Evidence-Based Practices: Shaping Mental Health Services Toward Recovery

Supported Employment

Supported Employment Fidelity Scale—Implementation Questions

Score Sheet

To complete the supported employment fidelity scale the rater obtains objective information from a variety of sources, including agency records, employment specialists, other practitioners and supervisors, program managers, and consumers. Individual meetings are recommended. Listed below are suggested questions that can be used to elicit information. The rater tries to obtain accurate information and not lead respondents to the desired answers that may not reflect the actual practice at the site. The format for interviewing is conversational and the questions listed here are not meant to be used as a structured interview. Information to make the ratings is not necessarily obtained in the order that the items are listed on the scale.

Staffing
1. Caseload size

Does each vocational staff person have a discreet caseload?
How many clients does each vocational staff person (full-time equivalent) have on his/her caseload?
How often does the vocational staff person meet with each person on the caseload? Approximately how long do clients stay on the caseload? When is a client removed from the caseload?

2. Vocational services staff

Do any of the vocational staff provide other services besides vocational, such as case management, day programming, or residential services?
How much of their time do they provide nonvocational services?

3. Vocational generalists

Do different vocational staff persons provide different aspects of the vocational service? For example, one person only does job development or one person only does job support. What different aspects of the vocational process does each provide?

Organization
1. Integration of rehabilitation treatment with mental health treatment

Do vocational workers interact with case managers about their mutual clients?
In what situations do they interact and how regularly (meetings, telephone, etc.)?
Are vocational workers assigned to work with specific case managers or case management teams?
Do they participate in shared decision making about client services? Who (staff) makes the final decision?
Where are the offices located for case managers and for vocational workers?

2. Vocational unit

Do the vocational workers have the same supervisor?
Do the vocational workers meet as a group for supervision? How often?
Do the vocational workers provide services for each others’ clients?

3. Zero exclusion criteria

What are the criteria to be eligible to receive vocational services?
Who makes referrals?
Who conducts the screening?
Are there provisions made for being sure no one is excluded?
What is the rate of referral?

Services
1. Ongoing, work-based vocational assessment

Does the program include vocational evaluation procedures?
What type of assessment procedures do you use and in which settings?
Are their certain assessment procedures that must be completed prior to obtaining a competitive job, e.g. testing, prevocational work adjustment?
How much preplacement assessment do you do?
How much time is spent on vocational assessment?

2. Rapid search for competitive job

What is the average length of time between when a person begins the program and the first contact with a competitive employer? What is the range of time?
What is the philosophy of the program about when to start the job search? Are there steps in the program that people take before starting to look for a job?

3. Individualized job search

How is it decided which jobs are identified in the job search? Who makes these decisions? What information is it based on?
How has the nature of the job market affected the type of jobs clients obtained?

4. Diversity of jobs developed

Does the vocational worker ever suggest to clients that they work at the same job setting as other clients? What percentage of clients work in the same job settings?
Does the vocational worker ever suggest to clients that they obtain the same type of job as other clients? What percentages of clients have the same type of work?

5. Permanence of jobs developed

What percentage of the jobs that the vocational worker suggests to clients are permanent, competitive jobs?
Does the vocational worker ever suggest jobs that are temporary, time-limited, or volunteer? How often?

6. Jobs as transitions

Do vocational workers help clients to find another job when one ends?
What percentage of the vocational worker’s clients who have ended jobs have been provided assistance in finding another job?
What are reasons a vocational worker would not help a client find another job when one has ended? (e.g., client was fired due to poor attendance, problems with substance abuse?)

7. Follow-along supports

Does the vocational worker provide follow-along supports to the client and the employer? What kind of supports?
What percentage of working clients has follow-along supports provided?
Is there a time limit for providing supports?

8. Community-based services

Where do the vocational workers spend most of their time?
What percentage of their time is spent outside the mental health facility? (Ask the vocational worker to review how she spends her time over the last couple of days to determine location of services.)

9. Assertive engagement and outreach

Does the vocational worker provide any outreach if a client does not engage or drops out of services?
What kinds of outreach are provided? How often are outreach attempts made? Is there a time limit to providing outreach if a client stops attending? What is the time limit?

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