Example Of Field Research Paper

How to Begin

Field reports are most often assigned in disciplines of the applied social sciences [e.g., social work, anthropology, gerontology, criminal justice, education, law, the health care professions] where it is important to build a bridge of relevancy between the theoretical concepts learned in the classroom and the practice of actually doing the work you are being taught to do. Field reports are also common in certain science disciplines [e.g., geology] but these reports are organized differently and serve a different purpose than what is described below.

Professors will assign a field report with the intention of improving your understanding of key theoretical concepts through a method of careful and structured observation of, and reflection about, people, places, or things existing in their natural settings. Field reports facilitate the development of data collection techniques and observation skills and they help you to understand how theory applies to real world situations. Field reports are also an opportunity to obtain evidence through methods of observing professional practice that contribute to or challenge existing theories.

We are all observers of people, their interactions, places, and events; however, your responsibility when writing a field report is to create a research study based on data generated by the act of designing a specific study, deliberate observation, a synthesis of key findings, and an interpretation of their meaning. When writing a field report you need to:

  • Systematically observe and accurately record the varying aspects of a situation. Always approach your field study with a detailed plan about what you will observe, where you should conduct your observations, and the method by which you will collect and record your data.
  • Continuously analyze your observations. Always look for the meaning underlying the actions you observe. Ask yourself: What's going on here? What does this observed activity mean? What else does this relate to? Note that this is an on-going process of reflection and analysis taking place for the duration of your field research.
  • Keep the report’s aims in mind while you are observing. Recording what you observe should not be done randomly or haphazardly; you must be focused and pay attention to details. Enter the observation site [i.e., "field"] with a clear plan about what you are intending to observe and record while, at the same time, being prepared to adapt to changing circumstances as they may arise.
  • Consciously observe, record, and analyze what you hear and see in the context of a theoretical framework. This is what separates data gatherings from simple reporting. The theoretical framework guiding your field research should determine what, when, and how you observe and act as the foundation from which you interpret your findings.

Techniques to Record Your Observations

Although there is no limit to the type of data gathering technique you can use, these are the most frequently used methods:

Note Taking
This is the most commonly used and easiest method of recording your observations. Tips for taking notes include: organizing some shorthand symbols beforehand so that recording basic or repeated actions does not impede your ability to observe, using many small paragraphs, which reflect changes in activities, who is talking, etc., and, leaving space on the page so you can write down additional thoughts and ideas about what’s being observed, any theoretical insights, and notes to yourself that are set aside for further investigation. See drop-down tab for additional information about note-taking.

Photography
With the advent of smart phones, high quality photographs can be taken of the objects, events, and people observed during a field study. Photographs can help capture an important moment in time as well as document details about the space where your observation takes place. Taking a photograph can save you time in documenting the details of a space that would otherwise require extensive note taking. However, be aware that flash photography could undermine your ability to observe unobtrusively so assess the lighting in your observation space; if it's too dark, you may need to rely on taking notes. Also, you should reject the idea that photographs are some sort of "window into the world" because this assumption creates the risk of over-interpreting what they show. As with any product of data gathering, you are the sole instrument of interpretation and meaning-making, not the object itself.

Video and Audio Recordings
Video or audio recording your observations has the positive effect of giving you an unfiltered record of the observation event. It also facilitates repeated analysis of your observations. This can be particularly helpful as you gather additional information or insights during your research. However, these techniques have the negative effect of increasing how intrusive you are as an observer and will often not be practical or even allowed under certain circumstances [e.g., interaction between a doctor and a patient] and in certain organizational settings [e.g., a courtroom].

Illustrations/Drawings
This does not refer to an artistic endeavor but, rather, refers to the possible need, for example, to draw a map of the observation setting or illustrating objects in relation to people's behavior. This can also take the form of rough tables or graphs documenting the frequency and type of activities observed. These can be subsequently placed in a more readable format when you write your field report. To save time, draft a table [i.e., columns and rows] on a separate piece of paper before an observation if you know you will be entering data in that way.

NOTE:  You may consider using a laptop or other electronic device to record your notes as you observe, but keep in mind the possibility that the clicking of keys while you type or noises from your device can be obtrusive, whereas writing your notes on paper is relatively quiet and unobtrusive. Always assess your presence in the setting where you're gathering the data so as to minimize your impact on the subject or phenomenon being studied.

ANOTHER NOTE:  Techniques of observation and data gathering are not innate skills; they are skills that must be learned and practiced in order to achieve proficiency. Before your first observation, practice the technique you plan to use in a setting similar to your study site [e.g., take notes about how people choose to enter checkout lines at a grocery store if your research involves examining the choice patterns of unrelated people forced to queue in busy social settings]. When the act of data gathering counts, you'll be glad you practiced beforehand.


Examples of Things to Document While Observing

  • Physical setting. The characteristics of an occupied space and the human use of the place where the observation(s) are being conducted.
  • Objects and material culture. This refers to the presence, placement, and arrangement of objects that impact the behavior or actions of those being observed. If applicable, describe the cultural artifacts representing the beliefs--values, ideas, attitudes, and assumptions--used by the individuals you are observing.
  • Use of language. Don't just observe but listen to what is being said, how is it being said, and, the tone of conversation among participants.
  • Behavior cycles. This refers to documenting when and who performs what behavior or task and how often they occur. Record at which stage is this behavior occurring within the setting.
  • The order in which events unfold. Note sequential patterns of behavior or the moment when actions or events take place and their significance.
  • Physical characteristics of subjects. If relevant, note age, gender, clothing, etc. of individuals being observed.
  • Expressive body movements. This would include things like body posture or facial expressions. Note that it may be relevant to also assess whether expressive body movements support or contradict the language used in conversation [e.g., detecting sarcasm].

Brief notes about all of these examples contextualize your observations; however, your observation notes will be guided primarily by your theoretical framework, keeping in mind that your observations will feed into and potentially modify or alter these frameworks.


Sampling Techniques

Sampling refers to the process used to select a portion of the population for study. Qualitative research, of which observation is one method, is generally based on non-probability and purposive sampling rather than probability or random approaches characteristic of quantitatively-driven studies. Sampling in observational research is flexible and often continues until no new themes emerge from the data, a point referred to as data saturation.

All sampling decisions are made for the explicit purpose of obtaining the richest possible source of information to answer the research questions. Decisions about sampling assumes you know what you want to observe, what behaviors are important to record, and what research problem you are addressing before you begin the study. These questions determine what sampling technique you should use, so be sure you have adequately answered them before selecting a sampling method.

Ways to sample when conducting an observation include:

Ad Libitum Sampling -- this approach is not that different from what people do at the zoo--observing whatever seems interesting at the moment. There is no organized system of recording the observations; you just note whatever seems relevant at the time. The advantage of this method is that you are often able to observe relatively rare or unusual behaviors that might be missed by more deliberate sampling methods. This method is also useful for obtaining preliminary observations that can be used to develop your final field study. Problems using this method include the possibility of inherent bias toward conspicuous behaviors or individuals and that you may miss brief interactions in social settings.

Behavior Sampling -- this involves watching the entire group of subjects and recording each occurrence of a specific behavior of interest and with reference to which individuals were involved. The method is useful in recording rare behaviors missed by other sampling methods and is often used in conjunction with focal or scan methods. However, sampling can be biased towards particular conspicuous behaviors.

Continuous Recording -- provides a faithful record of behavior including frequencies, durations, and latencies [the time that elapses between a stimulus and the response to it]. This is a very demanding method because you are trying to record everything within the setting and, thus, measuring reliability may be sacrificed. In addition, durations and latencies are only reliable if subjects remain present throughout the collection of data. However, this method facilitates analyzing sequences of behaviors and ensures obtaining a wealth of data about the observation site and the people within it. The use of audio or video recording is most useful with this type of sampling.

Focal Sampling -- this involves observing one individual for a specified amount of time and recording all instances of that individual's behavior. Usually you have a set of predetermined categories or types of behaviors that you are interested in observing [e.g., when a teacher walks around the classroom] and you keep track of the duration of those behaviors. This approach doesn't tend to bias one behavior over another and provides significant detail about a individual's behavior. However, with this method, you likely have to conduct a lot of focal samples before you have a good idea about how group members interact. It can also be difficult within certain settings to keep one individual in sight for the entire period of the observation.

Instantaneous Sampling -- this is where observation sessions are divided into short intervals divided by sample points. At each sample point the observer records if predetermined behaviors of interest are taking place. This method is not effective for recording discrete events of short duration and, frequently, observers will want to record novel behaviors that occur slightly before or after the point of sampling, creating a sampling error. Though not exact, this method does give you an idea of durations and is relatively easy to do. It is also good for recording behavior patterns occurring at a specific instant, such as, movement or body positions.

One-Zero Sampling -- this is very similar to instantaneous sampling, only the observer records if the behaviors of interest have occurred at any time during an interval instead of at the instant of the sampling point. The method is useful for capturing data on behavior patterns that start and stop repeatedly and rapidly, but that last only for a brief period of time. The disadvantage of this approach is that you get a dimensionless score for an entire recording session, so you only get one one data point for each recording session.

Scan Sampling -- this method involves taking a census of the entire observed group at predetermined time periods and recording what each individual is doing at that moment. This is useful for obtaining group behavioral data and allows for data that are evenly representative across individuals and periods of time. On the other hand, this method may be biased towards more conspicuous behaviors and you may miss a lot of what is going on between observations, especially rare or unusual behaviors. It is also difficult to record more than a few individuals in a group setting without missing what each individual is doing at each predetermined moment in time [e.g., children sitting at a table during lunch at school].


Alderks, Peter. Data Collection. Psychology 330 Course Documents. Animal Behavior Lab. University of Washington; Emerson, Robert M. Contemporary Field Research: Perspectives and Formulations. 2nd ed. Prospect Heights, IL: Waveland Press, 2001; Emerson, Robert M. et al. “Participant Observation and Fieldnotes.” In Handbook of Ethnography. Paul Atkinson et al., eds. (Thousand Oaks, CA: Sage, 2001), 352-368; Emerson, Robert M. et al. Writing Ethnographic Fieldnotes. 2nd ed. Chicago, IL: University of Chicago Press, 2011; Ethnography, Observational Research, and Narrative Inquiry. Writing@CSU. Colorado State University; Hazel, Spencer. "The Paradox from Within: Research Participants Doing-Being-Observed." Qualitative Research 16 (August 2016): 446-457; Pace, Tonio. Writing Field Reports. Scribd Online Library; Presser, Jon and Dona Schwartz. “Photographs within the Sociological Research Process.” In Image-based Research: A Sourcebook for Qualitative Researchers. Jon Prosser, editor (London: Falmer Press, 1998), pp. 115-130; Pyrczak, Fred and Randall R. Bruce. Writing Empirical Research Reports: A Basic Guide for Students of the Social and Behavioral Sciences. 5th ed. Glendale, CA: Pyrczak Publishing, 2005; Report Writing. UniLearning. University of Wollongong, Australia; Wolfinger, Nicholas H. "On Writing Fieldnotes: Collection Strategies and Background Expectancies.” Qualitative Research 2 (April 2002): 85-95; Writing Reports. Anonymous. The Higher Education Academy.

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This paper should be used only as an example of a research paper write-up. Horizontal rules signify the top and bottom edges of pages. For sample references which are not included with this paper, you should consult the Publication Manual of the American Psychological Association, 4th Edition.

This paper is provided only to give you an idea of what a research paper might look like. You are not allowed to copy any of the text of this paper in writing your own report.

Because word processor copies of papers don't translate well into web pages, you should note that an actual paper should be formatted according to the formatting rules for your context. Note especially that there are three formatting rules you will see in this sample paper which you should NOT follow. First, except for the title page, the running header should appear in the upper right corner of every page with the page number below it. Second, paragraphs and text should be double spaced and the start of each paragraph should be indented. Third, horizontal lines are used to indicate a mandatory page break and should not be used in your paper.


The Effects of a Supported Employment Program on Psychosocial Indicators

for Persons with Severe Mental Illness

William M.K. Trochim

Cornell University

Running Head: SUPPORTED EMPLOYMENT


Abstract

This paper describes the psychosocial effects of a program of supported employment (SE) for persons with severe mental illness. The SE program involves extended individualized supported employment for clients through a Mobile Job Support Worker (MJSW) who maintains contact with the client after job placement and supports the client in a variety of ways. A 50% simple random sample was taken of all persons who entered the Thresholds Agency between 3/1/93 and 2/28/95 and who met study criteria. The resulting 484 cases were randomly assigned to either the SE condition (treatment group) or the usual protocol (control group) which consisted of life skills training and employment in an in-house sheltered workshop setting. All participants were measured at intake and at 3 months after beginning employment, on two measures of psychological functioning (the BPRS and GAS) and two measures of self esteem (RSE and ESE). Significant treatment effects were found on all four measures, but they were in the opposite direction from what was hypothesized. Instead of functioning better and having more self esteem, persons in SE had lower functioning levels and lower self esteem. The most likely explanation is that people who work in low-paying service jobs in real world settings generally do not like them and experience significant job stress, whether they have severe mental illness or not. The implications for theory in psychosocial rehabilitation are considered.


The Effects of a Supported Employment Program on Psychosocial Indicators for Persons with Severe Mental Illness

Over the past quarter century a shift has occurred from traditional institution-based models of care for persons with severe mental illness (SMI) to more individualized community-based treatments. Along with this, there has been a significant shift in thought about the potential for persons with SMI to be "rehabilitated" toward lifestyles that more closely approximate those of persons without such illness. A central issue is the ability of a person to hold a regular full-time job for a sustained period of time. There have been several attempts to develop novel and radical models for program interventions designed to assist persons with SMI to sustain full-time employment while living in the community. The most promising of these have emerged from the tradition of psychiatric rehabilitation with its emphases on individual consumer goal setting, skills training, job preparation and employment support (Cook, Jonikas and Solomon, 1992). These are relatively new and field evaluations are rare or have only recently been initiated (Cook and Razzano, 1992; Cook, 1992). Most of the early attempts to evaluate such programs have naturally focused almost exclusively on employment outcomes. However, theory suggests that sustained employment and living in the community may have important therapeutic benefits in addition to the obvious economic ones. To date, there have been no formal studies of the effects of psychiatric rehabilitation programs on key illness-related outcomes. To address this issue, this study seeks to examine the effects of a new program of supported employment on psychosocial outcomes for persons with SMI.

Over the past several decades, the theory of vocational rehabilitation has experienced two major stages of evolution. Original models of vocational rehabilitation were based on the idea of sheltered workshop employment. Clients were paid a piece rate and worked only with other individuals who were disabled. Sheltered workshops tended to be "end points" for persons with severe and profound mental retardation since few ever moved from sheltered to competitive employment (Woest, Klein & Atkins, 1986). Controlled studies of sheltered workshop performance of persons with mental illness suggested only minimal success (Griffiths, 1974) and other research indicated that persons with mental illness earned lower wages, presented more behavior problems, and showed poorer workshop attendance than workers with other disabilities (Whitehead, 1977; Ciardiello, 1981).

In the 1980s, a new model of services called Supported Employment (SE) was proposed as less expensive and more normalizing for persons undergoing rehabilitation (Wehman, 1985). The SE model emphasizes first locating a job in an integrated setting for minimum wage or above, and then placing the person on the job and providing the training and support services needed to remain employed (Wehman, 1985). Services such as individualized job development, one-on-one job coaching, advocacy with co-workers and employers, and "fading" support were found to be effective in maintaining employment for individuals with severe and profound mental retardation (Revell, Wehman & Arnold, 1984). The idea that this model could be generalized to persons with all types of severe disabilities, including severe mental illness, became commonly accepted (Chadsey-Rusch & Rusch, 1986).

One of the more notable SE programs was developed at Thresholds, the site for the present study, which created a new staff position called the mobile job support worker (MJSW) and removed the common six month time limit for many placements. MJSWs provide ongoing, mobile support and intervention at or near the work site, even for jobs with high degrees of independence (Cook & Hoffschmidt, 1993). Time limits for many placements were removed so that clients could stay on as permanent employees if they and their employers wished. The suspension of time limits on job placements, along with MJSW support, became the basis of SE services delivered at Thresholds.

There are two key psychosocial outcome constructs of interest in this study. The first is the overall psychological functioning of the person with SMI. This would include the specification of severity of cognitive and affective symptomotology as well as the overall level of psychological functioning. The second is the level of self-reported self esteem of the person. This was measured both generally and with specific reference to employment.

The key hypothesis of this study is:

HO: A program of supported employment will result in either no change or negative effects on psychological functioning and self esteem.

which will be tested against the alternative:

HA: A program of supported employment will lead to positive effects on psychological functioning and self esteem.

Method

Sample

The population of interest for this study is all adults with SMI residing in the U.S. in the early 1990s. The population that is accessible to this study consists of all persons who were clients of the Thresholds Agency in Chicago, Illinois between the dates of March 1, 1993 and February 28, 1995 who met the following criteria: 1) a history of severe mental illness (e.g., either schizophrenia, severe depression or manic-depression); 2) a willingness to achieve paid employment; 3) their primary diagnosis must not include chronic alcoholism or hard drug use; and 4) they must be 18 years of age or older. The sampling frame was obtained from records of the agency. Because of the large number of clients who pass through the agency each year (e.g., approximately 500 who meet the criteria) a simple random sample of 50% was chosen for inclusion in the study. This resulted in a sample size of 484 persons over the two-year course of the study.

On average, study participants were 30 years old and high school graduates (average education level = 13 years). The majority of participants (70%) were male. Most had never married (85%), few (2%) were currently married, and the remainder had been formerly married (13%). Just over half (51%) are African American, with the remainder Caucasian (43%) or other minority groups (6%). In terms of illness history, the members in the sample averaged 4 prior psychiatric hospitalizations and spent a lifetime average of 9 months as patients in psychiatric hospitals. The primary diagnoses were schizophrenia (42%) and severe chronic depression (37%). Participants had spent an average of almost two and one-half years (29 months) at the longest job they ever held.

While the study sample cannot be considered representative of the original population of interest, generalizability was not a primary goal -- the major purpose of this study was to determine whether a specific SE program could work in an accessible context. Any effects of SE evident in this study can be generalized to urban psychiatric agencies that are similar to Thresholds, have a similar clientele, and implement a similar program.

Measures

All but one of the measures used in this study are well-known instruments in the research literature on psychosocial functioning. All of the instruments were administered as part of a structured interview that an evaluation social worker had with study participants at regular intervals.

Two measures of psychological functioning were used. The Brief Psychiatric Rating Scale (BPRS)(Overall and Gorham, 1962) is an 18-item scale that measures perceived severity of symptoms ranging from "somatic concern" and "anxiety" to "depressive mood" and "disorientation." Ratings are given on a 0-to-6 Likert-type response scale where 0="not present" and 6="extremely severe" and the scale score is simply the sum of the 18 items. The Global Assessment Scale (GAS)(Endicott et al, 1976) is a single 1-to-100 rating on a scale where each ten-point increment has a detailed description of functioning (higher scores indicate better functioning). For instance, one would give a rating between 91-100 if the person showed "no symptoms, superior functioning..." and a value between 1-10 if the person "needs constant supervision..."

Two measures of self esteem were used. The first is the Rosenberg Self Esteem (RSE) Scale (Rosenberg, 1965), a 10-item scale rated on a 6-point response format where 1="strongly disagree" and 6="strongly agree" and there is no neutral point. The total score is simply the sum across the ten items, with five of the items being reversals. The second measure was developed explicitly for this study and was designed to measure the Employment Self Esteem (ESE) of a person with SMI. This is a 10-item scale that uses a 4-point response format where 1="strongly disagree" and 4="strongly agree" and there is no neutral point. The final ten items were selected from a pool of 97 original candidate items, based upon high item-total score correlations and a judgment of face validity by a panel of three psychologists. This instrument was deliberately kept simple -- a shorter response scale and no reversal items -- because of the difficulties associated with measuring a population with SMI. The entire instrument is provided in Appendix A.

All four of the measures evidenced strong reliability and validity. Internal consistency reliability estimates using Cronbach's alpha ranged from .76 for ESE to .88 for SE. Test-retest reliabilities were nearly as high, ranging from .72 for ESE to .83 for the BPRS. Convergent validity was evidenced by the correlations within construct. For the two psychological functioning scales the correlation was .68 while for the self esteem measures it was somewhat lower at .57. Discriminant validity was examined by looking at the cross-construct correlations which ranged from .18 (BPRS-ESE) to .41 (GAS-SE).

Design

A pretest-posttest two-group randomized experimental design was used in this study. In notational form, the design can be depicted as:

R O X O

R O O

where:

R = the groups were randomly assigned

O = the four measures (i.e., BPRS, GAS, RSE, and ESE)

X = supported employment

The comparison group received the standard Thresholds protocol which emphasized in-house training in life skills and employment in an in-house sheltered workshop. All participants were measured at intake (pretest) and at three months after intake (posttest).

This type of randomized experimental design is generally strong in internal validity. It rules out threats of history, maturation, testing, instrumentation, mortality and selection interactions. Its primary weaknesses are in the potential for treatment-related mortality (i.e., a type of selection-mortality) and for problems that result from the reactions of participants and administrators to knowledge of the varying experimental conditions. In this study, the drop-out rate was 4% (N=9) for the control group and 5% (N=13) in the treatment group. Because these rates are low and are approximately equal in each group, it is not plausible that there is differential mortality. There is a possibility that there were some deleterious effects due to participant knowledge of the other group's existence (e.g., compensatory rivalry, resentful demoralization). Staff were debriefed at several points throughout the study and were explicitly asked about such issues. There were no reports of any apparent negative feelings from the participants in this regard. Nor is it plausible that staff might have equalized conditions between the two groups. Staff were given extensive training and were monitored throughout the course of the study. Overall, this study can be considered strong with respect to internal validity.

Procedure

Between 3/1/93 and 2/28/95 each person admitted to Thresholds who met the study inclusion criteria was immediately assigned a random number that gave them a 50/50 chance of being selected into the study sample. For those selected, the purpose of the study was explained, including the nature of the two treatments, and the need for and use of random assignment. Participants were assured confidentiality and were given an opportunity to decline to participate in the study. Only 7 people (out of 491) refused to participate. At intake, each selected sample member was assigned a random number giving them a 50/50 chance of being assigned to either the Supported Employment condition or the standard in-agency sheltered workshop. In addition, all study participants were given the four measures at intake.

All participants spent the initial two weeks in the program in training and orientation. This consisted of life skill training (e.g., handling money, getting around, cooking and nutrition) and job preparation (employee roles, coping strategies). At the end of that period, each participant was assigned to a job site -- at the agency sheltered workshop for those in the control condition, and to an outside employer if in the Supported Employment group. Control participants were expected to work full-time at the sheltered workshop for a three-month period, at which point they were posttested and given an opportunity to obtain outside employment (either Supported Employment or not). The Supported Employment participants were each assigned a case worker -- called a Mobile Job Support Worker (MJSW) -- who met with the person at the job site two times per week for an hour each time. The MJSW could provide any support or assistance deemed necessary to help the person cope with job stress, including counseling or working beside the person for short periods of time. In addition, the MJSW was always accessible by cellular telephone, and could be called by the participant or the employer at any time. At the end of three months, each participant was post-tested and given the option of staying with their current job (with or without Supported Employment) or moving to the sheltered workshop.

Results

There were 484 participants in the final sample for this study, 242 in each treatment. There were 9 drop-outs from the control group and 13 from the treatment group, leaving a total of 233 and 229 in each group respectively from whom both pretest and posttest were obtained. Due to unexpected difficulties in coping with job stress, 19 Supported Employment participants had to be transferred into the sheltered workshop prior to the posttest. In all 19 cases, no one was transferred prior to week 6 of employment, and 15 were transferred after week 8. In all analyses, these cases were included with the Supported Employment group (intent-to-treat analysis) yielding treatment effect estimates that are likely to be conservative.

The major results for the four outcome measures are shown in Figure 1.

_______________________________________

Insert Figure 1 about here

_______________________________________

It is immediately apparent that in all four cases the null hypothesis has to be accepted -- contrary to expectations, Supported Employment cases did significantly worse on all four outcomes than did control participants.

The mean gains, standard deviations, sample sizes and t-values (t-test for differences in average gain) are shown for the four outcome measures in Table 1.

_______________________________________

Insert Table 1 about here

_______________________________________

The results in the table confirm the impressions in the figures. Note that all t-values are negative except for the BPRS where high scores indicate greater severity of illness. For all four outcomes, the t-values were statistically significant (p<.05).

Conclusions

The results of this study were clearly contrary to initial expectations. The alternative hypothesis suggested that SE participants would show improved psychological functioning and self esteem after three months of employment. Exactly the reverse happened -- SE participants showed significantly worse psychological functioning and self esteem.

There are two major possible explanations for this outcome pattern. First, it seems reasonable that there might be a delayed positive or "boomerang" effect of employment outside of a sheltered setting. SE cases may have to go through an initial difficult period of adjustment (longer than three months) before positive effects become apparent. This "you have to get worse before you get better" theory is commonly held in other treatment-contexts like drug addiction and alcoholism. But a second explanation seems more plausible -- that people working full-time jobs in real-world settings are almost certainly going to be under greater stress and experience more negative outcomes than those who work in the relatively safe confines of an in-agency sheltered workshop. Put more succinctly, the lesson here might very well be that work is hard. Sheltered workshops are generally very nurturing work environments where virtually all employees share similar illness histories and where expectations about productivity are relatively low. In contrast, getting a job at a local hamburger shop or as a shipping clerk puts the person in contact with co-workers who may not be sympathetic to their histories or forgiving with respect to low productivity. This second explanation seems even more plausible in the wake of informal debriefing sessions held as focus groups with the staff and selected research participants. It was clear in the discussion that SE persons experienced significantly higher job stress levels and more negative consequences. However, most of them also felt that the experience was a good one overall and that even their "normal" co-workers "hated their jobs" most of the time.

One lesson we might take from this study is that much of our contemporary theory in psychiatric rehabilitation is naive at best and, in some cases, may be seriously misleading. Theory led us to believe that outside work was a "good" thing that would naturally lead to "good" outcomes like increased psychological functioning and self esteem. But for most people (SMI or not) work is at best tolerable, especially for the types of low-paying service jobs available to study participants. While people with SMI may not function as well or have high self esteem, we should balance this with the desire they may have to "be like other people" including struggling with the vagaries of life and work that others struggle with.

Future research in this are needs to address the theoretical assumptions about employment outcomes for persons with SMI. It is especially important that attempts to replicate this study also try to measure how SE participants feel about the decision to work, even if traditional outcome indicators suffer. It may very well be that negative outcomes on traditional indicators can be associated with a "positive" impact for the participants and for the society as a whole.


References

Chadsey-Rusch, J. and Rusch, F.R. (1986). The ecology of the workplace. In J. Chadsey-Rusch, C. Haney-Maxwell, L. A. Phelps and F. R. Rusch (Eds.), School-to-Work Transition Issues and Models. (pp. 59-94), Champaign IL: Transition Institute at Illinois.

Ciardiello, J.A. (1981). Job placement success of schizophrenic clients in sheltered workshop programs. Vocational Evaluation and Work Adjustment Bulletin, 14, 125-128, 140.

Cook, J.A. (1992). Job ending among youth and adults with severe mental illness. Journal of Mental Health Administration, 19(2), 158-169.

Cook, J.A. & Hoffschmidt, S. (1993). Psychosocial rehabilitation programming: A comprehensive model for the 1990's. In R.W. Flexer and P. Solomon (Eds.), Social and Community Support for People with Severe Mental Disabilities: Service Integration in Rehabilitation and Mental Health. Andover, MA: Andover Publishing.

Cook, J.A., Jonikas, J., & Solomon, M. (1992). Models of vocational rehabilitation for youth and adults with severe mental illness. American Rehabilitation, 18, 3, 6-32.

Cook, J.A. & Razzano, L. (1992). Natural vocational supports for persons with severe mental illness: Thresholds Supported Competitive Employment Program, in L. Stein (ed.), New Directions for Mental Health Services, San Francisco: Jossey-Bass, 56, 23-41.

Endicott, J.R., Spitzer, J.L. Fleiss, J.L. and Cohen, J. (1976). The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766-771.

Griffiths, R.D. (1974). Rehabilitation of chronic psychotic patients. Psychological Medicine, 4, 316-325.

Overall, J. E. and Gorham, D. R. (1962). The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799-812.

Rosenberg, M. (1965). Society and Adolescent Self Image. Princeton, NJ, Princeton University Press.

Wehman, P. (1985). Supported competitive employment for persons with severe disabilities. In P. McCarthy, J. Everson, S. Monn & M. Barcus (Eds.), School-to-Work Transition for Youth with Severe Disabilities, (pp. 167-182), Richmond VA: Virginia Commonwealth University.

Whitehead, C.W. (1977). Sheltered Workshop Study: A Nationwide Report on Sheltered Workshops and their Employment of Handicapped Individuals. (Workshop Survey, Volume 1), U.S. Department of Labor Service Publication. Washington, DC: U.S. Government Printing Office.

Woest, J., Klein, M. and Atkins, B.J. (1986). An overview of supported employment strategies. Journal of Rehabilitation Administration, 10(4), 130-135.


Table 1. Means, standard deviations and Ns for the pretest, posttest and gain scores for the four outcome variables and t-test for difference between average gains.

BPRSPretestPosttestGain
TreatmentMean3.25.1 1.9
sd 2.42.72.55
N 229229229
ControlMean3.43.0 -0.4
sd 2.32.52.4
N 233233233
t =9.979625p<.05
GASPretestPosttestGain
TreatmentMean5943 -16
sd 25.224.324.75
N 229229229
ControlMean6163 2
sd 26.722.124.4
N 233233233
t = -7.87075p<.05
RSEPretestPosttestGain
TreatmentMean4231 -11
sd 27.126.526.8
N 229229229
ControlMean4143 2
sd 28.225.927.05
N 233233233
t = -5.1889p<.05
ESEPretestPosttestGain
TreatmentMean2716 -11
sd 19.321.220.25
N 229229229
ControlMean2524 -1
sd 18.620.319.45
N 233233233
t = -5.41191p<.05

Figure 1. Pretest and posttest means for treatment (SE) and control groups for the four outcome measures.





Appendix A

The Employment Self Esteem Scale

Please rate how strongly you agree or disagree with each of the following statements.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

1. I feel good about my work on the job.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

2. On the whole, I get along well with others at work.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

3. I am proud of my ability to cope with difficulties at work.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

4. When I feel uncomfortable at work, I know how to handle it.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

5. I can tell that other people at work are glad to have me there.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

6. I know I'll be able to cope with work for as long as I want.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

7. I am proud of my relationship with my supervisor at work.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

8. I am confident that I can handle my job without constant assistance.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

9. I feel like I make a useful contribution at work.


StronglyDisagree


SomewhatDisagree


SomewhatAgree


StronglyAgree

10. I can tell that my co-workers respect me.

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Copyright ©2006, William M.K. Trochim, All Rights Reserved
Purchase a printed copy of the Research Methods Knowledge Base
Last Revised: 10/20/2006

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