In this article, we’ll provide you with a perfect research paper example that you can use to help you write your own. From this example, you’ll learn the following:
- How to format your paper
- How to title your paper
- How to write an introduction and craft a thesis
- How to cite sources
- How to write the body of the paper
- How to conclude your research paper
- And how to write a References or Works Cited page
For a paper written in MLA format, you’ll want to include the following information in the upper left hand corner of your paper, double-spaced:
Following this information will be the title of your essay. For this example, we’ve chosen to research the relationship between President Trump and his former Chief Advisor (now head of Breitbart News) Steve Bannon.
In your MLA-formatted research paper, the essay will come directly after the info provided in the upper left hand corner. Maintain the double-spacing but add no further spaces. Simply place the title in the center of the paper. For another example of how this should look, check out Purdue OWL. You can also find an example of how a research paper should be formatted in APA.
How Bannon and Trump Came Together to Win the White House—and Why They Separated before the Year was Out
Who is Steve Bannon?
How Did Trump Win the White House?
What was Bannon’s Role in the Trump Administration?
Why Did Bannon Resign as Trump’s Chief Advisor?
View this article for a list of other research paper topics.
The Impossible Balancing Act of Bannon and Trump
Why Trump Needed Bannon—and Then Why He Didn’t
How Bannon Used Trump to Win the White House—and How He Lost It Months Later
a. Bannon’s Background
b. Trump’s Background
c. Forging a Friendship to the White House
d. Different Directions
e. In or Out?
f. At Odds
Check out this article if you need assistance with completing a research paper outline.
Research Paper Introduction
The unlikely path of Donald Trump to the White House in the 2016 U.S. election will be remembered for years to come. Few pundits predicted it and even fewer polls projected it. However, with the help of one strategist—Steve Bannon—Trump was able to overcome numerous obstacles and win the Presidency. Bannon’s reward? He was named White House Chief Advisor. To the public, Bannon promised sweeping changes in Washington and e helped write Trump’s inaugural speech, in which a practical revolution was forecasted. However, by August of 2017, Bannon was out and the Trump Administration had done little to differentiate itself from the two Administrations that had preceded it.
This research paper will examine the nature of the relationship between Steven Bannon, the man who helped Trump win the White House, and Donald Trump, the man who let Bannon go after six short months of service in the Oval Office.
It is based primarily on information obtained from Joshua Green’s Devil’s Bargain and other journalists such as Pepe Escobar, independent journalist and roving correspondent for Sputnik News and Asia Times.
Hook Sentence / Essay Hook
Notice how the introductory paragraph begins. It uses an interesting fact to catch the reader’s attention. Since this research paper is about the Bannon-Trump relationship, the opening sentence of the introduction focuses on the “unlikely path of Donald Trump to the White House,” intimating that it is an event worth understanding. This is “the hook”—the line that draws the reader into the paper. It leads right into the subject of the paper—because it prompts the reader to wonder how Trump managed to do this? Why, with the help of Steve Bannon of course, is the answer. The intro goes on to explain that not all is rosy in D.C., however—and that is what takes us into the body of the paper.
Bannon rose from an unlikely background to be Trump’s top advisor throughout the second-half of his campaign in 2016. Bannon’s background was diverse: he had spent time in the military, as an employee of Goldman Sachs, as a Hollywood producer, a filmmaker, a speaker, an advocate of economic nationalism, and a news executive. It was through this latter role that he came into contact with Donald Trump (Green, 2017). Following a number of interviews in which the two seemed to see eye-to-eye, the pair decided to throw in together and push for the White House. Bannon saw in Trump “the perfect vehicle” for getting a policy of economic nationalism into the federal government. Trump saw in Bannon a firebrand workhorse with vision and the ability to plot a clear path to the White House by focusing on a group of voters feeling marginalized and ignored by the two biggest political parties in recent years—blue collar voters and rural Americans in Michigan, Pennsylvania and Ohio. These swing states became the key to Trump’s success in the election and it was Bannon who helped guide Trump’s message so that it resonated with this voting base. Bannon’s support of writers who were engaged in the fight against Trump’s opponent Hillary Clinton were also highly useful. The book Clinton Cash helped divert negative attention away from Trump towards Hillary in what would climax with a FBI investigation virtually right on the eve of Election Day (Green, 2017). By identifying the path to victory and helping others to throw shade at his opponent, Bannon enabled Trump to achieve the unthinkable.
What was so unthinkable about a Trump presidency was the fact that Trump’s own background was completely foreign to politics. He was an outsider. He was crass and unapologetic. The mainstream media loathed him. Yet he was a nimble user of social media and had millions of followers tuned in to his every tweet. Trump had been a hit on TV with The Apprentice. He knew that his brash, assertive, humorous but matter-of-fact business-like manner resonated with certain viewers. The problem was—how could he make it resonate with more? The answer was Steve Bannon. Bannon had attempted to use Palin prior to throwing in with Trump (Green, 2017). Palin had been a media darling too—but she lacked a particular oomph or essence that more Americans wanted to see. Trump had that oomph in spades. He paraded it around with a bravado that made his opponents wilt. Bannon recognized it and Trump recognized what Bannon could do: marshal the waiting powers of the alternative media to push back against the Establishment and make room for the outsider candidate.
And that is how they forged a friendship to the White House. With Bannon directing the way forward and honing Trump’s message, everything impossible suddenly became possible. The new Trump-Bannon team produced a script that resonated with those who despised the Establishment and wanted a strong leader to come and shake things up. Bannon helped shape Trump so that his political incorrectness was viewed as a boon rather than as a handicap. He supplied the political platform that Trump himself saw as the best pillars to stand on.
But everything changed once election night was over and the reality of shaping an Administration came into place. The Establishment was not going to go quietly—and suddenly all those who had publicly opposed Trump were now sweating to be included in his Administration. Even Mitt Romney who had been among the most vocal critics of Trump during the campaign was now dining with the President-Elect and back-peddling on all his criticisms (Anderson, 2016). Under pressure from the Establishment to work with career politicians, generals, and lobbyists, Trump began to move more towards the center, away from his base, removing those who had been most loyal to him throughout the difficult times. As the months rolled on, and Congress made it apparent that it would not work with Trump on any of his platform issues—from immigration to the Border Wall to healthcare reform to taxes—Trump’s popularity declined. He brought in his daughter Ivanka and son-in-law Jared for advice. He turned to Goldman Sachs for assistance—gave a key position to Gary Cohn (even though Trump had railed against Goldman during the campaign to rousing applause from his admirers). He even backtracked on his promise to pursue legal action against Hillary. The fight that he had demonstrated during the campaign seemed to fizzle out now that he was in the Oval Office. Bannon was pushed aside as a flood of newcomers came to the stage, jostling for the President’s ear. Bannon’s influence quickly waned and he and Trump now seemed to be going in two different directions. Trump’s generals wanted to ramp up the war in Afghanistan; Bannon wanted out. Trump wanted to confront North Korea over its missile program; Bannon saw no sense to such conflict. Trump wanted Cohn on board; Bannon saw Cohn as one of the biggest threats to his policy of economic nationalism. Trump and Bannon had gotten along so well on the campaign trail—but now they were going in two different directions.
The writing was soon on the wall. The question of whether Bannon was in or out would be answered by August, 2017. The man who helped get Trump elected would be ushered out and returned to his seat as head of Breitbart News, vowing to fight against those who opposed Trump’s policies (Escobar, 2017). The only problem was that Trump’s policies seemed to be up in the air, in flux, amenable, and unfixed. In truth, Bannon had been the policy man—Trump was just the vehicle. Now the vehicle was crammed full of new policy men, neoconservatives and neoliberals, and a new agenda was in the making. Congress would not work with the president on bringing those outsider politics to fruition.
And so it is now: Bannon is on the outside once more—after a brief stint on the inside, where he once aimed to help Trump “drain the swamp” of Washington corruption. Instead, after half a year of being blocked at every turn by the well-Established and well-entrenched swamp creatures working in D.C., Bannon got the hint: he was not welcome there; he would not be able to change it from the inside; Trump was theirs—not his; and so Bannon was sent home to do what he did best, start a war of words and threaten to pull down the pillars of the Establishment from the outside (Escobar, 2017).
Still, all was not lost. Bannon believed that the real Donald Trump was one who believed as his base believed. There were glimmers of this sentiment. Trump wanted to renegotiate NAFTA, put an end to offshoring, promote a Made in America policy, and get tough on illegal immigration. It was just a matter of finding enough people on the inside to support this agenda and weeding out those who opposed it. Bannon’s new plan, being back at Breitbart, was to help make it apparent to Trump just who his real friends were and who and how his enemies were hampering his agenda and disappointing his base of supporters.
Bannon and Trump came together like lightning to split the Establishment into fragments. Yet, like a futuristic robot, those fragments came back together in the days, weeks and months following Trump’s win and subsequent inauguration. They posed a formidable threat to the promises that Trump had made with the help of Bannon, who crafted the message and the way forward—a way that many voters in the swing states wanted to see executed in the coming four years. But he Establishment rushed the new President and within months, he had fumbled the ball. One by one, those who had been near him throughout the campaign were removed, causing further weakness within the camp of outsiders. Finally the Establishment set its sights on Bannon and quickly made him out to be more of a distraction than a help for Trump—and so the two agreed to part ways, Trump working with a new team of advisors within the Oval Office; Bannon attempting to rouse Trump’s core of supporters and marshal the strength that had gotten Trump elected in the first place for a new fight against those who opposed the message they had embraced just a half year earlier. Time would tell who would win this next stage of the fight.
Anderson, M. (2016). Once Trump’s loudest GOP critic, Mitt Romney meets with the president-elect. NPR. Retrieved from http://www.npr.org/2016/11/19/502569638/once-trumps-loudest-gop-critic-mitt-romney-set-to-meet-president-elect
Escobar, P. (2017). Bannon the Barbarian goes ‘thermonuclear’. Information Clearing House. Retrieved from http://www.informationclearinghouse.info/47656.htm
Green, J. (2017). Devil’s bargain: Steve Bannon, Donald Trump, and the storming of the presidency. NY: Penguin Press.
In this article, you learned a number of important points about how to write a research paper. The research paper example provided above hits all the main key elements, so let’s go through them one by one.
First: Pick a good, strong title. This will be your anchor—the theme to which your entire paper should be oriented.
Second: Always start off with an outline. The outline above helped keep the essay on track. It was a simple outline with an introduction, body and conclusion. It did not require a lot of details but it did make use of critical points in the development of the relationship between Bannon and Trump. With the help of the pre-determined title, the essay’s path was clear and the outline identified each of the key topics that the paper should address within the body paragraphs. Notice: each topic received its own paragraph to help tell the story of the Bannon-Trump alliance.
Third: Use your introduction to capture the attention of the reader. The title acts as the morsel—the little nugget that catches the reader’s eye. The “hook” which leads off the introductory paragraph acts as the snare that forces the reader to stick with the paper. The hook works by giving the reader some point or fact or critical question to consider. The rest of the paper is seen as the answer or follow-up to this hook—and that’s why the reader stays with it.
Fourth: Be sure to close out your introduction with a thesis statement. Tell the reader exactly what your paper will show and how it will do it. The essay example above noted where the key information came from and how it would be used to explain the Bannon-Trump relationship.
Fifth: Make sure the body of your paper follows the outline. Remember: you made that outline for a reason—so use it!
Sixth: Adhere to the standards and formatting guidelines of whatever writing style you are using—whether it is MLA, APA, Chicago or other.
Seven: Conclude your research paper by going over the main points of the essay and summarizing the findings. Don’t introduce any new information into the conclusion. Simply re-state the main ideas that your study found and try to give it a final sense of meaning: what do all the findings indicate? What does it all mean? If there is room for future research, explain the direction in which it should go.
Eight: Include a reference page that shows all your sources.
If you can follow these steps, you’ll have no problem crafting a great research paper on your own. As always, writing a research paper depends primarily on having done the research. So it is imperative that you actually read up on your topic. Make sure you understand, at least in broad or general terms, what it is you’ll be writing before you get started. You don’t have to finish all your research before you begin writing the paper. Indeed, sometimes as you write, you realize that you need more info on a particular idea. For this reason, writing and research should go together: don’t compartmentalize the two!
Helpful Hints and Reminders
1. Create a title that is meaningful and bold.
2. Develop an outline that will guide your writing process.
3. Stay on topic and don’t deviate from the thesis of your research paper.
4. Do the research! Solid writing depends upon a firm grasp of the subject!
Latest APA Format (6th edition)
Latest MLA Format (8th edition)
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This paper should be used only as an example of a research paper write-up. Horizontal rules signify the top and bottom edges of pages. For sample references which are not included with this paper, you should consult the Publication Manual of the American Psychological Association, 4th Edition.
This paper is provided only to give you an idea of what a research paper might look like. You are not allowed to copy any of the text of this paper in writing your own report.
Because word processor copies of papers don't translate well into web pages, you should note that an actual paper should be formatted according to the formatting rules for your context. Note especially that there are three formatting rules you will see in this sample paper which you should NOT follow. First, except for the title page, the running header should appear in the upper right corner of every page with the page number below it. Second, paragraphs and text should be double spaced and the start of each paragraph should be indented. Third, horizontal lines are used to indicate a mandatory page break and should not be used in your paper.
The Effects of a Supported Employment Program on Psychosocial Indicators
for Persons with Severe Mental Illness
William M.K. Trochim
Running Head: SUPPORTED EMPLOYMENT
This paper describes the psychosocial effects of a program of supported employment (SE) for persons with severe mental illness. The SE program involves extended individualized supported employment for clients through a Mobile Job Support Worker (MJSW) who maintains contact with the client after job placement and supports the client in a variety of ways. A 50% simple random sample was taken of all persons who entered the Thresholds Agency between 3/1/93 and 2/28/95 and who met study criteria. The resulting 484 cases were randomly assigned to either the SE condition (treatment group) or the usual protocol (control group) which consisted of life skills training and employment in an in-house sheltered workshop setting. All participants were measured at intake and at 3 months after beginning employment, on two measures of psychological functioning (the BPRS and GAS) and two measures of self esteem (RSE and ESE). Significant treatment effects were found on all four measures, but they were in the opposite direction from what was hypothesized. Instead of functioning better and having more self esteem, persons in SE had lower functioning levels and lower self esteem. The most likely explanation is that people who work in low-paying service jobs in real world settings generally do not like them and experience significant job stress, whether they have severe mental illness or not. The implications for theory in psychosocial rehabilitation are considered.
The Effects of a Supported Employment Program on Psychosocial Indicators for Persons with Severe Mental Illness
Over the past quarter century a shift has occurred from traditional institution-based models of care for persons with severe mental illness (SMI) to more individualized community-based treatments. Along with this, there has been a significant shift in thought about the potential for persons with SMI to be "rehabilitated" toward lifestyles that more closely approximate those of persons without such illness. A central issue is the ability of a person to hold a regular full-time job for a sustained period of time. There have been several attempts to develop novel and radical models for program interventions designed to assist persons with SMI to sustain full-time employment while living in the community. The most promising of these have emerged from the tradition of psychiatric rehabilitation with its emphases on individual consumer goal setting, skills training, job preparation and employment support (Cook, Jonikas and Solomon, 1992). These are relatively new and field evaluations are rare or have only recently been initiated (Cook and Razzano, 1992; Cook, 1992). Most of the early attempts to evaluate such programs have naturally focused almost exclusively on employment outcomes. However, theory suggests that sustained employment and living in the community may have important therapeutic benefits in addition to the obvious economic ones. To date, there have been no formal studies of the effects of psychiatric rehabilitation programs on key illness-related outcomes. To address this issue, this study seeks to examine the effects of a new program of supported employment on psychosocial outcomes for persons with SMI.
Over the past several decades, the theory of vocational rehabilitation has experienced two major stages of evolution. Original models of vocational rehabilitation were based on the idea of sheltered workshop employment. Clients were paid a piece rate and worked only with other individuals who were disabled. Sheltered workshops tended to be "end points" for persons with severe and profound mental retardation since few ever moved from sheltered to competitive employment (Woest, Klein & Atkins, 1986). Controlled studies of sheltered workshop performance of persons with mental illness suggested only minimal success (Griffiths, 1974) and other research indicated that persons with mental illness earned lower wages, presented more behavior problems, and showed poorer workshop attendance than workers with other disabilities (Whitehead, 1977; Ciardiello, 1981).
In the 1980s, a new model of services called Supported Employment (SE) was proposed as less expensive and more normalizing for persons undergoing rehabilitation (Wehman, 1985). The SE model emphasizes first locating a job in an integrated setting for minimum wage or above, and then placing the person on the job and providing the training and support services needed to remain employed (Wehman, 1985). Services such as individualized job development, one-on-one job coaching, advocacy with co-workers and employers, and "fading" support were found to be effective in maintaining employment for individuals with severe and profound mental retardation (Revell, Wehman & Arnold, 1984). The idea that this model could be generalized to persons with all types of severe disabilities, including severe mental illness, became commonly accepted (Chadsey-Rusch & Rusch, 1986).
One of the more notable SE programs was developed at Thresholds, the site for the present study, which created a new staff position called the mobile job support worker (MJSW) and removed the common six month time limit for many placements. MJSWs provide ongoing, mobile support and intervention at or near the work site, even for jobs with high degrees of independence (Cook & Hoffschmidt, 1993). Time limits for many placements were removed so that clients could stay on as permanent employees if they and their employers wished. The suspension of time limits on job placements, along with MJSW support, became the basis of SE services delivered at Thresholds.
There are two key psychosocial outcome constructs of interest in this study. The first is the overall psychological functioning of the person with SMI. This would include the specification of severity of cognitive and affective symptomotology as well as the overall level of psychological functioning. The second is the level of self-reported self esteem of the person. This was measured both generally and with specific reference to employment.
The key hypothesis of this study is:
HO: A program of supported employment will result in either no change or negative effects on psychological functioning and self esteem.
which will be tested against the alternative:
HA: A program of supported employment will lead to positive effects on psychological functioning and self esteem.
The population of interest for this study is all adults with SMI residing in the U.S. in the early 1990s. The population that is accessible to this study consists of all persons who were clients of the Thresholds Agency in Chicago, Illinois between the dates of March 1, 1993 and February 28, 1995 who met the following criteria: 1) a history of severe mental illness (e.g., either schizophrenia, severe depression or manic-depression); 2) a willingness to achieve paid employment; 3) their primary diagnosis must not include chronic alcoholism or hard drug use; and 4) they must be 18 years of age or older. The sampling frame was obtained from records of the agency. Because of the large number of clients who pass through the agency each year (e.g., approximately 500 who meet the criteria) a simple random sample of 50% was chosen for inclusion in the study. This resulted in a sample size of 484 persons over the two-year course of the study.
On average, study participants were 30 years old and high school graduates (average education level = 13 years). The majority of participants (70%) were male. Most had never married (85%), few (2%) were currently married, and the remainder had been formerly married (13%). Just over half (51%) are African American, with the remainder Caucasian (43%) or other minority groups (6%). In terms of illness history, the members in the sample averaged 4 prior psychiatric hospitalizations and spent a lifetime average of 9 months as patients in psychiatric hospitals. The primary diagnoses were schizophrenia (42%) and severe chronic depression (37%). Participants had spent an average of almost two and one-half years (29 months) at the longest job they ever held.
While the study sample cannot be considered representative of the original population of interest, generalizability was not a primary goal -- the major purpose of this study was to determine whether a specific SE program could work in an accessible context. Any effects of SE evident in this study can be generalized to urban psychiatric agencies that are similar to Thresholds, have a similar clientele, and implement a similar program.
All but one of the measures used in this study are well-known instruments in the research literature on psychosocial functioning. All of the instruments were administered as part of a structured interview that an evaluation social worker had with study participants at regular intervals.
Two measures of psychological functioning were used. The Brief Psychiatric Rating Scale (BPRS)(Overall and Gorham, 1962) is an 18-item scale that measures perceived severity of symptoms ranging from "somatic concern" and "anxiety" to "depressive mood" and "disorientation." Ratings are given on a 0-to-6 Likert-type response scale where 0="not present" and 6="extremely severe" and the scale score is simply the sum of the 18 items. The Global Assessment Scale (GAS)(Endicott et al, 1976) is a single 1-to-100 rating on a scale where each ten-point increment has a detailed description of functioning (higher scores indicate better functioning). For instance, one would give a rating between 91-100 if the person showed "no symptoms, superior functioning..." and a value between 1-10 if the person "needs constant supervision..."
Two measures of self esteem were used. The first is the Rosenberg Self Esteem (RSE) Scale (Rosenberg, 1965), a 10-item scale rated on a 6-point response format where 1="strongly disagree" and 6="strongly agree" and there is no neutral point. The total score is simply the sum across the ten items, with five of the items being reversals. The second measure was developed explicitly for this study and was designed to measure the Employment Self Esteem (ESE) of a person with SMI. This is a 10-item scale that uses a 4-point response format where 1="strongly disagree" and 4="strongly agree" and there is no neutral point. The final ten items were selected from a pool of 97 original candidate items, based upon high item-total score correlations and a judgment of face validity by a panel of three psychologists. This instrument was deliberately kept simple -- a shorter response scale and no reversal items -- because of the difficulties associated with measuring a population with SMI. The entire instrument is provided in Appendix A.
All four of the measures evidenced strong reliability and validity. Internal consistency reliability estimates using Cronbach's alpha ranged from .76 for ESE to .88 for SE. Test-retest reliabilities were nearly as high, ranging from .72 for ESE to .83 for the BPRS. Convergent validity was evidenced by the correlations within construct. For the two psychological functioning scales the correlation was .68 while for the self esteem measures it was somewhat lower at .57. Discriminant validity was examined by looking at the cross-construct correlations which ranged from .18 (BPRS-ESE) to .41 (GAS-SE).
A pretest-posttest two-group randomized experimental design was used in this study. In notational form, the design can be depicted as:
R O X O
R O O
R = the groups were randomly assigned
O = the four measures (i.e., BPRS, GAS, RSE, and ESE)
X = supported employment
The comparison group received the standard Thresholds protocol which emphasized in-house training in life skills and employment in an in-house sheltered workshop. All participants were measured at intake (pretest) and at three months after intake (posttest).
This type of randomized experimental design is generally strong in internal validity. It rules out threats of history, maturation, testing, instrumentation, mortality and selection interactions. Its primary weaknesses are in the potential for treatment-related mortality (i.e., a type of selection-mortality) and for problems that result from the reactions of participants and administrators to knowledge of the varying experimental conditions. In this study, the drop-out rate was 4% (N=9) for the control group and 5% (N=13) in the treatment group. Because these rates are low and are approximately equal in each group, it is not plausible that there is differential mortality. There is a possibility that there were some deleterious effects due to participant knowledge of the other group's existence (e.g., compensatory rivalry, resentful demoralization). Staff were debriefed at several points throughout the study and were explicitly asked about such issues. There were no reports of any apparent negative feelings from the participants in this regard. Nor is it plausible that staff might have equalized conditions between the two groups. Staff were given extensive training and were monitored throughout the course of the study. Overall, this study can be considered strong with respect to internal validity.
Between 3/1/93 and 2/28/95 each person admitted to Thresholds who met the study inclusion criteria was immediately assigned a random number that gave them a 50/50 chance of being selected into the study sample. For those selected, the purpose of the study was explained, including the nature of the two treatments, and the need for and use of random assignment. Participants were assured confidentiality and were given an opportunity to decline to participate in the study. Only 7 people (out of 491) refused to participate. At intake, each selected sample member was assigned a random number giving them a 50/50 chance of being assigned to either the Supported Employment condition or the standard in-agency sheltered workshop. In addition, all study participants were given the four measures at intake.
All participants spent the initial two weeks in the program in training and orientation. This consisted of life skill training (e.g., handling money, getting around, cooking and nutrition) and job preparation (employee roles, coping strategies). At the end of that period, each participant was assigned to a job site -- at the agency sheltered workshop for those in the control condition, and to an outside employer if in the Supported Employment group. Control participants were expected to work full-time at the sheltered workshop for a three-month period, at which point they were posttested and given an opportunity to obtain outside employment (either Supported Employment or not). The Supported Employment participants were each assigned a case worker -- called a Mobile Job Support Worker (MJSW) -- who met with the person at the job site two times per week for an hour each time. The MJSW could provide any support or assistance deemed necessary to help the person cope with job stress, including counseling or working beside the person for short periods of time. In addition, the MJSW was always accessible by cellular telephone, and could be called by the participant or the employer at any time. At the end of three months, each participant was post-tested and given the option of staying with their current job (with or without Supported Employment) or moving to the sheltered workshop.
There were 484 participants in the final sample for this study, 242 in each treatment. There were 9 drop-outs from the control group and 13 from the treatment group, leaving a total of 233 and 229 in each group respectively from whom both pretest and posttest were obtained. Due to unexpected difficulties in coping with job stress, 19 Supported Employment participants had to be transferred into the sheltered workshop prior to the posttest. In all 19 cases, no one was transferred prior to week 6 of employment, and 15 were transferred after week 8. In all analyses, these cases were included with the Supported Employment group (intent-to-treat analysis) yielding treatment effect estimates that are likely to be conservative.
The major results for the four outcome measures are shown in Figure 1.
Insert Figure 1 about here
It is immediately apparent that in all four cases the null hypothesis has to be accepted -- contrary to expectations, Supported Employment cases did significantly worse on all four outcomes than did control participants.
The mean gains, standard deviations, sample sizes and t-values (t-test for differences in average gain) are shown for the four outcome measures in Table 1.
Insert Table 1 about here
The results in the table confirm the impressions in the figures. Note that all t-values are negative except for the BPRS where high scores indicate greater severity of illness. For all four outcomes, the t-values were statistically significant (p<.05).
The results of this study were clearly contrary to initial expectations. The alternative hypothesis suggested that SE participants would show improved psychological functioning and self esteem after three months of employment. Exactly the reverse happened -- SE participants showed significantly worse psychological functioning and self esteem.
There are two major possible explanations for this outcome pattern. First, it seems reasonable that there might be a delayed positive or "boomerang" effect of employment outside of a sheltered setting. SE cases may have to go through an initial difficult period of adjustment (longer than three months) before positive effects become apparent. This "you have to get worse before you get better" theory is commonly held in other treatment-contexts like drug addiction and alcoholism. But a second explanation seems more plausible -- that people working full-time jobs in real-world settings are almost certainly going to be under greater stress and experience more negative outcomes than those who work in the relatively safe confines of an in-agency sheltered workshop. Put more succinctly, the lesson here might very well be that work is hard. Sheltered workshops are generally very nurturing work environments where virtually all employees share similar illness histories and where expectations about productivity are relatively low. In contrast, getting a job at a local hamburger shop or as a shipping clerk puts the person in contact with co-workers who may not be sympathetic to their histories or forgiving with respect to low productivity. This second explanation seems even more plausible in the wake of informal debriefing sessions held as focus groups with the staff and selected research participants. It was clear in the discussion that SE persons experienced significantly higher job stress levels and more negative consequences. However, most of them also felt that the experience was a good one overall and that even their "normal" co-workers "hated their jobs" most of the time.
One lesson we might take from this study is that much of our contemporary theory in psychiatric rehabilitation is naive at best and, in some cases, may be seriously misleading. Theory led us to believe that outside work was a "good" thing that would naturally lead to "good" outcomes like increased psychological functioning and self esteem. But for most people (SMI or not) work is at best tolerable, especially for the types of low-paying service jobs available to study participants. While people with SMI may not function as well or have high self esteem, we should balance this with the desire they may have to "be like other people" including struggling with the vagaries of life and work that others struggle with.
Future research in this are needs to address the theoretical assumptions about employment outcomes for persons with SMI. It is especially important that attempts to replicate this study also try to measure how SE participants feel about the decision to work, even if traditional outcome indicators suffer. It may very well be that negative outcomes on traditional indicators can be associated with a "positive" impact for the participants and for the society as a whole.
Chadsey-Rusch, J. and Rusch, F.R. (1986). The ecology of the workplace. In J. Chadsey-Rusch, C. Haney-Maxwell, L. A. Phelps and F. R. Rusch (Eds.), School-to-Work Transition Issues and Models. (pp. 59-94), Champaign IL: Transition Institute at Illinois.
Ciardiello, J.A. (1981). Job placement success of schizophrenic clients in sheltered workshop programs. Vocational Evaluation and Work Adjustment Bulletin, 14, 125-128, 140.
Cook, J.A. (1992). Job ending among youth and adults with severe mental illness. Journal of Mental Health Administration, 19(2), 158-169.
Cook, J.A. & Hoffschmidt, S. (1993). Psychosocial rehabilitation programming: A comprehensive model for the 1990's. In R.W. Flexer and P. Solomon (Eds.), Social and Community Support for People with Severe Mental Disabilities: Service Integration in Rehabilitation and Mental Health. Andover, MA: Andover Publishing.
Cook, J.A., Jonikas, J., & Solomon, M. (1992). Models of vocational rehabilitation for youth and adults with severe mental illness. American Rehabilitation, 18, 3, 6-32.
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Table 1. Means, standard deviations and Ns for the pretest, posttest and gain scores for the four outcome variables and t-test for difference between average gains.
Figure 1. Pretest and posttest means for treatment (SE) and control groups for the four outcome measures.
The Employment Self Esteem Scale
Please rate how strongly you agree or disagree with each of the following statements.
|1. I feel good about my work on the job.|
|2. On the whole, I get along well with others at work.|
|3. I am proud of my ability to cope with difficulties at work.|
|4. When I feel uncomfortable at work, I know how to handle it.|
|5. I can tell that other people at work are glad to have me there.|
|6. I know I'll be able to cope with work for as long as I want.|
|7. I am proud of my relationship with my supervisor at work.|
|8. I am confident that I can handle my job without constant assistance.|
|9. I feel like I make a useful contribution at work.|
|10. I can tell that my co-workers respect me.|
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