When a Thresholds member expresses interest in working, the member is referred to a supported employment specialist who, consistent with supported employment principles, fully engages in helping the member find a job and thrive in it. Specialists conduct individualized assessments, taking into account the member's history, interests, and preferences for everything from job location to work environment. Specialists then provide individualized support throughout the job process, including the search, application, hiring, continuity of performance, and transition (such as promotion or transfer) or exit processes from a job. The model also includes the principles of zero exclusion, a rapid and individualized job search, integration with mental health treatment, time-unlimited follow-along supports, individualized benefits planning, and a goal of competitive employment at a job with a fair wage. All of these principles are in line with Thresholds' mission to offer recovery-oriented services, making supported employment services a natural extension of Thresholds' work.
The employment specialist is part of an interdisciplinary team of mental health workers who combine their interventions to help a consumer find and keep employment. Teams consist of staff from various backgrounds, such as social work, psychology, and rehabilitation counseling. Their purpose is to provide for the wraparound services that enable consumers to learn strategies that help them manage in all domains of their lives, including employment. When someone is referred to employment services, the employment specialist reviews with the team what strategies have been helpful for that consumer in learning the skills that help in managing his or her illness and recovery. In addition, all members of the team help the consumer use strategies in the workplace that also assist in managing interpersonal issues, incorporating supervisory feedback, and improving job performance to maximize the chances for success on the job.
In this model, the psychiatrist is an essential member of the team. The mental health staff and the employment specialist consult with the doctor to discuss issues involving medication. Because the doctor is part of the team, access is simplified, and the doctor can advise about a consumer who may be experiencing increased symptoms at work. At such times, the psychiatrist may adjust medications or dosages to help a consumer stabilize symptoms and maintain job performance. This attentiveness often stops a downward cycle and reduces the risk of job termination.