1
The Japanese version of individualized Supported Employment Fidelity scale (JiSEF)
a) The items are almost the same asthe original IPS fidelityscale (IPS-25)
b) The items are partly changed from the original IPS fidelity scale (IPS-25)
c) The items have major changes from the original IPS fidelity scale (IPS-25)
Item label / Statements and anchor pointsStaffing (subscale. 1)
#1a) / Caseload size / Employment specialists have individual employment caseloads. The maximum caseload for any full-time Employment specialist is 20 or fewer clients
1= Ratio of 41 or more clients per employment specialist.
2= Ratio of 31-40 clients per employment specialist.
3= Ratio of 26-30 clients per employment specialist.
4= Ratio of 21-25 clients per employment specialist.
5= Ratio of 20 or fewer clients per employment specialist.
#2a) / Employment services staff / Employment specialists provide only employment services
1= Employment specialists provide employment services less than 60% of the time.
2= Employment specialists provide employment services 60 -74% of the time.
3= Employment specialists provide employment services 75 -89% of the time.
4= Employment specialists provide employment services 90 -95% of the time.
5= Employment specialists provide employment services 96% or more of the time.
#3a) / Vocational generalists / Each employment specialist carries out all phases of employment service, including [A] intake, [B] engagement, [C] assessment, [D] job placement (Business manner, job search and writing CV), [E] job coaching, and [F] follow-along supports before step down to less intensive employment support from another mental health practitioner.
1= Employment specialist only provides vocational referral service to job-placement offices and vocational centers.
2= Employment specialist maintains caseload but refers clients to other agencies providing vocational services.
3= Employment specialist provides four phases ([A] to [F]) of the employment service
4= Employment specialist provides five phases ([A] to [F]) of employment service.
5= Employment specialist carries out all six phases ([A] to [F]) of employment service
Organization (subscale. 2)
#4 / Integration of rehabilitation with mental health treatment team assignment / - Anagency has at least one employment specialist and one case manager.
- Employment specialists and case managers work in the same unit/department
- Employment specialists and case managers work in a team setting to provide employment services and follow-up services
1 = There are no case managers in the organization or employmentspecialists havethe role of a case manager to provide mental health services.
2. = An agency has employment specialist(s) and case manager(s), but they do not have regular face-to-facemeetings.
3 = Employment specialist(s) and case manager(s) have a regular face-to-facemeeting once a month.
4 = Employment specialist(s) and case manager(s) have regular face-to-facemeetingstwice or thrice a month.
5 = Employment specialist(s) and case manager(s) have a regular face-to-facemeeting once a week.
#5 / Integration of rehabilitation with mental health treatment thru frequent team member contact / [A] Case managers understand the value and importance of work for clients
[B] Employment specialists and case managers have a meeting every week to discuss clients’ employment and follow-up.
[C] Case managers provide medical and livingservices to enable clients toget a job or keep their employment.
[D] Case managers and employment specialists are in contact with psychiatrists and social workers at the hospitals/clinics thatclients visit, by accompanying clients to the hospitals/clinics and participating in care conferences.
In terms of [A] to [D];
1 =None is present
2= One is present
3= Two are present
4= Three are present
5= Four are present
/In terms of [B][C][D], raters score “done” if more than 80% of caseloads received such services.
/If an agency does not have at least one case manager, the score is rated as “1”
#6a) / Collaboration between employment specialists and vocational rehabilitation counselors / Each employment specialist has frequent contacts with staff in other vocational rehabilitation facilities (job-placement offices and vocational centers and other types of job support agencies for people with disability), in order to discuss shared clients’ information and identify potential referrals.
1=Employment specialists and staff in other vocational rehabilitation facilities have contacts less than quarterly to discuss shared clients and referrals. OR Employment specialists and staff in other vocational rehabilitation facilitiesdo not communicate.
2=Employment specialists and staff in other vocational rehabilitation facilities have contacts at least quarterly.
3=Employment specialists and staff in other vocational rehabilitation facilities have contacts at least monthly
4= Employment specialists and staff in other vocational facilities have scheduled, face-to-face meetings at least quarterly, OR have contacts (phone, e-mail, in person) weekly.
5= Employment specialists and staff in other vocational facilities have scheduled, face-to-face meetings at least monthly AND have contacts (phone, e-mail, in person) weekly.
#7 / Vocational unit / - At least 2 full-time employment specialists comprise the employment unit. One unit has at least a supervisor. They have weekly client-based group supervision following the supported employment model in which strategies are identified and job leads are shared. They provide coverage for each other’s caseload when needed.
- Where an agency has only one employmentspecialist, the employment specialist is expected to comprise the employment unit with employment specialists in other agencies. In this case, employment specialists do not cover individual employment specialists’ caseloads, but identify strategies for job supports and share job information through group supervision (however, the score is rated “1” in this case).
1= Employment specialistsdo not have a unit meetingthat is led by a supervisor.
2= Employment specialists have a unit meeting that is led by a supervisor more than once a month.
3= Employment specialists have a unit meeting that is led by a supervisor more than once a month. Group supervision is based on the IPS 8 principles.
4= Employment specialists have a unit meeting that is led by a supervisor more than once a month. Group supervision is based on the IPS 8 principles.They provide coverage for each other’s caseloads when needed.
5 = Employment specialists have a unit meeting that is led by a supervisor more than once a week. Group supervision is based on the IPS 8 principles. They provide coverage for each other’s caseloads when needed.
/If an agency does not havea supervisor, the score is rated as “1”
#8b) / Role of employment supervisor / Supported employment unit is led by a supported employment team leader (a supervisor). Employment specialists’ skills are developed and improved through outcome-based supervision.A supervisor has the following five key roles of the employment.
[A]One full-time equivalent (FTE) supervisor is responsible for no more than 10 employment specialists.
[B]Supervisor reviews weekly client outcomes with employment specialists. Supervisor sets goals to improve program performance when needed.
[C] Supervisor conducts monthly individual or group supervision designed to review client situations and identify new strategies and ideas to help clients in their work lives
[D] Supervisor accompanies employment specialists, who are new or having difficulty with job development, in the field monthly to improve skills by observing, modeling, and giving feedback on skills, e.g., meeting employers for job development.
[E] Supervisor communicates with staff in other community mental health serviceagencies or psychiatric hospitals/clinics, and helps them understand that employment is important in personal recovery for people with mental illness.
In terms of [A] to [E];
1 = None or one is present
2= Two are present
3= Three are present
4= Four are present
5= Five are present
/If an agency does not havea supervisor, the score is rated as “1”
#9 / Zero exclusion criteria / All clients interested in working have access to supported employment services regardless of job readiness factors, substance abuse, symptoms, history of violent behavior, cognition impairments, treatment non-adherence, and personal presentation. These apply during supported employment services too.Employment specialists offer to help with another job when one has ended, regardless of the reason that the job ended or number of jobs held.If otheragencies providing other type of vocationalrehabilitation services have theirscreening criteria, the supported employmentagency does not use the criteria to exclude anybody. Clients are not screened out formally or informally.
[A] The agency has formal or confidentialcriteria for screening aclient who wants to receive the services.
[B] The agency does not provide services forclients who have been identifiedas being unable to work based on the criteria in other agencies, or who havea criminal history/history of violent behavior, substance abuse, severesymptoms/cognition impairments, problem withcommutingto the agencies, medication non-adherence, personal presentation, or instability in work motivation.
[C] Users cannotstart their job hunt if they have the following problems:severe symptoms/cognition impairments, problem with commuting to the agencies, medication non-adherence, personal presentation, or instability in work motivation.
[D]Providing servicesfor people who leave a job or get fireddepends on the reasons.
[E] The agencyprovidesthe services only when people have theirdisability certificate in the social welfare system.
In terms of [A] to [E];
1 = [A] is present
2= Three of [B] to [E] are present
3= Two of [B] to [E] are present
4= Oneof [B] to [E] is present
5= None is present
#10b) / Agency focus on competitive employment / Agency promotes competitive work through multiple strategies
[A] Agency intake includes questions about interest in employment.
[B] Agency displays written postings (e.g., brochures, bulletin boards, posters) about working and supported employment services, in lobby and other waiting areas.
[C] Agency focus on job support for severe mental illness (More than 70% of clients have a diagnosis of schizophrenia, major depression, or bipolar disorder)
[D] Agency supports ways for clients to share work stories with other clients and staff (e.g., agency-wide employment recognition events, in-service training, peer support groups, agency newsletter articles, invited speakers at client treatment groups, etc.).
[E] Agency measures rate of competitive employment and shares outcomes with agency leadership and staff.
In terms of [A] to [E];
1= One or none is present
2= Two are present
3= Three are present
4= Four are present
5= Five are present
#11 / Executive team support for supported employment / Agency executive team members (e.g., CEO/Executive Director, Chief Operating Officer, QA Director, Chief Financial Officer, Clinical Director, Medical Director, Human Resource Director) assist with supported employment implementation and sustainability. The following five key components of executive team support are present.
[A] Executive Director and Clinical Director demonstrate knowledge regarding the principles of evidence-based supported employment based on the IPS model.
[B] Executive Director and Clinical Director undergo evaluation using the fidelity scale.
[C] Executive Director and Clinical Director review the results of fidelity assessment and outcomes (e.g., employment rates), and identify problems in the agency.
[D] Executive Director and Clinical Director make a plan to achieve a high fidelity score and good outcomes (high employment rates).
[E] Executive Director and Clinical Director implement the above plan.
In terms of [A] to [E];
1= One is present
2= Two are present
3= Three are present
4= Four are present
5= Five are present
Service (subscale. 3)
#12 / Work incentives planning / - All clients are offered assistance in obtaining comprehensive, individualized work incentives planning before starting a new job and assistance accessing work incentives planning thereafter when making decisions about changes in work hours and pay.
- A specialist for social securityexplainsclients 1) about income securities, benefits, pension, and other types of social securities and 2) about the influence of the use of social securities in clients’ total incomes. OR Employment specialists and case managers refer clients to professionals who can explain the above work incentives and social securities.
- An example of a specialist for social securityis a certified social insurance labor consultant or a trainedsocial worker
[A] The agency has a specialist for social securities. OR The agency contacts a specialist for social security outside the agency.
[B] All clients can receiveservices from a specialist for social securitywhen needed.
[C] Clients can receive counseling for individualized work incentives planning when clients need to make decisions about changes in work hours and days, and when they are promoted or change their job.
[D] The agency has a documented form for individualized work incentives planning.
In terms of [A] to [D];
1 =None is present
2= One is present
3= Two are present
4= Three are present
5= Four are present
#13a) / Disclosure / Employment specialists provide clients with accurate information and assist with evaluating their choices to make an informed decision regarding what is revealed to the employer about having a disability.
[A] Employment specialists do not require all clients to disclose their psychiatric disability at the work site in order to receive services.
[B] Employment specialists offer to discuss with individual clients the possible costs and benefits (pros and cons) of disclosure at the work site in advance of clients disclosing at the work site. Employment specialists describe how disclosure relates to requesting accommodations and the employment specialist’s role communicating with the employer.
[C] Employment specialists discuss specific information to be disclosed (e.g., disclose receiving mental health treatment, or presence of a psychiatric disability, or difficulty with anxiety, or unemployed for a period of time, etc.) and offers examples of what could be said to employers.
[D] Employment specialists discuss disclosure on more than one occasion (e.g., if clients have not found employment after two months or if clients report difficulties on the job.)
In terms of [A] to [D];
1 =None is present
2= One is present
3= Two are present
4= Three are present
5= Four are present
#14 / Ongoing, work-based vocational assessment / - Initial vocational assessment occurs over 2-3 sessions and is updated with information from work experiences in competitive jobs. A vocational profile form that includes information about preferences, experiences, skills, current adjustment, strengths, personal contacts, and so on is updated with each new job experience.
- Environmental assessments including clients’ living skill and accommodations are evaluated in parallel with vocational assessments.
- Sources of information include the client, treatment team, clinical records, and with the client’s permission, from family members and previous employers. (Practical training [long-term vocational training] can be used only when users strongly want it, but practical training should not be used for assessment)
1= Vocational evaluation is conducted prior to job placement with emphasis on office-based assessments, standardized tests, intelligence tests, work samples. OR There are nodaily service records or ongoing assessments.
2= Vocational assessment may occur through a stepwise approach that includes: prevocational work experiences (e.g., work units in a day program), volunteer jobs, or set aside jobs (e.g., sheltered workshop jobs).(The clients have to participate in a group-based work program, pre-vocational work training, or volunteer jobs before their job hunt.)
3= Employment specialists assist clients in finding competitive jobs directly without systematically reviewing interests, experiences, strengths, etc. and do not routinely analyze job loss (or job problems) for lessons learned.
4= Initial vocational assessment occurs over 2-3 sessions in which interests and strengths are explored. Employment specialists help clients learn from each job experience and also work with the treatment team to analyze job loss, job problems and job successes. They do not document these lessons learned in the vocational profile, OR The vocational profile is not updated on a regular basis.
5= Initial vocational assessment occurs over 2-3 sessions in which interests and strengths are explored. Employment specialists help clients learn from each job experience and also work with the treatment team to analyze job loss, job problems and job successes. They document these lessons learned in the vocational profile, AND The vocational profile is updated on a regular basis.
#15a) / Rapid job search for competitive job / Initial employment assessment (including meeting with staff can refer clients to job interview), first face-to-face employer contact or face-to-face job-placement office staff contact by the client or the employment specialist about a competitive job occurs within 30 days (one month) after program entry.
The average periods of randomly selected caseloads is:
1= over 9 months after agency/program entry
2= over 5 months – less than 9 months after agency/program entry
3= over 2 months – less than 5 months after agency/program entry
4= over 1 months – less than 2 months after agency/program entry
5= less than 1 months after agency/program entry
#16 / Individualized job search / - Employment specialists make employer/job-placement office staff contacts aimed at making a good job match based on clients’ preferences (relating to what each person enjoys and their personal goals) and needs (including experience, ability, symptomatology, health, etc.) rather than the job market (i.e., those jobs that are readily available).
- An individualized job search plan is developed and updated with information from the vocational assessment/profile form and new job/educational experiences.
The employment serviceplanning documents for randomly selected caseloads are based on clients’preference and personal needs described in their assessment documents.
1= Under 25% of employment service planning documents matched with clients’ preference and personal needs described in their assessment documents
2 = 25 - 49% did
3 = 50 - 74% did
4 = 75 - 89% did
5 = 90 - 100% did
#17 / Job development - Frequent employer contact / - Each employment specialists contacts with employers or job-placement office staff in order to refer clients to job interview, almost everyday
- Each employment specialists use a weekly tracking form to document contacts with employer or job-placement office staff
Face-to-face contact(s) with employers or jobplacement office staff is(are) done;
1= Onceper week (or no contacts)
2= More than twice per week, but no tracking form to document such contacts
3= More than 4 times, and documenting such contacts to be weekly monitored by a supervisor
4= More than 5 times, and documenting such contacts to be weekly monitored by a supervisor