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Purpose
Purpose
This module explores the services related to transition for youth who are moving from school to adulthood. There are a number of resources in this module that are valuable regardless of what age you are working with as transition starts the day kids enter school.
Retrieved from: TOT 3: Transitioning from School to Adult Services (2019)
There are many factors that must be considered when supporting young adults with mental health concerns in their transition from school to the community and roles and responsibilities of adulthood. Upon leaving high school, most transition-age students do not receive services that adequately support them in acquiring the skills needed for gainful employment and/or college or post-high school training (Furstenberg, 2009; Osgood et al., 2005).
Some of the most important considerations for schools and key school personnel include:
Increased risk of dropping out of high school or not finishing college
Higher risk for unplanned pregnancies
Higher rates of substance use/abuse
Unemployment and underemployment
Increased issues related to criminal activity
Additional Contributing Factors (CMHPC, 2009) include:
Low academic achievement impacts access to college and/or competitive training
Tendency to not perform well on skills that are judged to be critical to work performance by managers/employers
Limited self-determination skills
Reduced autonomy with respect to job/work goals
Difficulties with interpersonal relationships and communication/social skills
Lack of transition service
Disability insurance and related benefits may de-incentivize employment seeking behaviors
Listen to some additional information on why graduation rates for students with social/emotional disabilities are statistically the worst:
(If link does not work, copy and paste into your browser)
Feel free to click on the link That's where I met 15-year old Kaylan to get more information about how two high school students may benefit from school-based transition planning and services.
The Individual With Disabilities Education Act (IDEA) guarantees students with disabilities (including social-emotional and psychiatric) the right to free, appropriate education and resources. Long-term studies and data suggest that most students with psychiatric disabilities tend to be limited or denied opportunities to participate in constructive educational and vocational activities after graduation. As such, Transition Planning provides a conceptual framework for developing long-term post-graduation goals and the services and strategies that will support students in transitioning from school to adult life.
Retrieved from: TOT 3: Transitioning from School to Adult Services (2019)
A Transition Specialist or Service Coordinator is one of the most important parts of a transition program for young adults with psychiatric and/or social-emotional problems. The California Mental Health Planning Counsel identify several core elements to be included in transition programs in schools (CMHPC, 2009).
Academic Interventions: This element goes beyond teaching to supporting students so they can develop the basic skills needed to succeed in school. Skills include organizing time and materials, recognizing when and who to ask for help, learning how to ask for help, making good choices every day, delaying gratification, setting goals and focusing on outcomes of school participation and having a “plan B” for when things don’t work out.
Vocational Programing: This element focuses on helping youth identify interests, learn basic work skills and prepare to transition to competitive employment. There are numerous EBP related to vocational programming. One program includes five phases starting at a point where the vocational counselor works side-by-side with the youth, and then increasing responsibility until they are able to apply for competitive employment.
Self-Determination Skills: Self-Determination is equated with motivation. People with good self-determination develop intrinsic tendencies to behave in ways that are effective and satisfying. This will be covered more extensively later in this module. Take a moment and review the Practice Brief in the Readings and resources folder on Self-Determination and Transition.
Rights and Services as a Disabled Person: This element refers to helping youth understand their rights as a person with a disability. Teaching youth about social services that might support employment and independent living is a key aspect of transition. What are the services available for them to use, what are the misconceptions, what are the options and most important what are the resources in the community that they can use to navigate an extremely confusing and complex policy based system for health, mental health, employment and community-based living. Teaching youth how to use their voice to advocate for their rights, speak up when their rights are violated and to report abuses will be the largest challenge for transition programs as so many youth come out of communities that are problematic, families with limited emotional and financial resources and systems that are punitive when children have psychiatric disabilities.
The Transition-Age Youth with Emotional and Behavioral Disabilities: Moving Toward Self-Sufficiency document contains some information about a few of the EBP available related to these core elements. You can download it for more information or for future reference.
http://www.dhcs.ca.gov/dataandstats/reports/Mental%20Health/TAYPaper.pdf
Retrieved from: TOT 3: Transitioning from School to Adult Services (2019)
RENEW
RENEW
A systematic transition planning (school to career) and individualized wraparound process for youth with emotional and behavioral challenges. It is one of the most researched evidence-informed transition programs specifically for students with SED. Since 1996, RENEW has been provided by schools, community mental health centers, community-based providers, and IOD staff members to youth. The program prioritizes providing ongoing support to each youth to design and pursue a plan for the successful transition from school to adult life. RENEW has substantially increased the high school completion, employment, and post-secondary education participation rates among our most vulnerable youth. RENEW is an evidence based practice and does require training to maintain fidelity when implementing the program. The training is three days, resulting in a certification and access to the RENEW resources.
Take some time to explore the RENEW website
In particular, review: Video: RENEW Overview: Transition Supports for Youth with Emotional and Behavioral Challenges. You may access this by clicking the main heading RENEW and the subheading About RENEW. .
http://iod.unh.edu/projects/rehabilitation-empowerment-natural-supports-education-and-work-renew
Retrieved from: TOT 3: Transitioning from School to Adult Services (2019)
General Discussion Post:
General Discussion Post:
After you review the program post your thoughts/comments and your answers to the following questions in reference to RENEW. Why might this be a great fit for an OT practitioner?; How might he/she be able to use occupation to complement or support the RENEW approach?; Would you recommend RENEW to OT practitioners…why or why not?
I think as an OT practitioner this program can be very useful to help implement goal directed outcomes. This program looks at many aspects of the student’s life, which as an OT can be very similar to what we do. This program, however, puts our theories and lens onto paper to help the student understand what areas in their lives need improvements. The one girl in the video talks about how she did not know that some of the people she loves the most are actually some of the worst influences in her life and she did not realize it until she sat and created a graph of the people in her life. I think as an OT we see that and use it in MOHO or PEO without intentionally telling the client. This program, however, lets us think out loud to promote our theories and instill them into student’s who may not be able to see their own weaknesses and volition on a day to day basis. I think using the student’s occupations and really targeting their volition can make the RENEW program the best that it can be. By using something that motivated the students and implement that into their daily routines can make them want to succeed and better themselves. I think any occupation could be used to complement the RENEW program. Small achievements can be made anywhere and all the students need to see is that with some drive and desire to achieve, anything is and can be possible.
I think I would recommend this program to OT practitioners if the setting was right. I think it has a lot of benefits, but I also think that there needs to be a specific student that would gain the most benefits out of a program like this. I think overall this program has a good ideology behind it and has the evidence to support its success, so I would suggest and recommend it to other OTs.
There are many EBPs for helping kids with psychiatric disabilities explore vocation options but fewer when it comes to going to college. This is unfortunate as statistically more people are going to college on medication for psychiatric disabilities. This article in the Chicago Tribune does a nice job of highlighting some of the issues faced by young adults with psychiatric disabilities who leave for college.
http://www.chicagotribune.com/sc-hlth-0218-mental-illness-college-20150212-story.html
(Copy and Paste if the link doesn’t work).
Once again, high school graduates with psychiatric disabilities (and their parents) need to know and understand their rights as disabled students. Students also need to have the training and support to be able to vocalize their rights and ask for what they need in a higher education system that is often under informed about disability and the rights of students with disabilities – especially disabilities that are not visually obvious. They also need to know how to navigate higher education policies that set up barriers to success. This could be a really important role for occupational therapists in high school settings.
In the readings and resources folder you will find an FAQ on rights of students with disabilities in higher education. This is a great resource for a transitional team working with students who are planning to move to higher education. Transition teams need to help students learn about and connect with campus disability services as this is key to transition. Also it is very important that the team help students and their families set up counseling services, psychiatric services or other community based services before the student moves to school.
This is another really great resource on the Best Colleges website. Spend a few minutes looking over the website to see what resources it offers.
http://www.bestcolleges.com/resources/college-planning-with-psychiatric-disabilities/
Retrieved from: TOT 3: Transitioning from School to Adult Services (2019)
General Discussion Post:
General Discussion Post:
If you could create the perfect school-based transitional OT position what would that look like? Would it be in elementary school, high school, on an administrative or school board level? There is no right or wrong here – speculate on how the distinct skills we have as OT practitioners could impact school-based transition services for kids with psychiatric disabilities. How might an occupation-based focus support the staff already working on transitions in the education system you chose to address? Don’t be afraid to think out of the box if you want. Sometimes we forget that we can bring OT to non-OT jobs and be very successful!
In my perfect transition program, students would be screened and given the services they need at an early age. Keeping college in mind but realizing that college may not be their path. I think preparing students for other areas of practice at earlier ages is so much more important, not only for society, but for the students own mental health. Imagine going to school every day knowing that you don’t want to go to college, so what’s the point of succeeding now in earlier grades? If kids had other options where they could work with their hands or be creative, it might generate a whole new generation of people with less mental health problems because they don’t “fit’ in the typical educational system.
If I could create the perfect transitional program for students, I think I would want to target all students and not just the ones with diagnosed conditions. I think there is a gap in our education system which includes the a lack of other option other than college. The school systems currently sets up every child go to college. Now that I have been to college and experienced it on my own, I don’t think every human being is destined to go to college. I knew more people that dropped out of college than I was anticipating coming from a town that put such pressure on students to be excellent. I as a child growing up knew from day one that is wasn't a question of “if” I go to college, but “where” I’ll go to college. My parent placed that pressure on me for as long as I can remember. Well, what if I wanted to be a mechanic? Or a chef? Those are areas of practice that do not require a college education. Our schools today want and force students to prepare them for college, even though, not all kids are ready or want to go to college. To me, I think transitional programs in high school should be an option for student who do not want to take the college path. Students should be required to take home economy classes to learn to sew if they want to become a seamstress or work in the garage if they see themselves as a mechanic or work in a workshop if they wish to become a carpenter. I think our schools have limited the options that are available to students other than the college route.
In my perfect transition program, students would be screened and given the services they need at an early age. Keeping college in mind but realizing that college may not be their path. I think preparing students for other areas of practice at earlier ages is so much more important, not only for society, but for the students own mental health. Imagine going to school every day knowing that you don’t want to go to college, so what’s the point of succeeding now in earlier grades? If kids had other options where they could work with their hands or be creative, it might generate a whole new generation of people with less mental health problems because they don’t “fit’ in the typical educational system.
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