A SUPERVISORY STRATEGY TO IMPROVE WORK PERFORMANCE FOR LOWER FUNCTIONING RETARDED CLIENTS IN A SHELTERED WORKSHOP

A multiple component strategy was investigated for aiding staff responsible for supervising production of lower functioning retarded clients on contract tasks in an institution-based sheltered workshop. The strategy was assessed in a combined multi-element, multiple baseline across groups design with a reversal component. Production performance increased during the production supervisory strategy with all 16 clients, with the range of increase varying from a few percentage points to 150% of baseline production. Both the clients and staff (responsible for conducting the research) preferred working under experimental conditions rather than under baseline conditions which approximated those found in “typical” sheltered workshops.     

Behavioral assessment and treatment of acquired visuoperceptual disorders

Visuoperceptual deficits are common sequelae of damage to either hemisphere of the brain, but are typically more pronounced following injuries involving the right cerebral hemisphere. Common visuoperceptual disorders include visual field cuts, hemi-inattention and hemi-spatial neglect, hemi-perceptual deficits, and gaze and visual pursuit disturbances. A number of behavioral interventions have been developed to teach patients to compensate for acquired visual deficits. Studies addressing assessment and treatment issues in this area are reviewed, and future directions for research are outlined.     

Methodological and theoretical issues in neuropsychological assessment

While there are philosophical and theoretical differences between neuropsychologists and behavior therapists, it is suggested that a significant reconciliation can be achieved in regard to assessment and treatment of the brain-damaged patient. While brain damage is often viewed as an irreversible disorder, there is evidence that substantial recovery of function can occur, particularly when adequate retraining is provided. There are practical and empirical considerations that suggest that neuropsychological tests are currently the best tools available for behavioral assessment of brain-damaged patients. However, the results of these tests can be used not only diagnostically but also to identify target behavioral deficits that may be rehabilitated through systematic retraining efforts. Such rehabilitation efforts can be optimally planned, implemented, and evaluated through an alliance between the neuropsychologist, who identifies the ability and deficit pattern, and the behavior therapist, who devises and evaluates the retraining program. It is possible that the successes of behavior therapy in numerous clinical and educational applications can be repeated in the cases of brain-damaged patients. However, such success would appear to be contingent on appreciation of the high degree of specificity often seen in neurological deficit patterns and the great complexities involved in the relationships between brain function and behavior.     

The Influence of Holland's Vocational Interests on Work-Family Conflict: An Exploratory Analysis

Drawing on a sample of 438 working professionals from various organizations across the central United States, the authors investigated the relationship between Holland's (1959, 1997) RIASEC (Realistic, Investigative, Artistic, Social, Enterprising, Conventional) model and employee perceptions of work-family conflict. Results revealed that the RIASEC model contributed unique variance in predicting work-family conflict beyond demographic characteristics and the Big Five personality constructs. The RIASEC interests were found to be associated with different dimensions of work-family conflict. These results signal that vocational interests may influence not only work-related attitudes and behaviors (e.g., job satisfaction, performance), but also one's ability to balance work and family demands.     

The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans

This study evaluated the efficacy of adding contingency management techniques to vocational rehabilitation (VR) to improve treatment outcome as measured by entry into competitive employment. Nineteen dually diagnosed veterans who entered VR in the Veterans' Administration's compensated work therapy (CWT) program were randomly assigned to CWT (n = 8) or to CWT with enhanced incentives (n = 11). Over the first 16 weeks of rehabilitation, those in the incentives condition could earn up to dollar 1,006 in cash for meeting two sets of clinical goals: (a) remaining abstinent from drugs and alcohol and (b) taking steps to obtain and maintain a competitive job. Results indicate that relative to participants in the CWT-only group, those in the incentives condition engaged in more job-search activities, were more likely to remain abstinent from drugs and alcohol, were more likely to obtain competitive employment, and earned an average of 68% more in wages. These results suggest that rehabilitation outcomes may be enhanced by restructuring traditional work-for-pay contingencies to include direct financial rewards for meeting clinical goals.     

Depression and Contributors to Vocational Satisfaction in Roman Catholic Secular Clergy

A nationally selected, random sample of Roman Catholic secular (i.e., diocesan) priests was examined using the Center for Epidemiological Studies-Depression scale and an instrument developed for this study to assess contributors to priests' vocational satisfaction. In addition, a self-report inventory gathered information regarding participants' demographics as well as four categories of predictor variables (i.e., overall level of vocational satisfaction, social support, spiritual activities, physical environment). The study yielded a response rate of 45%. Secular clergy reported rates of depression approximately seven times greater than are found in the general population, and also indicated that the recent sexual abuse scandal in the Roman Catholic church had negatively affected their mood. Priests' engagement in sacramental activities contributed greatly to their vocational satisfaction, and low levels of vocational satisfaction were found to be most predictive of depression. Factors comprising priests' vocational satisfaction were External Manifestations (e.g., preaching, teaching), Internal Manifestations (e.g., prayer life, affirmation of God's call), and Social Manifestations (e.g., relationships with parishioners, appreciation from others).     

Does 'mental kinesiophobia' exist?

In this study the relevance of the concept of mental kinesiophobia (respectively cogniphobia or fear of mental exertion) for clients with chronic stress problems was explored. It was hypothesized that cognitive, chronic stress complaints, such as concentration problems or decreased problem solving abilities, could be catastrophized as signs of heightened personal vulnerability, with a chance of becoming permanent. As a consequence, mental exertion is avoided. This line of reasoning comes from the existing concept of kinesiophobia. This concept describes the avoidance behavior in chronic benign pain patients and refers to their fear of inflicting irreversible bodily damage due to physical exertion.An illustrative case of cogniphobia is presented. In an explorative pilot-study it was demonstrated that chronically stressed clients scored significantly higher on an experimental questionnaire measuring avoidance tendencies for mental exertion, compared with actively working employees. Consequences for treatment and suggestions for further study are discussed.     

Enhancing Social Justice by Promoting Prosocial Values in Career Development Interventions

In career counseling, social justice is typically integrated by helping oppressed groups navigate their way around obstacles of injustice while also working to dislodge the oppressive conditions from society. The authors affirm both of these courses of action while also advocating a third strategy: inviting clients to serve as agents of change by introducing and incorporating prosocial values into career development interventions. This article makes the case that this strategy may enhance client well‐being while simultaneously promoting harmony among organizations and society. Support for this strategy comes from theory, research, and the ethical approaches for working with values in counseling.     

Modulation of N400 in chronic non-fluent aphasia using low frequency Repetitive Transcranial Magnetic Stimulation (rTMS)

Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43 months post stimulation. The present study aimed to investigate the electrophysiological correlates associated with the application of rTMS through measurement of the semantic based N400 Event-related brain potentials (ERP) component. Low frequency (1 Hz) rTMS was applied to the anterior portion of the homologue to Broca’s area (pars triangularis), for 20 min per day for 10 days, using a stereotactic neuronavigational system. Twelve non-fluent persons with aphasia, 2-6 years post stroke were stimulated. Six participants were randomly assigned to receive real stimulation and six participants were randomly assigned to receive a blind sham control condition. ERP measures were recorded at baseline, 1 week and 2 months subsequent to stimulation. The findings demonstrate treatment related changes observed in the stimulation group when compared to the placebo control group at 2 months post stimulation indicating neuromodulation of N400 as a result of rTMS. No treatment related changes were identified in the stimulation group, when compared to the sham group from baseline to 1 week post stimulation. The electrophysiological results represent the capacity of rTMS to modulate neural language networks and measures of lexical-semantic function in participants with non-fluent aphasia and suggest that time may be an important factor in brain reorganization subsequent to rTMS.