This guide, based on more than ten years of study of depressed parents and their families, offers... more This guide, based on more than ten years of study of depressed parents and their families, offers strategies, action plans, and resources to help readers provide for their children\u27s healthy development
Health care services can play a critical role in supporting employment among people with disabili... more Health care services can play a critical role in supporting employment among people with disabilities and can sometimes be the difference between working and not working for those with disabilities. 1 The health insurance and service delivery reforms underway in U.S. will benefit persons with disabilities; however, the reforms may not fully meet the employment-related
There is wide geographic variation in Social Security Disability Insurance (DI) and Supplementary... more There is wide geographic variation in Social Security Disability Insurance (DI) and Supplementary Security Income (SSI) participation across the United States. The authors describe the variation. Using data from Social Security Administration reports and results from the Census Bureau’s American Community Survey, the authors decompose the geographic variation in program participation into component parts including variation in disability prevalence and variation in program participation among working-age persons with disabilities. The variation in participation among persons with disabilities is further decomposed into socioeconomic subcomponents.
In this brief, the authors use an example of a Behavioral Risk Factor Surveillance System (BRFSS)... more In this brief, the authors use an example of a Behavioral Risk Factor Surveillance System (BRFSS)-based disability study conducted in Massachusetts to describe how the BRFSS can be used for disability research. The study implemented a follow-up survey to the Massachusetts BRFSS and gathered data on the employment-related health insurance needs of individuals with disabilities.
Consumers with serious mental illness face many barriers to employment. The goal of the focus gro... more Consumers with serious mental illness face many barriers to employment. The goal of the focus group study summarized in this article was to better understand the perspectives of those who most directly interface with employment services, namely consumers and providers. Fortyfour consumers and 32 providers participated in focus groups across Massachusetts. The guiding questions posed to participants were What are the barriers? and What are the facilitators? Participants identified a range of factors, including those related to psychiatric conditions. However, contextual factors, particularly those related to the service system, the Social Security system, and stigma, were considered to be the most daunting barriers. Solutions to barriers at both the practice and the policy level are suggested.
The Affordable Care Act (ACA) provides health insurance to many working-age adults with disabilit... more The Affordable Care Act (ACA) provides health insurance to many working-age adults with disabilities, but we do not expect the new coverage or existing insurance options to fully meet their employment-related health care needs. Wraparound services have the potential to foster employment among people with disabilities. We use Massachusetts, which implemented health care reform in 2006, as a case study to estimate the wraparound health care expenditures and use for workers with disabilities. We identified a group of employed, working-age people with disabilities whose primary health insurance is Medicare or private insurance and who use the Medicaid Buy-In Program for wraparound coverage. We analyzed claims to estimate expenditures and use. Wraparound expenditures averaged $427 per member per month. Community-based services for both mental and non-mental health, which are generally not covered by Medicare or private insurance, accounted for 63% of all expenditures. The number who used community-based services was low, but the expenditures were high. The majority of the remaining expenditures were for services usually covered by primary insurance including: inpatient and outpatient, pharmacy and professional services. Expenditures were higher for people with Medicare compared to private insurance. This case study suggests that, from a total program cost perspective, wraparound demand is greatest for community-based services. From a member utilization perspective, the demand is greatest for coverage that alleviates out-of-pocket costs for services provided by primary insurance. Additional analysis is needed to further assess the design options for wraparound programs and their feasibility.
... Employers express concerns about and may be less likely to hire those with psychiatric disabi... more ... Employers express concerns about and may be less likely to hire those with psychiatric disabilities (Bordieri, Drehmer & Taylor, 1997; Cook ... disabled, and create a psychological barrier to employment (Estroff, Zimmer, Lachicotte, Benoit & Patrick, 1997; MacDonald-Wilson, 1999 ...
The employment rate among persons with disabilities is much lower compared to persons without dis... more The employment rate among persons with disabilities is much lower compared to persons without disabilities. Lengthy lists have been put forward to explain the low employment rate but there has been little study to estimate the amount of labor (labor supply) non-working persons with disabilities are ready to provide. We describe the potential labor supply using a 2010 Massachusetts Behavioral Risk Factor Surveillance System follow-up survey of working-age persons in with disabilities, Approximately 55% of persons with disabilities in Massachusetts are not working. We find that the potential labor supply among these persons is substantial. Three-quarters indicate they would accept a job offer that included both good hours and good wages. The wage expectations are not excessive. Approximately 50% report they would accept a job with wages of $10/hour and nearly all (96%) report they would accept a job with wages of $20/hour. Some persons with disabilities want part-time employment but m...
Telework is most commonly performed from a person's home, and thus can accommodate the needs ... more Telework is most commonly performed from a person's home, and thus can accommodate the needs of persons with disabilities ranging from agoraphobia to quadriplegia. Telework is a practice that appears to meet Universal Design criteria, viz., a broad-spectrum design feature that is beneficial to the general population, but is particularly helpful to persons with disabilities. However, some disability advocates fear that the practice is unacceptably isolating and compromises community integration and competitive employment. The National Telework Consumer Survey was designed to inform the debate with real primary data on consumers' views. We surveyed a population of persons with disabilities who had differing degrees of connection with a national disability employment network that recruits, trains, and hires prospective workers with disabilities to fulfill assignments the organization has brokered with government agencies and businesses. The survey sample frame consisted of near...
The purpose of this study was to examine time use patterns and variables related to time use, inc... more The purpose of this study was to examine time use patterns and variables related to time use, including feelings about time use, time management, and academic achievement, among normal college students. Time use was examined from the perspective of the model of human occupation. One hundred and six male and female occupational therapy students enrolled at Worcester State College in Worcester, MA completed two self-report questionnaires and a demographic questionnaire. The subjects completed the Occupational Questionnaire (Riopel Smith, Kielhofner, and Watts, 1986) which measured time use (activities engaged in during a typical 24-h period), and feelings about time use (related to competence, value, enjoyment) for the activities they reported. In addition, they completed the Time Management Questionnaire (Britton and Tesser, 1990, which measured their time attitudes, preferences for short range planning, and preferences for long range planning. The results of the study suggest that o...
This study examined the perspectives of people with psychiatric disabilities and employment servi... more This study examined the perspectives of people with psychiatric disabilities and employment service providers regarding factors that most directly help or hinder consumer efforts to obtain and maintain employment. Forty-four adults with serious mental illness (SMI) (consumers) and 30 providers participated in 12 focus groups across Massachusetts. We began both consumer and provider groups by posing two broad questions: 1) what factors most help people with SMI get and keep jobs (facilitators), and 2) what factors most prevent people with SMI from getting and keeping jobs (barriers)? Data were analyzed qualitatively and both person and environmental factors were highlighted. Among facilitators, participants agreed that quality consumer-provider relationships and individualized employment services are most instrumental in helping consumers achieve employment goals. Participants identified a range of environmental barriers, including issues related to the service system, entitlement pr...
To determine if there were observable cues of personality to be found in the appearance and expre... more To determine if there were observable cues of personality to be found in the appearance and expressive behaviour of six men and six women with Parkinson's disease. Participants completed a personality measure and engaged in an individual, videotaped interview. Four trained raters measured the expressive behaviour demonstrated in the videotapes. A correlational design was used to explore associations between self-reported personality and measures of expressive behaviour. In this sample, more eyebrow furrowing indicated significantly higher levels of Neuroticism and less formal dress indicated significantly higher levels of Openness to Experience. These associations remained large and significant after controlling for the effect of disease severity. Whereas previous research has focused on the detrimental effect of Parkinson's disease symptoms on first impressions, this study explored the potential for accurate first impressions of personality by identifying observable cues of personality. Findings suggest that in early stages of Parkinson's disease there may be plausible and intuitive cues of personality present in expressive behaviour.
A guiding premise of occupational therapy practice is that it is beneficial to allow clients free... more A guiding premise of occupational therapy practice is that it is beneficial to allow clients freedom of choice in selecting and participating in activities. This study examined subjects’ affective responses to having or lacking freedom of choice in completing an activity and explored how those responses might differ when subjects did the activity in individual as opposed to group settings. Forty female undergraduate and graduate students participated in an origami activity under four different experimental conditions: a) individual–choice; b) individual–no choice; c) group–choice; and d) group–no choice. Afterward, each subject rated how she felt about herself while participating in the activity by using Osgood’s semantic differential designed to elicit responses in terms of three affective factors: evaluation, power, and activity. Data analysis revealed an interaction between the two independent variables on the power factor such that subjects who were not permitted choice responde...
The American Journal of Occupational Therapy, 1998
Objective. Two studies examined the internal consistency and test-retest reliability of the Adole... more Objective. Two studies examined the internal consistency and test-retest reliability of the Adolescent Leisure Interest Profile (ALIP), an 86-item measure of adolescent leisure activity interest, leisure participation, and feelings about leisure. In addition, leisure activity interests and participation f adolescents with and without disabilities were described, and the ability of the ALIP to discriminate among four groups of adolescents was examined. Method. After preliminary item development, two separate reliability studies of the ALIP were conducted. The ALIP was administered twice to 88 adolescents with psychiatric, learning, and physical disabilities and to 28 adolescents without disabilities. In both studies, the second administration took place from 7 days to 14 days after the first. In addition, data from the first administration in both reliability studies were combined to examine the ability of the ALIP to discriminate among adolescents with and without disabilities. Resu...
Objective. Two studies examined the reliability and validity of the Self-Assessment of Occupation... more Objective. Two studies examined the reliability and validity of the Self-Assessment of Occupational Functioning (SAOF), a 23-item self-assessment of perceptions of strengths and weaknesses relative to occupational functioning, grounded in the Model of Human Occupation. Method. The first study examined the test–retest reliability of the SAOF, and involved 37 college students without disabilities who completed the SAOF twice. The second study, which involved 39 young persons hospitalized with psychiatric disorders, examined internal consistency reliability of the SAOF, and examined correlations between SAOF scores and composite scores on the Self-Perception Profile, a widely used measure of perceived competence. In addition, data from both studies were combined to examine the ability of the SAOF to discriminate between the college students without disabilities and the young persons with psychiatric disorders. Results. Kappa and intraclass correlation coefficients (ICCs) were used to e...
This article describes the development of the Occupational Performance History Interview, an inst... more This article describes the development of the Occupational Performance History Interview, an instrument designed to gather an accurate and clinically useful history of an individual’s work, play, and self-care performance from psychosocially and/or physically disabled adolescents, adults, and older persons. Following the identification and validation of content and the development of format, the instrument was field-tested and revised. An examination of reliability across time and raters indicated that although part of the instrument ratings met or exceeded levels of acceptable stability, further development and testing is indicated.
This guide, based on more than ten years of study of depressed parents and their families, offers... more This guide, based on more than ten years of study of depressed parents and their families, offers strategies, action plans, and resources to help readers provide for their children\u27s healthy development
Health care services can play a critical role in supporting employment among people with disabili... more Health care services can play a critical role in supporting employment among people with disabilities and can sometimes be the difference between working and not working for those with disabilities. 1 The health insurance and service delivery reforms underway in U.S. will benefit persons with disabilities; however, the reforms may not fully meet the employment-related
There is wide geographic variation in Social Security Disability Insurance (DI) and Supplementary... more There is wide geographic variation in Social Security Disability Insurance (DI) and Supplementary Security Income (SSI) participation across the United States. The authors describe the variation. Using data from Social Security Administration reports and results from the Census Bureau’s American Community Survey, the authors decompose the geographic variation in program participation into component parts including variation in disability prevalence and variation in program participation among working-age persons with disabilities. The variation in participation among persons with disabilities is further decomposed into socioeconomic subcomponents.
In this brief, the authors use an example of a Behavioral Risk Factor Surveillance System (BRFSS)... more In this brief, the authors use an example of a Behavioral Risk Factor Surveillance System (BRFSS)-based disability study conducted in Massachusetts to describe how the BRFSS can be used for disability research. The study implemented a follow-up survey to the Massachusetts BRFSS and gathered data on the employment-related health insurance needs of individuals with disabilities.
Consumers with serious mental illness face many barriers to employment. The goal of the focus gro... more Consumers with serious mental illness face many barriers to employment. The goal of the focus group study summarized in this article was to better understand the perspectives of those who most directly interface with employment services, namely consumers and providers. Fortyfour consumers and 32 providers participated in focus groups across Massachusetts. The guiding questions posed to participants were What are the barriers? and What are the facilitators? Participants identified a range of factors, including those related to psychiatric conditions. However, contextual factors, particularly those related to the service system, the Social Security system, and stigma, were considered to be the most daunting barriers. Solutions to barriers at both the practice and the policy level are suggested.
The Affordable Care Act (ACA) provides health insurance to many working-age adults with disabilit... more The Affordable Care Act (ACA) provides health insurance to many working-age adults with disabilities, but we do not expect the new coverage or existing insurance options to fully meet their employment-related health care needs. Wraparound services have the potential to foster employment among people with disabilities. We use Massachusetts, which implemented health care reform in 2006, as a case study to estimate the wraparound health care expenditures and use for workers with disabilities. We identified a group of employed, working-age people with disabilities whose primary health insurance is Medicare or private insurance and who use the Medicaid Buy-In Program for wraparound coverage. We analyzed claims to estimate expenditures and use. Wraparound expenditures averaged $427 per member per month. Community-based services for both mental and non-mental health, which are generally not covered by Medicare or private insurance, accounted for 63% of all expenditures. The number who used community-based services was low, but the expenditures were high. The majority of the remaining expenditures were for services usually covered by primary insurance including: inpatient and outpatient, pharmacy and professional services. Expenditures were higher for people with Medicare compared to private insurance. This case study suggests that, from a total program cost perspective, wraparound demand is greatest for community-based services. From a member utilization perspective, the demand is greatest for coverage that alleviates out-of-pocket costs for services provided by primary insurance. Additional analysis is needed to further assess the design options for wraparound programs and their feasibility.
... Employers express concerns about and may be less likely to hire those with psychiatric disabi... more ... Employers express concerns about and may be less likely to hire those with psychiatric disabilities (Bordieri, Drehmer & Taylor, 1997; Cook ... disabled, and create a psychological barrier to employment (Estroff, Zimmer, Lachicotte, Benoit & Patrick, 1997; MacDonald-Wilson, 1999 ...
The employment rate among persons with disabilities is much lower compared to persons without dis... more The employment rate among persons with disabilities is much lower compared to persons without disabilities. Lengthy lists have been put forward to explain the low employment rate but there has been little study to estimate the amount of labor (labor supply) non-working persons with disabilities are ready to provide. We describe the potential labor supply using a 2010 Massachusetts Behavioral Risk Factor Surveillance System follow-up survey of working-age persons in with disabilities, Approximately 55% of persons with disabilities in Massachusetts are not working. We find that the potential labor supply among these persons is substantial. Three-quarters indicate they would accept a job offer that included both good hours and good wages. The wage expectations are not excessive. Approximately 50% report they would accept a job with wages of $10/hour and nearly all (96%) report they would accept a job with wages of $20/hour. Some persons with disabilities want part-time employment but m...
Telework is most commonly performed from a person's home, and thus can accommodate the needs ... more Telework is most commonly performed from a person's home, and thus can accommodate the needs of persons with disabilities ranging from agoraphobia to quadriplegia. Telework is a practice that appears to meet Universal Design criteria, viz., a broad-spectrum design feature that is beneficial to the general population, but is particularly helpful to persons with disabilities. However, some disability advocates fear that the practice is unacceptably isolating and compromises community integration and competitive employment. The National Telework Consumer Survey was designed to inform the debate with real primary data on consumers' views. We surveyed a population of persons with disabilities who had differing degrees of connection with a national disability employment network that recruits, trains, and hires prospective workers with disabilities to fulfill assignments the organization has brokered with government agencies and businesses. The survey sample frame consisted of near...
The purpose of this study was to examine time use patterns and variables related to time use, inc... more The purpose of this study was to examine time use patterns and variables related to time use, including feelings about time use, time management, and academic achievement, among normal college students. Time use was examined from the perspective of the model of human occupation. One hundred and six male and female occupational therapy students enrolled at Worcester State College in Worcester, MA completed two self-report questionnaires and a demographic questionnaire. The subjects completed the Occupational Questionnaire (Riopel Smith, Kielhofner, and Watts, 1986) which measured time use (activities engaged in during a typical 24-h period), and feelings about time use (related to competence, value, enjoyment) for the activities they reported. In addition, they completed the Time Management Questionnaire (Britton and Tesser, 1990, which measured their time attitudes, preferences for short range planning, and preferences for long range planning. The results of the study suggest that o...
This study examined the perspectives of people with psychiatric disabilities and employment servi... more This study examined the perspectives of people with psychiatric disabilities and employment service providers regarding factors that most directly help or hinder consumer efforts to obtain and maintain employment. Forty-four adults with serious mental illness (SMI) (consumers) and 30 providers participated in 12 focus groups across Massachusetts. We began both consumer and provider groups by posing two broad questions: 1) what factors most help people with SMI get and keep jobs (facilitators), and 2) what factors most prevent people with SMI from getting and keeping jobs (barriers)? Data were analyzed qualitatively and both person and environmental factors were highlighted. Among facilitators, participants agreed that quality consumer-provider relationships and individualized employment services are most instrumental in helping consumers achieve employment goals. Participants identified a range of environmental barriers, including issues related to the service system, entitlement pr...
To determine if there were observable cues of personality to be found in the appearance and expre... more To determine if there were observable cues of personality to be found in the appearance and expressive behaviour of six men and six women with Parkinson's disease. Participants completed a personality measure and engaged in an individual, videotaped interview. Four trained raters measured the expressive behaviour demonstrated in the videotapes. A correlational design was used to explore associations between self-reported personality and measures of expressive behaviour. In this sample, more eyebrow furrowing indicated significantly higher levels of Neuroticism and less formal dress indicated significantly higher levels of Openness to Experience. These associations remained large and significant after controlling for the effect of disease severity. Whereas previous research has focused on the detrimental effect of Parkinson's disease symptoms on first impressions, this study explored the potential for accurate first impressions of personality by identifying observable cues of personality. Findings suggest that in early stages of Parkinson's disease there may be plausible and intuitive cues of personality present in expressive behaviour.
A guiding premise of occupational therapy practice is that it is beneficial to allow clients free... more A guiding premise of occupational therapy practice is that it is beneficial to allow clients freedom of choice in selecting and participating in activities. This study examined subjects’ affective responses to having or lacking freedom of choice in completing an activity and explored how those responses might differ when subjects did the activity in individual as opposed to group settings. Forty female undergraduate and graduate students participated in an origami activity under four different experimental conditions: a) individual–choice; b) individual–no choice; c) group–choice; and d) group–no choice. Afterward, each subject rated how she felt about herself while participating in the activity by using Osgood’s semantic differential designed to elicit responses in terms of three affective factors: evaluation, power, and activity. Data analysis revealed an interaction between the two independent variables on the power factor such that subjects who were not permitted choice responde...
The American Journal of Occupational Therapy, 1998
Objective. Two studies examined the internal consistency and test-retest reliability of the Adole... more Objective. Two studies examined the internal consistency and test-retest reliability of the Adolescent Leisure Interest Profile (ALIP), an 86-item measure of adolescent leisure activity interest, leisure participation, and feelings about leisure. In addition, leisure activity interests and participation f adolescents with and without disabilities were described, and the ability of the ALIP to discriminate among four groups of adolescents was examined. Method. After preliminary item development, two separate reliability studies of the ALIP were conducted. The ALIP was administered twice to 88 adolescents with psychiatric, learning, and physical disabilities and to 28 adolescents without disabilities. In both studies, the second administration took place from 7 days to 14 days after the first. In addition, data from the first administration in both reliability studies were combined to examine the ability of the ALIP to discriminate among adolescents with and without disabilities. Resu...
Objective. Two studies examined the reliability and validity of the Self-Assessment of Occupation... more Objective. Two studies examined the reliability and validity of the Self-Assessment of Occupational Functioning (SAOF), a 23-item self-assessment of perceptions of strengths and weaknesses relative to occupational functioning, grounded in the Model of Human Occupation. Method. The first study examined the test–retest reliability of the SAOF, and involved 37 college students without disabilities who completed the SAOF twice. The second study, which involved 39 young persons hospitalized with psychiatric disorders, examined internal consistency reliability of the SAOF, and examined correlations between SAOF scores and composite scores on the Self-Perception Profile, a widely used measure of perceived competence. In addition, data from both studies were combined to examine the ability of the SAOF to discriminate between the college students without disabilities and the young persons with psychiatric disorders. Results. Kappa and intraclass correlation coefficients (ICCs) were used to e...
This article describes the development of the Occupational Performance History Interview, an inst... more This article describes the development of the Occupational Performance History Interview, an instrument designed to gather an accurate and clinically useful history of an individual’s work, play, and self-care performance from psychosocially and/or physically disabled adolescents, adults, and older persons. Following the identification and validation of content and the development of format, the instrument was field-tested and revised. An examination of reliability across time and raters indicated that although part of the instrument ratings met or exceeded levels of acceptable stability, further development and testing is indicated.
Uploads
Papers by Alexis Henry