Residential immersive life skills programs for youth with disabilities: service providers' perceptions of change processes

Abstract

Background: Residential immersive life skills (RILS) programs are designed to equip youth with physical disabilities with the foundational life skills required to assume adult roles. The objective was to determine RILS service providers' perceptions of the active ingredients of the intervention change process. Methods: Thirty-seven service providers from various disciplines completed measures to assess expertise status and participated in qualitative interviews. Qualitative themes were derived, and similarities and differences in themes were identified for blinded groups of novices, intermediates, and experts. Results: The three main themes, reflecting change processes, were: (a) creating a supportive program atmosphere with multiple opportunities for learning, (b) using strategies to support, encourage, and engage youth, and (c) intentionally fostering youth experiences of skill development, social interaction, and pride in accomplishment. In contrast to the novices, experts displayed a more holistic perspective and paid attention to higher-order issues such as providing opportunities and enabling youth. Conclusion: The findings indicate how RILS service providers work to create a program atmosphere and employ strategies to intentionally foster particular youth experiences. The findings explicate service providers' theories of practice, the intentional design of RILS program environments to bring about client change, and the value of service provider expertise.

Implications for Rehabilitation

• Service providers of youth independence-oriented life skills programs can intentionally create a learning-oriented and supportive program atmosphere by using non-directive, coaching/guiding, and engagement strategies

• Youth experiences of skill development, shared experience with others, and pride in accomplishment can be cultivated by providing a range of learning opportunities, including choice making, problem-solving, and skill mastery

• Compared to more novice service providers, experts discussed managing the program conditions and context, creating opportunities for choice and new experiences, and adopting a facilitating and enabling role (coaching and capitalizing on teachable moments)

• Adolescents
• change processes
• disabilities
• independence program
• intervention strategies
• life skills
• service providers
• youth

Acknowledgements

We thank Diane Savage and C. J. Curran for their support, Alyssa Willoughby for assistance with data collection, Lisa Blenkhorn for assistance with qualitative data analyses, and Madhu Pinto for assistance with quantitative data analyses and article preparation. We also extend our thanks to the service providers who participated in the study, and Holland Bloorview Kids Rehabilitation Hospital, McMaster Children's Hospital, and ErinoakKids Centre for Treatment and Development for their support of this research.

Declaration of interest

This work was funded by the Centre for Leadership in Participation and Inclusion with the support of the Holland Bloorview Kids Rehabilitation Hospital Foundation. Gillian King holds the Canada Research Chair in Optimal Care for Children with Disabilities, funded by the Canadian Institutes of Health Research. The authors alone are responsible for the content and writing of this paper. Three of the authors (Jones-Galley, Morrison, Isihi) have been involved in the delivery of RILS programs. All authors contributed to the research and the preparation of the paper for publication.