The Rotterdam Supported Education Program: an integration of services

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The Rotterdam Supported Education Program an
integration of services

• USPRA Conference
• Phoenix, June 2006
• Lies Korevaar
• Anne Sullivan

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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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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

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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
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WHO ARE SERVED BY THEROTTERDAM SEd PROGRAM?
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SUPPORTED EDUCATION PARTICIPANTS
(YOUNG) ADULTS WITH LONGTERM 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 30.6
• Range 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 years
• Range 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 education 53
• 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, 1993 n 94
Sexe M V Age Mean Range Marital status Single Married Living Situation Alone With family With others Sheld.Clinic Other Education Primary Secondary. Tertiairy. Unknown Diagnosis Schizophrenia Mood disorder Personality disorder Other Unknown Mean years of contact with MH Medication Yes No 49 51 30,6 17-51 80 20 42 31 - 24 3 31 53 16 - 31 18 24 24 3 6,5 80 20 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 - - - - - 14 - - 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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THREE ASPECTS OF CARE
Safety, Health Stability
Problem- oriented
Environmentally oriented
Support (Care)
Treatment (Cure)
Developmentally oriented
Rehabilitation
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Traditional treatment plan

1. 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 plan

1. 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 principle
Student 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 Work
ing Patient gtClient/consumer gtCitizen
gt Learning gt 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
Classroom IMPULSE Zadkine College
Keep
Individual
On-site Support Zadkine College Support Service
Mobile Support MH-org. Rehab. Center
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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
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)
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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)

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INTEGRATION OF SERVICES
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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 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

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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

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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
• Whether to Tell
• What to Tell
• Who to Tell
• When to Tell
• How to Tell

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Exercise

• Step 1 Identify Whether to Tell
• Identify benefits
• Identify risks
• 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 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?
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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 Korevaar e.l.korevaar_at_pl.hanze.nl