rehab: CM will provide MHS by using RCCS exercises such as SOAR (Supportive Choice Making) to help member make more informed choices about taking his medications, and skill-building to help him improve communication and decision-making skills, including his ability to manage situations he is likely to encounter in the workplace.

CMS: CM and Employment Specialist will provide linkage and referrals to jobs/employers in the community, and check-in regularly with member once he is employed to assess progress.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce symptoms of thought disorder.

Medication: Nurse will assist with medication management to help member overcome impairments related to lack of med adherence as described in CFS 8.

Member will complete and submit employment applications as agreed upon with his CM and Employment Specialist, and let them know about any barriers he encounters in the application process.

71. Member will be engaged in competitive employment in at least 8 of the next 12 months, as evidenced by pay stubs provided by member or report of supervisor.  Baseline:  Had a job for nearly 5 months, lost it due to relapse/hospitalization, now returning to workforce.

Rehab: CM will provide MHS by using RCCS exercises such as SOAR (Supportive Choice Making) to help member make more informed choices about taking his medications, and skill-building to help member improve communication and decision-making skills, including his ability to manage situations he is likely to encounter in the workplace.

CMS: CM and Employment Specialist will provide linkage and referrals to jobs/employers in the community, and check-in regularly with member once he is employed to assess progress.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce symptoms of thought disorder.

Medication: Nurse will assist with medication management to help member overcome impairments related to lack of med adherence (see CFS 8).

Member will complete and submit employment applications as agreed upon with his CM and Employment Specialist, and let them know about any barriers he encounters in the application process.

72. Member will increase the number of hours he spends doing structured volunteer work, from a baseline of 0 hours per week to a goal of 6 or more hours a week, and sustain this change for 6 months, as measured by member self-report and report of his supervisor.

Rehab: CM will model prosocial behaviors (e.g., making eye contact, smiling, greeting others) that promote better interpersonal functioning in a work environment, and use role-play, role-reversal, and feedback to help member internalize them. Will help member develop skills for interviewing and for dealing with situations he is likely to encounter at his volunteer site.

CMS: CM will facilitate linkage to volunteer opportunities in member’s community, and check in regularly to monitor his progress.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce symptoms of thought disorder. Nurse will assist with medication management to help member overcome impairments related to inconsistent med adherence.

Medication: Nurse will conduct annual nursing assessments to assist physician with ruling-out organic causes of mental health symptoms and to identify physical conditions neglected as a result of mental illness that may warrant referral. 

Member will consider his interests and strengths, and come up with 3 or 4 places he would like to work.

73. Member will increase the number of hours he works per week, from a baseline of 3 to a goal of 12, and maintain this change for the remainder of the cycle, as measured by pay-stubs and collateral from employer.

Rehab: CM will work to increase member’s motivation by helping him identify positive reasons for working (e.g., greater sense of accomplishment, increased income, better self-esteem, potential improvement in mood, opportunity to make friends, etc.). Will stress the importance of taking medications as prescribed and reducing/eliminating unnecessary sources of stress (which makes symptoms worse and communication more challenging).

CMS: With member’s approval, CM will contact member’s supervisor or visit his job site on a regular basis to monitor progress, consult with manager/supervisor, and work collaboratively to resolve any problems that arise.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce symptoms of thought disorder.

Medication: Nurse will assist with medication management to help member overcome impairments related to lack of med adherence (see CFS 8).

Member will inform his CM or a member of his treatment team immediately if any work-related issues arise that he is unsure how to resolve.

74. Member will increase the number of days per week that he works, from a baseline of 1 to a goal of 5, and maintain this change for the remainder of the cycle, as measured by pay-stubs and collateral from employer.

Rehab: CM will work to increase member’s motivation by helping him identify positive reasons for working (e.g., greater sense of accomplishment, increased income, better self-esteem, potential improvement in mood, opportunity to make friends, etc.). Will help member learn to distinguish between passive, assertive, and aggressive styles of communication, and role-play mock disagreements with him so he can practice expressing his feelings through appropriate, assertive statements.

CMS: With member’s approval, CM will contact member’s supervisor or visit his job site on a regular basis to monitor progress, consult with manager/supervisor, and work collaboratively to resolve any problems that arise.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce symptoms of anger and mood lability.

Medication: Nurse will assist with medication management to help member overcome impairments related to lack of med adherence (see CFS 8).

Member will practice the skills he learns and apply them at work, and inform his CM if any work-related issues arise that he is unsure how to resolve.

75. Member will reduce instances of being late to work, from a baseline of 5x/10 scheduled work days to a goal of 1x/10 scheduled work days, and sustain this change for 3 consecutive months, as measured by report of employer and member self-report.

Rehab: CM will help member improve his punctuality by using reminders such as an alarm clock, smart phone alerts, and other prompts; and by maintaining a more consistent bedtime. CM will assist member in identifying patterns in his behavior and decision-making that have led to problems at work in the past, with the goal of helping him anticipate and take action on issues before they affect his job performance. 

CMS: With member’s approval, CM will contact member’s supervisor or visit his job site on a regular basis to monitor progress, consult with manager/supervisor, and work collaboratively to resolve any issues that arise.

Member will practice using the techniques he learns and discuss the results with his CM during their weekly meetings.

76. Member will decrease instances of missing work without notifying his supervisor in advance, from a baseline of 1x/10 scheduled work days to a goal of 0x/10 scheduled work days, and sustain this change for 6 months, as measured by report of employer and member self-report.

Rehab:  CM will help member identify patterns in his behavior and decision-making that have led to job loss in the past, with the goal of improving his ability to anticipate and take action on issues before they cause problems. Will help member develop a plan for what to do – who to call, when, and in what order – if he feels he may be unable to report to work as scheduled.

CMS: With member’s approval, CM will contact member’s supervisor or visit his job site on a regular basis to monitor progress, consult with manager/supervisor, and work collaboratively to resolve any issues that arise.

Member will follow the plan that he and his CM develop and inform his CM if any work-related issues arise that he is unsure how to resolve.

77. Member will increase the number of months he is able to maintain steady employment, from a baseline of 1 month to a goal of 3 months, and sustain this change for at least 3 months, as measured by pay stubs or other evidence provided by member.

Rehab: CM will teach member techniques for managing disagreements he has with his supervisor, such as disengaging without giving in (i.e., asking for time to think and temporarily excusing himself so that he can regain his composure). Will help member identify patterns in his behavior and decision-making that have led to job loss in the past, with the goal of improving his ability to anticipate and take action on issues before they cause problems. 

CMS: With member’s approval, CM will contact member’s supervisor or visit his job site on a regular basis to monitor progress, consult with manager/supervisor, and work collaboratively to resolve any issues that arise.

Member will practice using the anger-management skills he learns, maintain and awareness of his triggers, and use the skills he has learned to manage workplace disagreements.

78. Member will reduce instances of walking off the job in anger, from a baseline of 1x/employed month to a goal of 0x/employed month, and sustain this change for 6 consecutive months, as evidenced by report of employer and/or member self-report.

Rehab: CM will teach member techniques for managing disagreements he has with his supervisor, such as disengaging without giving in (i.e., asking for time to think and temporarily excusing himself so that he can regain his composure). Will help member identify patterns in his behavior and decision-making that have led to job loss in the past, with the goal of improving his ability to anticipate and take action on issues before they cause problems. 

CMS: With member’s approval, CM will contact member’s supervisor or visit his job site on a regular basis to monitor progress, consult with manager/supervisor, and work collaboratively to resolve any issues that arise.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to reduce depression and mood lability. Nurse will assist with medication management to help member overcome impairments related to inconsistent adherence to med regimen.

Member will practice using the anger-management skills he learns, maintain and awareness of his triggers, and use the skills he has learned to manage workplace disagreements.

79. Member will increase the number of jobs he applies for, from a baseline of 0 per week to a goal of at least 2 per week, and sustain this change for 6 months or until he gets a job, as measured by copies of completed job applications or other evidence provided by member.

Rehab: CM will provide coaching, modeling, and prompts to help member develop skills for inquiring about jobs, interviewing, and for dealing with situations he is likely to encounter in the workplace (fixed schedules, deadlines, specific duties, etc.).

CMS: CM and Employment Specialist will provide CMS to help member conduct job searches, connect with prospective employers, identify promising job leads, and apply for positions.

Member will work collaboratively with his CM and Benefits Specialist to connect with potential employers.

80. Member will be either 1) be engaging in structured, work-like activity (volunteer or paid) that makes use of her clerical abilities and experience, or 2) employed P/T as a clerk with an insurance company.  Baseline: Not working or volunteering but has extensive work experience in a clerical capacity working in the insurance field.

Rehab: CM will use modeling, role-play, and rehearsal to help member develop skills for inquiring about jobs, interviewing, and for dealing with situations she is likely to encounter in the workplace (fixed schedules, deadlines, specific duties, etc.).

CMS: CM and Employment Specialist will provide CMS to help member connect with prospective employers, identify promising job leads, and apply for positions.

Member will work collaboratively with his CM and Benefits Specialist to connect with potential employers.

81. Member will increase the number of classes she completes with a passing grade, from a baseline of 0 to a goal of 2 per semester, and sustain this change for 2 semesters, as measured by transcripts provided by member.

Rehab: CM will provide skill building to help member develop positive alternatives to maladaptive behaviors (i.e., improved communication skills, more effective coping skills, improved ability to manage mental illness, etc.).

CMS: CM will facilitate ongoing linkage with member’s school and assist with registration, accessing disabled student services, obtaining student aid, etc. Will meet with member regularly to assess progress and determine needs.

Collateral: CM will educate member’s significant support persons on her mental illness, how they can improve her access to services, and how they can help her achieve her goals.

Member will implement the alternative coping skills she learns from her CM and apply them to real-world situations as often as possible.

82. Member will complete 1 class at his local community college regardless of the grade he earns, as evidenced by transcripts provided by member.  Baseline:  0, due to member dropping out whenever he gets a low score on a test or homework assignment.

Rehab: CM will help member explore self-defeating patterns in his behavior and assist him with developing a plan for change going forward. Will teach member de-escalation techniques to help him make better choices, such as deep breathing, journaling, seeking feedback from significant others, participating in peer support groups, and engaging in physical exercise.

CMS: CM will assist with member with registration, accessing disabled student services, student aid, etc. Will meet with member regularly to assess progress.

Therapy: Clinician will use therapeutic interventions such as CBT to help member identify and correct inaccurate thoughts about himself and others that may be contributing to his feelings of anger and tendency to overreact.

Member will implement the alternative coping skills he learns, apply them to real-world situations as often as possible, and discuss the results with his CM during their weekly meetings.

83. Member will enroll at Santa Ana College and complete at least one class towards her BA, as evidenced by transcripts and/or other documentation she provides. Baseline: Some coursework done but not enrolled in school.

Rehab: CM will help member explore self-defeating patterns in her behavior and help her develop a plan for change going forward. Will help member learn to recognize the early warning signs of mania (unable to sleep, takes on significantly more work than usual, begins planning elaborate projects) and assist her with developing a plan for what to do when she observes them.

CMS: CM will facilitate linkage to Santa Ana College, assist with registration and access to disabled student services and student aid. Will meet with member regularly to monitor progress.

Medication: MD/NP will provide psychoeducation and prescribe and monitor psychiatric medications to stabilize mood. Nurse will assist with medication management to help member overcome impairments related to inconsistent adherence to med regimen.

Group: Group Facilitator will conduct DBSA group (Depression and Bipolar Support Alliance) to help participants form connections with similarly-diagnosed peers, recognize they are not alone, share experiences and solutions, and celebrate accomplishments.

Member will practice using the alternative coping skills she learns, attend group, and take her medications as prescribed.

84. Member will complete his current classes and those he is enrolled in for next semester.  Baseline:  Enrolls in classes, then withdraws from all of them when he feels offended or disrespected by a teacher.

Rehab: CM will help member explore self-defeating patterns in his behavior and help him develop a plan for change going forward. Will teach member de-escalation techniques to help him make better choices, such as deep breathing, journaling, seeking feedback from significant others, participating in peer support groups, and engaging in physical exercise.

Therapy: Clinician will use therapeutic interventions such as CBT to help member identify and correct inaccurate thoughts about himself and others that may be contributing to his feelings of anger and tendency to overreact.

Group: Group Facilitator(s) will conduct Coping Skills and DBSA (Depression and Bipolar Support Alliance) Groups to help participants form connections with peers, recognize they are not alone, share experiences, and celebrate accomplishments.

Member will attend Coping Skills and DBSA groups and use the Common Ground library to learn more about people like himself who have made a successful recovery from mental illness.

 

 

 

All PHI has been de-identified per HIPAA Privacy Rule