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Reality orientation versus sheltered workshops as treatment for the institutionalized aging.

The effects of two psychosocial treatments, Reality Orientation and Sheltered Workshops, were evaluated against an assessment-only control. Thirty nursing home residents (mean age, 64.4 years) were randomly assigned to one of two groups in one of the three experimental conditions. Residents assigned to therapy conditions met for 15 group sessions led by trained nursing home personnel. Program effects were assessed before and after treatment using three variables: the Life Satisfaction Index-A, nurses' ratings, and behavior observations. The Sheltered Workshop treatment produced significant gains in Life Satisfaction Index-A scores and staff perceived social interest; Reality Orientation resulted in nonsignificant decrements in Life Satisfaction Index-A scores. Neither treatment produced effects on observer-rated on-ward behavior. The results underscore the importance of empirically evaluating therapy effects with the institutionalized aging and suggest that Sheltered Workshops may be more beneficial for this population than has previously been recognized.

Adult

Clinical use of the Quick Test with sheltered workshop clients.

The purpose of this note is to provide clinical reference data on the Quick Test responses of 48 adult sheltered workshop clients. The mean IQs for Forms 1, 2, and 3 were 66.3, 67.6, and 69.7, respectively. The mean IQ for combined Form 1 + 2 + 3 was 68.4. Standard deviations of IQs for the three forms were 13.68, 13.99, and 15.31, respectively, and for Form 1 + 2 + 3 was 13.65. There were 17 females and 31 males ranging in age from 18-2 to 61-1. These data provide tentative local norms for psychologists to use when the Quick Test is given to evaluate mentally subnormal clients of these sheltered workshops for placement or to predict their success in work programs. Future norms should be checked and updated for workshop clients.

Adolescent

Effects of price manipulations on consumer behavior in sheltered workshop token economy.

The consumer behavior of institutionalized retarded clients in a sheltered workshop token economy were evaluated by changing prices in the workshop store. In the first experiment we found that clients displayed elasticity of demand in that raising the prices of frequently purchased goods reduced the frequency and amount spent on more expendable items. Results from the second experiment showed that this change in spending pattern was not due to the relative modal unit price of item classes. The regulation of demand for consumer goods is a potentially useful way to maintain economic balance and effectiveness of a token economy.

Adolescent

The case for a flexible, long-term sheltered workshop for psychiatric patients.

In making his case for a flexible, long-term sheltered workshop, the author presents seven propositions that he supports with reviews of outcome studies in psychiatric treatment and rehabilitation. He submits that it is unrealistic to expect a lasting cure for many psychiatric patients; that despite rehospitilizations, many patients spend most of their lives in the community, where their vocational performance is poor; that total vocational rehabilitation is an unrealistic goal for many of the patients but that in our culture employment is essential to self-respect; and that hospital patients can and will work in hospital workshops and in community workshops after discharge. In addition, he describes a work-for-pay program affiliated with a psychiatric day hospital.

Day Care, Medical

The physical, psycho-social and vocational effectiveness of a sheltered workshop for brain-damaged war veterans.

This two-year investigation of the rehabilitation effectiveness of a sheltered workshop for severely brain-damaged war veterans who had been deemed non-feasible for the Ministry of Defense's usual rehabilitation services, included: (a) a multi-disciplinary staff, (b) adapted jobs, (c) client involvement in workshop management and maintenance, (d) client earnings and (e) social activities. Brain-damaged war veterans from the Tel Aviv area constituted the experimental group. Persons with similar neurological impairment, cognitive, emotional disabilities and social handicaps constituted the control group. In interviews at the beginning and end of the research period, the rehabilitation workshop members and the families expressed a significantly greater increase in satisfaction with a variety of major life activities than did members of the control group and their families. It would appear that sheltered work can increase the brain-damaged persons' satisfaction with major life activities by ameliorating the personal, social and vocational dysfunction that accompanies and aggravates the consequence of brain damage.

Adolescent

Retarded adult's discrete work performance in a sheltered workshop as a function of overall productivity and motivation.

Production times of high and low retarded adults in a sheltered workshop were analyzed in terms of actual time working as opposed to actual time not working and under conditions of standard and high motivation. Under standard conditions, low productivity was primarily the result of more time spent not working. High motivation attenuated this effect. The results were discussed in terms of cognitive vs. motivational interpretations of individual differences in work performance.

Adult

Relationship between dimensions of adaptive behavior and sheltered workshop productivity.

A factor analysis was performed on the 24 domains of the AAMD Adaptive Behavior Scale using a sample of 217 adult retarded workshop clients. Of the seven dimensions found to describe adaptive behavior, Personal Independence, Social Maladaptation, and Personal Maladaptation accounted for the majority of variance in the factor matrix. Scores on each of the seven factors were obtained for all clients and used to predict productivity in a workshop setting as defined by average hourly salary for the time period in which the scale was administered. A stepwise regression analysis yielded a highly significant regression effect in which the factors of Personal Independence and Social Maladaptation accounted for 25% of the variance in salary and had a multiple correlation coefficient of .50 with the predicted variable. We concluded that adaptive behavior is a multidimensional variable, significantly affecting productivity in sheltered workshop settings.

Adaptation, Psychological

Expanding a sheltered workshop to replace nonpaying patient jobs.

Mental hospitals with large numbers of inactive chronic patients often have a history of hospital farms and shops that provided meaningful, though unpaid, occupation to hundreds of patients. The reforms of work programs brought about by the Souder v. Brennan decision were long overdue, the author says, but the resulting termination of work programs in many hospitals means many benefits to patients have been lost. At one state hospital, many of the jobs eliminated by the Souder decision were replaced by an expansion of the hospital's sheltered workshop, which operates under a work activities center certificate. A project in which patients made and assembled parts for unpainted wooden toys was responsible for much of the expansion.

Economics