Different perspectives•

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Community participation through Education

Supported Education

for young people with psychosocial problems

SECiSo project, Hamburg, March 15 2018 Presenters: Lies Korevaar & Jacomijn Hofstra


• Why focus on (Supported) Education?

• Supported Education Toolkit

• The Choose-Get-Keep model of SEd

• Specific SEd interventions

• Questions & discussion

Why focus on (Supported) Education?

Different perspectives

• Personal future perspective

• Educational perspective

• Mental Health perspective

• Economical perspective

• Intra- & interpersonal perspective


Ryan’s educational story Personal perspective…

A journey from despair…

…to a life filled with purpose

Research project ’Recovery After an Initial Schizophrenia Episode (RAISE)

Educational perspective...

• Early school leaving is a big problem (in Europe)

• An estimated 6% of students in Higher Education report mental health problems serious enough to need mental health services (2001/2005)

• 50% of them needs extra support to finish their education

• Yet on most colleges, students with mental health problems can’t get appropriate services

• Inflexible structure of the school system

Mental health perspective …

• Most college students are young adults

• Young adulthood represents a high risk for the onset of mental health and psychosocial problems

• Typical onset for many serious mental illnesses is between ages 17-25, as most young people are beginning higher education & careers

• Currently we see more and more youth in the age between 12-17 with mental health problems dropping out of school



Problem- oriented

Developmentally oriented

Environmentally oriented

Treatment (Cure)

Support (Care)

Psychosocial Rehabilitation

(Living, Working, Learning, Socializing) Safety, Health & Stability


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

SEd / 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)

Economic perspective...

• Increasing #’s of young adults attend college;

college degrees are required for success

• Early-onset of mental health or psychosocial problems contributes to under- and unemployment through its effects on education

• People with long term mental health or psychosocial problems who enter the labour market, most of the time, end up in low-paid jobs


Intrapersonal Cognitive problems

Cognitive problems vary from person to person, but often include difficulties with:

Remembering to do things in the future

Planning and ordening

Sustaining attention and concentration

Learning new information and remembering it

Problem-solving in a logical way

Flexibility in thinking

Social-emotional problems

Collaboration with fellow students

Making and maintaining contact

Fear for stigma and discrimination

Low self-esteem

Dealing with stress

Responding to feedback


Supported Education Toolkit

Mission of SEd

To help young people with psychosocial and/or mental health problems to

choose, get and keep regular education

(Unger & Anthony, 1992)


Youth not in employment, education or training (NEET):

• have a right to be in school and to use the resources of that institution

• can learn and be successful in an educational setting

• have a right to self-determination and to set their own goals and timelines within the policies of the institution

• have a right to learn from their mistakes and to have the opportunity to grow over time

Two sub groups

Youth and young adults with psychosocial problems

“Drop outs” Current students

Return to school Remain at school

Choose & get Keep

Education Education



• Toolkit is freely available at:


• The toolkit has been translated into Dutch, Norwegian, Czech, Portuguese and Swedish

Supported Education model

Overall Supported Education Process

1. Engage 2. Assess Readiness 3. Select a SEd Strategy

Engagement Readiness Choosing Achieving Development School Student Role

4. Plan/Deliver Supported Education (& Other) Services

Adapted from: Cohen, M., Farkas, M., & Cohen, B.: (1986). Functional Assessment: Training package.

Boston, MA: Center forPsychiatric Rehabilitation.

Partnership, connectedness

First and foremost the focus of the

practitioner must be on what the

person/participant/user connects to

us and others, and not on what him

or her distinguish from us and



Partnership & Ownership SEd principle

Role + setting of preference

(student) + (educational)

Skills + Support

Success + Satisfaction

How do we support the participants with choosing?

What is available?

Decision making box


criteria Option A Option B Option C









Decision making box

Personal criteria

Accountancy Option A

course at Option B

college Option C

1. Small classes (max. 25 students) +- + ++

2. Teachers who give extra explanation ? + ?

3. University level leading towards a diploma + + +

4. Not to much working in groups - -- +-

5. Nearby home +- ++ +-

6. Quiet place at school to do my homework +- + --

Skills & Support

Educational Goal Success + Satisfaction Skills+Support Skills+Support


Critical skills!!


Critical resources!!

General support services

Functional Assessment (FA)

What are the skills you need to be successful and satisfied at school?

Resource Assessment (RA)

What are the resources you need to be successful and satisfied at school?


Types of Skills

Physical skills

Social skills (interpersonal)

Emotional skills (intrapersonal)

Intellectual / cognitive skills

Hanze University Groningen, Research Department of Rehabilitation

Types of Supports

Person – Supervisor, Peer, Minister, Physician, etc.

Place – Library, Social Club, Private Space in Group Home, etc.

Thing – Work Uniform, Tools, Rent Money, Alarm Clock, etc.

Activity – Family Visits, Medication Monitoring, Therapy, Leisure Activity, Blood Pressure Check, etc.

Adapted from: Cohen, M., Danley, K., & Nemec, P. (1985) TrainingTechnology:

Direct Skill Teaching. Boston, MA: Center for Psychiatric Rehabilitation


Specific interventions

* ImpulSE Decision Making Course

* Peer Support Group

* Disclosure instrument

ImpulSE Decision Making Course Choose & Get

Support of participants in a group setting

What is available?

ImpulSE course

Participants: 8-12 Duration: 12 weeks

Frequency: 1 day per week for 6 hours Participants: young people who

dropped out of school,

want to return to school,

but do not yet know what

kind of education they prefer


Programme CHOOSING

1. Identifying Persona criteria 2. Describing educationals options

3. Making a choice (matching criteria with options)

Decision making box


criteria Option A Option B Option C








Personal Characteristics

Participants of 5 courses

51 participants: male: 30 female: 21 Age: 17- 37 year

Living situation: living independently; living together with family or friend; supported housing;


Diagnoses: schizophrenia; affective disorder;

personality disorder; anorexia nervosa; autism Duration of contact with Health Care: 1-16 years Medication: 70%

Education (before start): Primary education 31%;

Secondary education 53%; Tertiary education 16%



35 completed the course (69%)

28 made a choice for further education (55%) 7 chose for work or another short course (14%)


• Secondary school for adults

• Community College: Nurse; Cook; Beauty specialist

• University of Applied Sciences: Social Work; Law;

Physiotherapy; Economics; International business;

Laboratory worker; Hotel management

• University: International Business


Peer Support Group


The Peer Support group provides self help for students with

(mental health) problems through exchange of experiences, providing mutual support and (study) tips

The focus is on the student role

Not on the problems or the role of patient



- 8-10 students

Group supervisors

- 1 expert by experience (ex consumer & graduate nurse) - 1 expert in group dynamics & rehabilitation



One topic per session:

• Sharing concerns and successes

• Giving and receiving support

• Balance between studying and personal problems

• Financial Aid

• Needed & available Support Services

• Disclosure: ‘To tell or not to tell’

“To tell or not to tell”

Disclosing your (mental health) problems

People with chronical diseases and disabilities

belong to the most disadvantaged group of

people in our society.

(Rapportage Gehandicapten, 2002)


Dilemma: do I tell or do I not tell others about my (psychosocial) problems?

Some important aspects:

• Do I benefit from disclosing?

• Who do I tell and why?

• What, if people find out?

• What do they think of me?


5 aspects of Disclosing Disclosing your background

To tell or not to tell?

a. What are the benefits of

disclosing? b. What are the disadvantages of disclosing?

c. Compare the benefits and the disadvantages. Which are most important to you? Rank the benefits and disadvantages of disclosing from most important to least important.

D. Did you make a choice? Do you tell or not?

Essential ingredients 1. Partnership, connectedness 2. Functional approach: addressing

concerns specifically related to academic goals and success 3. Tailored to the individual, that is

normalizing and flexible

4. Clearly defined activities: developing an educational goal, functional assessment, resource assessment

A B C of

Supported Education


12 13 14 of Treatment A B C of Supported Education

Not only runners move forward, also they who limp

Not only Steffi Graf moves forward,

also young people in Germany with

psychosocial problems





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