Direct Skills Teaching of Work-Related Conversational Skills for Individuals With Disabilities

Abstract

Work-related soft skills such as cultural awareness and effective communication, along with cognitive factors, influence success in school and in the workplace. This pilot study evaluated the feasibility of a small group intervention using the direct skills teaching (DST) approach to teach basic conversational skills in a work setting. A four-session group intervention using the “Conversing With Others” curriculum based on the DST approach was delivered to 146 participants in 22 groups by graduate counseling students. Participants reported greater confidence with engaging a coworker in conversation as well as high satisfaction with the group intervention in general. This pilot study provided data on the feasibility of this intervention and supported its use as a pedagogical tool for counselors-in-training.

Keywords

employment direct skills teaching small talk soft skills disability

Introduction

Employment, as a form of social integration, may influence individual satisfaction and various dimensions of wellness, particularly for individuals with disabilities (IWD; Stephens, Collins, & Dodder, 2005). IWD face persistent challenges in gaining meaningful employment. As a whole, IWD encounter issues such as unemployment or underemployment, low wages, and a lack of support in the workplace (Stephens et al., 2005). Inadequate job-related soft skills were associated with higher rates of unemployment including representing 90% of job losses for adolescents with disabilities (Cook & Razzano, 2000; Mueser, Salyers, & Mueser, 2001). A recent study found that employers who self-reported as not actively recruiting employees with disabilities stated a lack of employability skills or “soft skills” as one of major reasons for not hiring them (Ju, Zhang, & Pacha, 2012).

A significant factor that has not received enough consideration in preparing IWD for employment is the lack of job-related “soft skills” (Duncan & Dunifon, 2012). By definition, soft skills are personality traits, and social graces, as well as one’s emotional, interpersonal, adaptive, and problem-solving skills (Grugulis & Vincent, 2009). Soft skills complement “hard” skills, which represent the technical requirements of a job (Kyllonen, 2013). Moreover, soft skills empower individuals in the workplace to communicate with and collaborate effectively with coworkers and supervisors, which is theoretically consistent with higher job satisfaction (Kyllonen, 2013). When IWD gain meaningful employment in a role of their choosing, their overall functioning improves significantly (Stephens et al., 2005).

The soft skill of “small talk,” also termed “phatic” communication, describes a multidimensional potential for talk in social or work settings, where individuals’ relational goals supersede their pledge to factuality and instrumentality (Coupland, Coupland, & Robinson, 1992). The term phatic communion or “small talk” suggests the assortment of purportedly trivial, informal, and nonserious modes of communication specifically linked to the general communicative function of talking (Coupland, 2003). Malinowski designated phatic communion as a type of union that is established through the exchanging of words (Kendon, Harris, & Key, 1975). Proficiencies in “small talk” at the workplace may help to further one’s career (Kyllonen, 2013) as soft skills such as awareness of other people’s interests which may differ from one’s own, and effective communication, along with cognitive factors, are a factor in success in school and in the workplace (Kyllonen, 2013). Therefore, enhanced soft skills in the workplace are important with the potential outcome of advancing individuals with longer job tenure or career advancement.

Employability is also affected by the skill set of an individual’s aptitude to respond to conflictual conditions. Enhancing collaboration is the first step in improving soft skills (Kyllonen, 2013). Knowing how to address or avoid problematic discussion subjects or taboos such as politics, religion, and sex could affect a professional relationship and, if not handled well, potentially negatively influence an employer’s judgment of the individual’s self-management skills. Studies have shown that difficulties in maintaining jobs among IWD are magnified by the lack of soft skills for assessing interpersonal conflict (Kyllonen, 2013).

The need for conversational skills can also arise in the context of wage and hour laws. Meal period and break times are required by state laws, although this varies from state to state. For example, in California, an employee is entitled to two 10-min rest breaks and a 30-min lunch break after working 5 hr; except however, if the workday will be completed within 6 hr or less (U.S. Department of Labor, Bureau of Labor Statistics, 2018). Otherwise, the employer owes this employee 2 hr of premium pay, at the regular hourly rate, for the time worked through these mandated breaks (U.S. Department of Labor, Bureau of Labor Statistics, 2018). States such as New Jersey require an employee under the age of 18 be provided with a 30-min break after five consecutive hours of work (U.S. Department of Labor, Bureau of Labor Statistics, 2018). Some states such as New Jersey do not require employers to provide breaks, including lunch breaks, for workers 18 years or older (U.S. Department of Labor, Bureau of Labor Statistics, 2018). Meal breaks, whether an obligation of employers or not, commonly result in groups of workers taking this time together. It is important for individuals to be able to use the soft skill of conversing with others in the workplace during breaks and other times at work when there is informal conversation.

As research indicates, soft skills can be taught and, when acquired, will assist in the growth of an individual as an employee potentially leading to increased success and satisfaction on the job. For adults with psychiatric disabilities, soft skills such as the ability to converse with others and to fit in at a work setting are critical to job retention (Kinoshita et al., 2013). Soft skills go hand-in-hand with employability skills, which refer to general and nontechnical competencies required for performing all jobs, regardless of type or level (Ju et al., 2012). Soft skills teaching for IWD addresses the fundamental constructs that may increase the likelihood of IWD obtaining and maintaining competitive employment (Riggio & Tan, 2013).

Unfortunately, current research on methods to improve job-related interpersonal skills for IWD is inconsistent and suffers from methodical weaknesses such as lack of controlled studies (Riggio & Tan, 2013). Most skills training has focused on adults with psychiatric disabilities. The purpose of this current study is to evaluate the feasibility of the direct skills teaching (DST) approach to improve the skill of making conversation in the workplace, which we termed Conversing With Others. This is an intervention targeted at individuals with a wide variety of disabilities who are receiving vocational services. Feasibility trials are often the first step in testing whether an intervention could be implemented (Bowen et al., 2009). The study intended to assess the acceptability and the practicality of this intervention (Bowen et al., 2009).

Method

Participants

Participants for the study were 146 adults with disabilities (psychiatric, developmental, intellectual, physical, learning, co-occurring) who were recruited from 14 community-based mental health and state vocational programs in the Northeast of the United States. The programs offer a variety of services including vocational rehabilitation services, mental health services and counseling, vocational assessment, education and vocational training, job placement assistance, case management services, and postemployment follow-up. Inclusion criteria for the DST groups were age 18 or over, English speaking, and interested in improving basic conversational skills for a work environment. Exclusion criteria were non-English speaking and lack of interest in getting or keeping employment.

The study received an exempt status institutional review board approval. Potential participants were informed that the groups were being led by master’s level counseling students participating in their internship experience who were under both agency and counseling faculty supervision. It was explained to participants that the data collected from the questionnaires were anonymous and would be analyzed and reported in the aggregate.

Participants were asked to complete a 10-item questionnaire at the beginning of the group and at the end of the group about their perceptions of their ability to make conversation. The pre and post questionnaires were identical. At the end of the group, participants also completed a questionnaire about their satisfaction with the group.

Measures

Participant background information including diagnoses was obtained from participant’s agency files. If the information was not available in the charts, the group facilitators were asked to give their best estimate. A paper and pencil questionnaire was used to elicit participant self-report of their perceptions of their conversational skill level (Oursler, n.d.). Cronbach’s alpha for this 10-item scale is .56 among 135 participants with complete data on these 10 items. The validity information is unknown to this scale at this moment. The same questionnaire was used pre and post group. This 10-item survey used a 5-point Likert-type scale (1 = strongly disagree; 2 = disagree; 3 = neutral; 4 = agree; 5 = strongly agree). Some sample questions included “My coworkers are usually interested in the same things I am interested in”; and “Part of having a good conversation is being a good listener” (see Table 2).

In addition to the pre and post questionnaire, participants completed an overall satisfaction questionnaire at the end of the group. The items in the satisfaction questionnaire asked about different aspects of the group experience. The first item stated, “the overall quality of the group was” followed by three rating choices of “satisfactory,” “good,” and “excellent.” The second item stated, “I think the information I received will be helpful to me on the job” and included the following response options of “disagree,” “not sure,” “agree,” and “strongly agree.” The third item stated, “the group held my interest,” with the response options of “disagree,” “not sure,” “agree,” and “strongly agree.” The fourth item stated, “the number of group sessions was,” followed by the response choices “not enough,” “about right,” and “too many.” The fifth item stated, “I feel confident I can use the skill I learned in the group,” followed by the response options of “strongly disagree,” “disagree,” “not sure,” “agree,” and “strongly agree.” The final item stated, “I would recommend this group to a friend,” followed by the choices “no,” “not sure,” and “yes.”

To enhance the richness of the data collected, there were five open-ended qualitative questions at the end of the survey: (a) What did you like about the group? (b) What would you change or improve about the group? (c) What will you do differently as a result of attending the group? (d) What other information would it be helpful to include in the group? and (e) Any other comments?

As the target population for the groups was IWD, group facilitators were instructed to assess group members’ accommodation needs for groups and surveys and provide for these based upon participant needs and/or requests. In some cases, this required modifications to the administration of the group materials, but the content was not changed. Some accommodations/modifications provided were extra time for the activity, having items read aloud to the group or individual group member (if needed), rereading items, providing additional clarification regarding the Likert-type scale meaning, and providing individualized assistance with completing the survey (i.e., scribe, reader etc.). On two occasions, student group facilitators provided their group participants with readers/scribes because participants had a visual impairment and/or blindness. Participants with visual impairments were also provided with materials in large print or Braille, as needed.

To measure fidelity to the intervention, after each session, the group facilitators completed a standardized Fidelity form assessing group fidelity to the manual with a critical reflection of the session. The form asked four standardized qualitative questions: Session notes on modules covered and session length, adaptations/modifications from the session outline, the overall impression of group including participant reactions, and recommended adaptations/modifications for future groups. Group facilitators completed the Fidelity form after each session and submitted the form to the internship instructors.

Intervention

Master’s-level graduate counseling students completing the counseling internship organized and led the groups. The students had varying amounts of prior practical experience facilitating groups. All had previously completed a course in Group Methods as part of their graduate studies. Approximately half (n = 12, 54.5%) of the students were from ages 25 to 30, while eight (36.4%) were from ages 30 to 40, and two (9.1%) were in the age range of 40 to 55. The mean age of students was 32.41 with a standard deviation of 8.40. Sixteen students (72.7%) were female while 6 (27.3%) were male. The group facilitators came from diverse backgrounds. Over half of the group facilitators were European American (n = 15, 68.2%), three (13.6%) were Hispanic American, three (13.6%) were Asian Americans, and one (4.5%) was African American. The groups took place during 2011–2017.

The curriculum for the Conversing With Others skill group was based on the DST approach developed by the Boston University Center for Psychiatric Rehabilitation (Farkas & Anthony, 2010) and often referred to as the Choose-Get-Keep approach. In the past, social skills training curricula have received criticism for encouraging participant passivity (Ellison et al., 2002; Shern et al., 2000). The DST methodology

systematically incorporates basic educational and cognitive techniques so that providers can outline the knowledge needed to learn any relevant skill, develop a structured lesson plan to teach each component behavior and involve the person and individuals in the relevant environment in practice and generalization efforts. (Farkas & Anthony, 2010, p. 119)

DST has been recognized as a promising practice in psychiatric rehabilitation services for individuals with psychiatric disabilities (Rogers, Anthony, & Farkas, 2006). DST is one part of the “Choose-Get-Keep” approach. In this approach, individuals are assisted with identifying a desired role within their community, for instance, valued roles such as student or employee (Choose), followed by assisting the person to Get the valued role, and using DST as part of assisting individuals to gain the critical skill needed for success and satisfaction (Keep) in the valued role. As part of a larger approach, DST departs from typical Social Skills Training in several important aspects. These include (a) the emphasis on identifying an overall rehabilitation goal (ORG) in the Choose phase, (b) teaching the skills specifically needed to attain and maintain the ORG, (c) modifying the lessons as needed in partnership with participants, and (d) incorporating basic cognitive and behavioral techniques. DST defines a skill as knowledge followed by a corresponding behavior (Cohen, Danley, & Nemec, 1985). To ensure ease of adoption, each skill is subdivided into three or four steps, all stated in behavioral terms, that comprise the essential components of the skill. As each step is taught (knowledge) and practiced (behavior), feedback and refinement suggestions are provided by the facilitator. The target outcome is that participants will acquire the knowledge and adopt the behavior required to execute the skill in the target environment. Instruction of a new skill using a DST approach involves (a) identifying the dimensions of the skill using a Content Outline, (b) structuring a curriculum that includes lesson plans for teaching the target skill, and (c) encouraging participants to practice the skill in-session (Farkas & Anthony, 2010).

The curriculum materials were designed to be used by counselors at an agency to address skill deficits without the need for staff to have specialized training in the curriculum. The students were provided with a detailed instructional manual with the curriculum for each of the four group sessions, but received no special training other than to follow the instructions in the manual and not to add or delete materials in the curriculum. To encourage intervention fidelity, students were instructed to follow the manual unchanged, and if needed, to make accommodations only to the delivery of the curriculum. Also, students were instructed to lead the group on their own and not to have agency staff as coleaders. Detailed group directions were included in the curriculum, so that students could lead the group without specialized training.

Using the DST approach, the curriculum was based on a Content Outline describing the elements of the skill, and the ROPES approach was used for teaching the skill (Cohen et al., 1985). The Content Outline is the basis of the course in that it is a one-page outline that includes the name and description of the skill, the benefits of using the skill, the four behaviors comprising the skill, and the conditions when the skill would be used. The ROPES approach provides a structure for each session of the group. The elements of ROPES are (a) a Review of previous content or in the first session, discussion of what participants know about the skill, (b) an Overview of the content for the session, (c) Presentation of information for the session, (d) Exercises for practice, and (e) a Summary of the session (Cohen et al., 1985). Each session focused on one of the four steps or behaviors making up the skill. The Content Outline is reviewed at the beginning of each session as part of the Review so that participants become familiar with it.

The manual also included the following information: (a) a list of materials needed for each session, (b) exercise handouts and/or forms, (c) recommended time allotments for each segment of the session, and (d) detailed instructions on content for each part of the session including directions for leading and processing exercises. Group facilitators were instructed to write down the major points of the teaching and of group discussion on a chalk board or flip chart to emphasize group ideas and concepts and to assist in overcoming deficits in concentration. To attempt to retain group participation, facilitators were encouraged to provide refreshments, make reminder phone calls and/or emails, and assist in making transportation arrangements. Each of the four group sessions was 60 to 90 minutes long, depending upon the needs/abilities of the group.

The skill of Conversing With Others requires an individual to be able to participate in a verbal, reciprocal exchange of thoughts and ideas with other individuals. This is commonly referred to as “small talk.” The outcome is for the individual to be able to maintain an informal conversation about topics other than oneself in a work setting by doing the following four behaviors: (a) choosing topics for conversation, (b) demonstrating interest in what others are saying, (c) changing a topic, and (d) concluding a conversation (see appendix for the content outline). At the fourth group, the participants role-play with a fellow participant a scenario of engaging in conversation during a work-related break time. This activity is structured to assist the participant to put together all the elements learned in the group by demonstrating the use of the skill in a simulated work experience.

Analysis

Prior to statistical analysis, examination of the descriptive statistics and the distributional form of all variables was performed. The data were entered into SPSS 19 and a paired sample t test analysis was used to examine the pre and post simple treatment effects.

Results

Participant demographic characteristics for the entire participant group are described in Table 1. Individuals participated in one of 22 groups run by 22 graduate students enrolled in the M.S. in Rehabilitation Counseling program and completing internships at various agencies serving people with disabilities. The group size in this study ranged from four to 10 participants. Most groups (17 out of 22) ran four sessions while five groups ran five and six sessions in total. Attendance rate was excellent, with 73.6% of participants attended 75% or more of the sessions, while 71.5% of participants attended all sessions. Mean participant age for the 146 subjects who contributed in the outcome data was 35.6 years. Participants varied in categories of disabilities including psychiatric, developmental, intellectual, physical, learning, sensory (visual impairment), neurological (i.e., traumatic brain injury), cognitive, and co-occurring disorders (see Table 1). The average educational level was 1 year post high school. More than half of the participants were male (n = 84, 57.5%), while 37.7% (n = 55) were female. European Americans represented 50% (n = 73) of the participants involved in the study, with African Americans making up the second largest population (n = 47, 32.2%) of the participants. Other participants included Hispanic American, Asian American, and other ethnic backgrounds. The largest group of participants were participants with psychiatric disabilities (n = 62, 42.5%). Very few of them were currently competitively employed (n = 6, 4.1%). On average, they had worked 6 to 7 years.

Table 1.

Demographic and Diagnostic Characteristics, and Employment History of Study Sample (N = 146).

Demographic Variable	n	%
Gender
Male	84	57.5
Age range
18−24	42	28.8
25−70	104	71.2
Race/ethnicity
European American	73	50
Other	72	50
Currently employed	6	4.1
Disability type (yes/no)
Psychiatric disability	62	42.5
Other (i.e., Developmental Disabilities; Physical Disabilities; Learning Disabilities; Intellectual Disabilities)	80	57.5
	M	SD
Age	35.60	13.37
Years of education	12.44	2.04
Years of competitive employment	6.79	8.95
Attended sessions	3.78	1.21

Note. Dev = Developmental Disabilities.

There were significant findings for questions on the pre–post questionnaire concerning four behaviors in relation to Conversing With Others. These were choosing a topic, demonstrating interest, changing a topic, and concluding a conversation (see Table 2). For the behavior of choosing a topic, results were significant as demonstrated in the two pre- and postsurvey questions assessing one’s ability to choose a topic during a conversation: “My coworkers usually want to talk about the same things I want to talk about” (t = −2.09, p = .04), and “I can research topics to talk about during lunchtime” (t = −3.63, p = .00). For the behavior of changing a topic, results were also significant in pre- and postintervention questions assessing this behavior: “When I have something really important to say, it is okay to interrupt my coworkers when they are having a conversation during lunchtime” (t = 2.16, p = .03). For the behavior of concluding a conversation, significant results were obtained before and after intervention as assessed by the survey question. “When I don’t want to talk about a topic during lunch, I should get up and walk away in the middle of the conversation” (t = 3.08, p = .00). For the behavior of demonstrating interest, results were significant in pre- and postintervention question assessing this behavior: “Part of having a good conversation is being a good listener” (−2.39, p = .02).

Table 2.

Pre and Post Questionnaire for “Group on Conversing With Others” Module (N = 146).

Questions	Pregroup rating		Postgroup rating		T	p	Effect size
Questions	M	SD	M	SD	T	p	Effect size
1. My coworkers are usually interested in the same things I am interested in.	3.44	1.12	3.63	1.09	−1.50	.14	0.17
2. My coworkers usually want to talk about the same things I want to talk about.	3.30	1.03	3.51	1.05	−2.09	.04*	0.21
3. I can discuss anything I want to at work, as long as it is lunchtime or on my break.	3.54	1.13	3.44	1.33	0.70	.48	−0.08
4. Work is the only topic we should discuss when we are at lunch with coworkers.	2.46	1.23	2.54	1.20	−0.63	.53	0.07
5. It is okay to tell jokes about other people in the room, as long as they can’t hear me.	2.06	1.10	2.06	1.15	0.00	1.00	0.00
6. I can research topics to talk about during lunchtime.	3.44	1.10	3.80	0.88	−3.63	.00*	0.36
7. When I have something really important to say, it is okay to interrupt my coworkers when they are having a conversation during lunchtime.	2.46	1.19	2.23	1.14	2.16	.03*	−0.20
8. Once I start a conversation I expect to spend the rest of the lunch period talking about my topic.	2.58	1.17	2.47	1.23	0.88	0.38	−0.09
9. When I don’t want to talk about a topic during lunch, I should get up and walk away in the middle of the conversation.	2.52	1.20	2.13	1.04	3.08	0.00*	−0.35
10. Part of having a good conversation is being a good listener.	4.33	0.87	4.55	0.73	−2.39	0.02*	0.27

Note. 1 = strongly disagree; 2 = disagree; 3 = neutral; 4 agree; 5 = strongly agree.

p ≤ .05.

Results indicate that the intervention demonstrates further acceptability, that is, positive acceptance by clients, demonstrated from the satisfaction survey. As shown in Table 3, group participants reported overwhelming satisfaction toward the groups. Over 90% of group participants reported “agree” or “strongly agree” to the following: “The overall quality of the group was good/excellent; I think the information I received will be helpful to me on the job; The group held my interest; and I feel confident that I can use the skill I learned in the group.” Over 65% of group participants reported “agree” or “strongly agree” to the following: “The number of sessions was about right”; and “I would recommend this group to a friend.” Over 90% of participants expressed that (a) the group held their interest; (b) the information would be helpful on the job; and (c) they felt confident that they could use the skills learned in the group. Over 90% of the participants rated the overall quality of the group as good or excellent, and over 75% of the participants rated the instructor’s knowledge of the subject as high.

Table 3.

Satisfaction Survey (N = 146).

Item in Satisfaction Survey	n	%
The overall quality of the group was good/excellent	112	91.1
The instructor’s knowledge was good/excellent	116	79.4
I think the information I received will be helpful to me on the job (agree/strongly agree)	110	90.2
The group held my interest (agree/strongly agree)	115	92.7
The number of sessions was about right	97	79.5
I feel confident that I can use the skill I learned in the group (agree/strongly agree)	113	91.9
I would recommend this group to a friend	100	68.5

Qualitative analysis of comments from group participants when asked, “What did you like about the group?” included the following: “It taught me how to communicate better with others”; “I can get a job. I could learn something”; “We go in depth with skills and common scenarios on when to use certain skills”; “I liked the actual role-playing, the input from others in the group. I liked the honesty, and to see myself from another point of view”; and “It taught me how to share with another person, how I think, what I like, and feel that I’m getting closer to get to know someone.” Common themes found among the participants included appreciating the interactive approach, where confidence building was explored, as well as learning how to change topics and how to have appropriate conversations.

When asked, “What would you change or improve about the group?” qualitative analysis of comments from group participants included the following: “I would like to have more classes so I can get a job”; “More talks on schooling/college and more dittos. Maybe small essay on topic”; “More conversation. I liked the worksheets”; “I would have added 3 or 4 more sessions”; “The size, bigger would be better. Longer length per session”; and “I would like these groups to be more like an adult version of show and tell which encourages individuals to go out and do something different than usual and come back to the group and talk about the experience.” Several themes were evident among participants including desire for increased sessions per week, increased length of time for each session, and facilitating groups with larger numbers of participants. Although many participants noted suggestions, several individuals reported, “I wouldn’t change anything”; and “Nothing needs to be changed in the group.”

Qualitative analysis of comments from group participants when asked, “What will you do differently as a result of attending the group?” included the following: “Think more positively and use the skills that I learned”; “Try to be more proactive when interacting and less inhibited”; “Make more eye contact during conversation and when talking to my friends”; “I would try harder not to talk about myself all the time”; “Spend a little more time and attention speaking to a fellow employee”; “I will have a conversation with people and I know how to change a topic”; “I will attempt to listen more closely to what people say and how they say it”; and “Try to talk about your interests but nothing that is too weird or uninteresting.” After attending the group, individuals reported interest in becoming more observant at work about conversing with others such as being aware, attentive, and looking for cues when someone is uninterested in a topic.

Qualitative analysis of comments from group participants when asked, “What other information would it be helpful to include in the group?” included the following: “How to talk to peers versus talking to superiors such as supervisors”; “How to act on a job interview”; “Walking away from a situation”; “How to disengage from a hostile situation”; and “Understanding more about people’s personalities, their cultures, how to socialize with different people.” Some participants reported a thorough understanding and grasp of concepts explained throughout the groups, therefore, noting, “None. I learned everything I needed to learn in this group. It was very helpful.”

Qualitative analysis of comments from group participants when asked, “Any other comments?” included the following: “It would be better if people continued to communicate after the group ended”; “Good groups. Good exchanges”; “The people that are helping us are very good”; “The instructor is smart and intelligent and shared a lot of good information”; and “It would be good to have a female’s point of view.” As many individuals noted no further comments, their longing for more groups was apparent as a collective theme throughout all who participated. These results indicate that group participants were able to learn the value of conversational skill and report an increase in confidence in utilizing the acquired skill within their future workplaces. Participants learned and practiced the steps of a new skill and were able to state when this skill might be used in the workplace. Group participants reported an overall satisfaction level with the small group interventions and the content they learned and practiced during each session.

Qualitative analysis of group leaders’ answers to the question concerning participant reactions on the Fidelity form, indicated that the groups were helpful and that individuals learned various skills that helped them in conversing with others. According to one group leader, participants learned certain subjects are not appropriate to discuss in the workplace (i.e., religion, politics, or other coworkers). Another group leader conveyed that the overall group promoted peer support and that it offered suggestions and encouragement for others. One group leader wrote that participants reported a high level of enjoyment in being able to listen as well as converse with others more successfully. A group leader who worked with individuals with autism reported his participants “loved” the groups; even the agency had expressed a high level of satisfaction with the groups as well. Another group leader noted that participants now “have the knowledge of how they can initiate a conversation, change the topic when the conversation seems to be going nowhere, and that they also learned how to end conversation.” One group leader noted that individuals with developmental disabilities had demonstrated improved skill functioning in the final role-play of the last session. Those differences were observable in their ability to demonstrate attention and interest in someone else during a conversation.

Qualitative analysis of the group leaders’ responses to questions concerning adaptations and modifications (Fidelity form completed by group leaders after each session) suggested a need for future modifications for different disability groups. For example, a group leader, who worked with individuals with developmental disabilities, reported that participants within his group were comfortable with the amount of content in each session, but, at times, wanted more time spent on explaining certain topics. When group participants were asked whether the directions were reviewed too quickly, they disagreed, but did ask to spend more time on certain exercises and on the main points of the group. When group participants were asked whether the directions were reviewed too quickly, they disagreed, but did ask to spend more time on certain exercises and on the main points of the group. Results of another group showed the importance of designing and utilizing group curricula that was specific to a population such as individuals with developmental disabilities. As such, homework assignments, and even the terminology of the concepts, were too advanced for the population. As for future modifications, reading materials need to be adapted to a lower reading level. Group leaders working with individuals with developmental disabilities expressed that increasing the number of sessions but requiring a shorter duration may be helpful for this population. Some group leaders suggested that shortening the duration would also assist with scheduling demands if groups were implemented at specific agencies where time for groups was limited. Audio versions of reading materials were suggested for those who cannot read.

Discussion

The results indicate that individuals with a wide range of disabilities can be taught to deliver the skill, “Conversing With Others” in a group setting simulating informal conversation in a work setting. Among the 146 participants who participated in the curriculum which was delivered in 22 groups by 22 graduate students, participants had a variety of disabilities including cognitive, physical, sensory, psychiatric, and substance use disorders. Favorable responses to the group were received from participants across disabilities. Participants who had different disabilities were placed in the same group, and participants were able to benefit from the group, regardless of the disabilities participants within the group had. Most participants reported increased preparedness about engaging in conversations with coworkers at workplaces by following the steps of the skill, Conversing With Others. Results were statistically significant for a number of the pre–post questions (see Table 3). The average effect size for youth and adults with disabilities was in the small to moderate range. Some items did not reach significance level, for example, participants remained in their disagreeing position with the item, “It is okay to tell jokes about other people in the room, as long as they can’t hear me,” after the intervention. This indicates that the participants understood basic social norms in social interactions with others and agreed with respecting others in social interaction even before the groups. Other items such as, “I can discuss anything I want to at work, as long as it is lunchtime or on my break,” and “Work is the only topic we should discuss when we are at lunch with coworkers” also did not reach significance. Participants remained neutral concerning these items and did not change their position as a group. This could suggest that the behavior, “choosing topics for conversation” will need to be practiced more thoroughly during the groups.

Results indicate that group participants were able to learn the steps of the skill of Conversing With Others and report an increase in confidence in utilizing the acquired skill within their current or future workplace. Group participants reported an overall satisfaction level with the group intervention and the skill they learned in the group. By using the soft skill of Conversing With Others, an individual may be able to establish work relations with coworkers and thereby obtain more informal social support at work, which may help increase job tenure.

As demonstrated in Table 3, the results show that teaching soft skills through group intervention can increase an individual’s level of confidence about using the skill of Conversing With Others in work settings. Subjects reported overwhelming satisfaction toward the groups. Although this study demonstrated only the outcome for one skill, it can be speculated that teaching other soft skills through group interventions may serve to increase an individual’s level of confidence for the usage of the soft skill in work settings. In the DST approach, the focus is on teaching one critical skill that will facilitate success and satisfaction in the target environment and focusing on that one skill to bring about behavioral change. This is in contrast to other skills teaching methods which strive to teach multiple skills over an extended time period. The DST approach has the advantage of facilitating behavioral change in a relatively short number of sessions. While the skill of Conversing With Others was taught in a group setting, it is also possible to use the DST approach to teach a skill to an individual in need of improvement of the skill in question.

The present findings suggest that the “Conversing With Others” curriculum and the approach to training entry level rehabilitation counselors in the model have promise for addressing in a group setting the lack of skill in making “small talk” at work that is an issue for many IWD seeking employment. A focus on training in this work-related skill for IWD is especially important to the field because IWD strive to engage in valued life roles such as worker (Davis, 2003; Davis, Koroloff, & Ellison, 2012) but experience difficulty in getting and keeping employment. In addition to the skill of Conversing With Others, other work-related skills could be fostered in employment training programs for this population (Lindsay, Adams, McDougall, & Sanford, 2012). The study offers hope for people with disabilities and their families as it provides preliminary data for the feasibility of this approach.

This study also addresses another important issue for practitioners who are working with IWD to choose, get, and keep employment and other valued roles. Often, such individuals lack a critical skill for success and satisfaction in the target environment. Practitioners could benefit from having prepared curricula specific to a needed skill that the practitioner could use without the need for training. The curriculum manual designed for this study was an effort to address this need. The fact that a large number of graduate students working at various sites with an ethnically heterogeneous population of participants with various disabilities could successfully implement this curriculum without specialized training provides additional support for the potential generalizability of the DST approach. No minimum level of competence was required beforehand in delivering the curriculum except that group facilitators were master’s program graduate students in their final year and had previously completed a master’s level course in Group Methods. Subsequent research using the curriculum from this project will address whether other human services practitioners in the field could deliver similar results. If so, this could be of major benefit for the practitioners, the agency, and most importantly, the individual with a disability.

Feasibility trials are often the first step in testing whether an intervention could be implemented with efficacy and effectiveness (Bowen et al., 2009). There are eight recommended areas of focus when considering the feasibility of an intervention: Acceptability, Demand, Implementation, Practicality, Adaptation, Integration, Expansion, and Limited Efficacy testing (Bowen et al., 2009). It is recommended that smaller feasibility studies utilizing mixed methods (i.e., qualitative and quantitative) might yield innovative and helpful results (Bowen et al., 2009). Our study has demonstrated acceptability of the intervention, in that the target population and those involved in implementing the intervention reported favorable reactions to the intervention. The intervention has demonstrated possible demand from the field, as the programs reported willingness to implement these groups for future clients. Furthermore, results of needs assessment in the format of focus groups and surveys suggest the need for social skills training for people with disabilities at work (Lu, Oursler, Herrick, & Gao, n.d.). It demonstrated practicality by using limited resources and being able to be implemented without special training for the group leaders. Its adaptation was demonstrated by its possible flexibility to accommodate different disabilities. It showed possible feasibility in future integration and expansion in the existing rehabilitation programs and agencies. The data also provided limited efficacy testing through the self-report measures of perceptions of participant development of conversational skills. Results from the participant satisfaction survey, along with qualitative responses of the participants and group facilitators, provided further innovative details of the intervention. All together, data support the feasibility of the intervention.

This was a feasibility study to see whether the DST approach for teaching the skill, “Conversing With Others,” could be implemented successfully across a wide variety of agencies serving individuals with various disabilities. The findings suggest that the groups are easy to implement and were well liked by participants. Teaching one skill takes about four sessions, which can be run in 4 weeks if delivered once a week, or 2 weeks if delivered twice a week. This is in contrast with broad social skills training approaches such as the UCLA Workplace Fundamentals, which requires 5 to 6 months, twice a week, 1.5 hr-long sessions to complete. Findings show promising results for future curriculum groups using the DST approach.

While findings are positive, as this was a small pilot study, a true experimental study of the DST groups with longitudinal follow-up data on employment outcome, job satisfaction, and the collection of employer feedback may inform the field. Future studies focused on needs assessment to identify what are the most critical skills IWD need for getting and keeping employment are recommended. Feasibility studies are needed to explore the richness of the needs of modifications based on different disability groups and associated limitations. Curricula on other critical skills, such as “Responding to feedback,” and “Asking for help at work,” are in the process of being developed and studied to facilitate improvements in services for persons with disabilities. This on-going exploration will assist counselors with an effective, easy-to-use small group intervention to enhance employment-related critical skills, for individuals with various types of disabilities using rehabilitation services.

As this was a pilot study, several limitations exist. This study utilized graduate-level counselors-in-training to facilitate the groups, so the group leaders were not licensed practitioners in the field. The students were required to run these groups to fulfill a requirement for their internship and may not be representative of employees at the sites. The students were highly motivated. Some made reminder calls to participants and brought healthy snacks to the groups to attract attendance. This may have superficially increased the attendance rate, as 84.9% of participants attended more than half of the sessions and 71.5% attended all sessions. There was no formal fidelity measure of the groups. The survey on self-perception of conversational skills was not validated before (Oursler, n.d.). Furthermore, there was no control group with no follow-up data regarding whether group participants used the skill of Conversing With Others or experienced longer job tenure. Generalization and maintenance of learned skills are two major components of skill development (Nemec, McNamara, & Walsh, 1992). While this is a skill to be used in the context of lunchtime, in environments such as break-rooms, the current manual did not include a training session on generalization and maintenance of this particular skill. Finally, self-report data do not report the ability level of an individual’s conversational skill, but rather their self-perception of the skill they learned in the group.

Despite these limitations, this study supports the feasibility of the DST approach for training entry-level rehabilitation counselors to use the DST approach to assist individuals with various types of disabilities served at vocational and other community programs for IWD to prepare them for employment or other valued roles in the community. This study highlights the importance of DST, specifically related to soft skills utilized within the workplace, and notes the improvement among IWD in their confidence level and self-perception of skill acquisition. This study highlights the possibility of preparing a curriculum manual to teach a soft skill for work, that is, Conversing With Others, that can potentially be used by practitioners without the need for specialized training. The data show promising signals for future testing. Future randomized clinical trials utilizing mixed methods and long-term follow-up would be able to shed light on essential questions such as, “who can benefit from this intervention,” “what modifications people with different disabilities would need,” and “how can clients apply skills learned in session in a real workplace setting.”

Footnotes

Appendix

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was supported by Rutgers-SHP Dean’s Intramural Grant.

References

Bowen

D. J.

Kreuter

Spring

Cofta-Woerpel

Linnan

Weiner

. . . Fernandez

(2009). How we design feasibility studies. American Journal of Preventive Medicine, 36, 452–457.

Cohen

Danley

Nemec

(1985). Direct skills teaching reference handbook. Boston, MA: Center for Psychiatric Rehabilitation.

Cook

J. A.

Razzano

L. A.

(2000). Vocational rehabilitation for persons with schizophrenia: Research and implications for practice. Schizophrenia Bulletin, 26, 87–103.

Coupland

(2003). Small talk: Social functions. Research on Language and Social Interaction, 36, 1–6.

Coupland

Robinson

(1992). “How are you?” Negotiating phatic communion. Language in Society, 21, 207–230.

Davis

(2003). Addressing the needs of youth in transition to adulthood. Administration and Policy in Mental Health, 30, 495–509.

Davis

Koroloff

Ellison

(2012). Between adolescence and adulthood: Rehabilitation research to improve services for youth and young adults. Psychiatric Rehabilitation Journal, 35, 167–170.

Duncan

Dunifon

(2012). “Soft skills” and long-run labor market success. In Polachek

Tatsiramos

(Eds.), Research in Labor Economics: Vol. 35. 35th anniversary retrospective (pp. 313–339). Bingley, UK: Emerald Group Publishing Limited.

Ellison

Anthony

Sheets

Dodds

Barker

Massaro

Wewiorski

(2002). The integration of psychiatric rehabilitation services in behavioral health care structures: A state example. Journal of Behavioral Health Services & Research, 29, 381–393.

10.

Farkas

Anthony

W. A.

(2010). Psychiatric rehabilitation interventions: A review. International Review of Psychiatry, 22, 114–129.

11.

Grugulis

Vincent

(2009). Whose skill is it anyway? “Soft skills” and polarization. Work, Employment and Society, 23, 597–615.

12.

Zhang

Pacha

(2012). Employability skills valued by employers as important for entry-level employees with and without disabilities. Career Development and Transition for Exceptional Individuals, 35, 29–38.

13.

Kendon

Harris

R. M.

Key

M. R.

(1975). Organization of behavior in face-to-face interaction. The Hague, The Netherlands: Mouton.

14.

Kinoshita

Furukawa

T. A.

Kinoshita

Honyashiki

Omori

I. M.

Marshall

Kingdon

(2013). Supported employment for adults with severe mental illness. Cochrane Database of Systematic Reviews, 9, CD008297.

15.

Kyllonen

(2013). Soft skills for the workplace. Change: The Magazine of Higher Learning, 45(6), 16–23.

16.

Lindsay

Adams

McDougall

Sanford

(2012). Skill development in an employment-training program for adolescents with disabilities. Disability and Rehabilitation, 34, 228–237.

17.

Oursler

J. D.

Herrick

Gao

(2018). Needs assessment for transition age youth with disabilities to succeed in employment settings. Unpublished Manuscript, Rutgers University, Piscataway, NJ.

18.

Mueser

K. T.

Salyers

M. P.

Mueser

P. R.

(2001). A prospective analysis of work in schizophrenia. Schizophrenia Bulletin, 27, 281–296.

19.

Nemec

P. B.

McNamara

Walsh

(1992). Direct skills teaching. Psychosocial Rehabilitation Journal, 16, 13–25.

20.

Oursler

J. D.

(n.d.). Self-assessment of conversational skill and knowledge. Unpublished manuscript, Rutgers University, Piscataway, NJ.

21.

Riggio

Tan

S. J.

(2013). Leader interpersonal and influence skills: The soft skills of leadership. London, England: Routledge.

22.

Rogers

Anthony

Farkas

(2006). The choose-get-keep approach to psychiatric rehabilitation. Rehabilitation Psychology, 51, 247–256.

23.

Shern

Tsemberis

Anthony

Lovell

Richmond

Felton

. . . Cohen

(2000). Serving street-dwelling individuals with psychiatric disabilities: Outcomes of a psychiatric rehabilitation clinical trial. American Journal of Public Health, 90, 1873–1878.

24.

Stephens

D. L.

Collins

M. D.

Dodder

R. A.

(2005). A longitudinal study of employment and skill acquisition among individuals with developmental disabilities. Research in Developmental Disabilities, 26, 469–486.

25.

U.S. Department of Labor, Bureau of Labor Statistics. (2018). Occupational outlook handbook, 2017-2018. Retrieved from http://www.bls.gov/ooh/education-training-and-library/librarians.htm