Past Research

PD Approach

Taking Charge: Improving Employment Outcomes for Individuals with Psychiatric Disabilities in the Oklahoma Department of Rehabilitation Services Using a Positive Deviance Approach

The Oklahoma Department of Rehabilitation Services (OKDRS) provides vocational, educational, and independent living services to individuals with disabilities. They developed a leadership program called Wicked Innovations Next Generation Solutions (WINGS) in 2010, and have since graduated their third cohort of the team in March of 2015. Cohort 3 included 19 DRS staff members who worked on projects with goals of improving employment outcomes for individuals with severe mental health issues, identifying targeted training needs for staff and improved financial literacy for clients and staff. The team focused on improving employment outcomes for individuals with psychiatric disabilities is led by Carmaleta McQuay, Gladys Monroe, Stephynne Stevens, and Vickie Farris. The team has identified Positive Deviance (PD) as a method for identifying solutions that already exist within the community to improve employment outcomes for individuals with severe mental illness and amplifying these solutions to address this wicked problem. They are completing this journey of PD inquiry alongside Andrea Hall, Director of Innovations for the OKDRS, Joe Cordova, OKDRS Director, Arvind Singhal, Samuel Shirley and Edna Holt Marston Endowed Professor of Communication and Director of the Social Justice Initiative in The University of Texas at El Paso’s (UTEP’s) Department of Communication, and Kristin Kosyluk, Assistant Professor or Rehabilitation Counseling in UTEP’s Department of Rehabilitation Sciences.

 

 The WINGS Team is pictured here (from left to right) Carmaleta McQuay, Gladys Monroe, Stephynne Stevens, Vickie Farris, Andrea Hall, and Joe Cordova.

  

 

Positive Deviance (PD) is an approach to solving complex health and social issues, which “flips” this traditional research question on its head. Instead of asking “What factors predict poor outcomes?” PD asks, “Are there individuals in the community with x, y, and z risk factors, who are successfully navigating these issues without additional resources?” PD aims to uncover solutions that are hidden in plain sight, and ultimately amplify these solutions to produce programs that can be offered to the larger community to produce positive change.

The PD approach assumes that within every community lie individuals or groups whose uncommon behaviors and strategies enable them to find better solutions to problems than their peers although everyone has access to the same resources and faces the same challenges (Pascale, Sternin, & Sternin, 2010). These outliers are deviants because their uncommon behaviors are not the norm; they are positive deviants because they have found ways to effectively address the problem, while most others have not (Singhal, 2013). Application of PD inquiry to health has opened the door to a new way to approach and solve complex problems in the healthcare industry (Singhal, Buscell, & Lindberg, 2010; Singhal, Buscell, and Lindberg, 2014).

PD was successfully used to improve the nutritional status of children in several settings in the 1990s (Bolles, Speraw, Berggren, & Lafontant, 2002; Sethi, Kashyap, Seth, & Agarwal, 2003; Sternin, Sternin, & Marsh, 1997; Sternin, Sternin, & Marsh, 1999). To date, the PD approach has been employed in over 40 countries to solve a host of social and health problems from solving endemic malnutrition in Vietnam, to preventing the spread of hospital-acquired infections in the U.S. A recent study in the Netherlands identified positive deviance practices that enhanced psychological resilience among students of Rotterdam’s VMBO schools who hailed from lower socio-economic backgrounds and minority immigrant groups (Bouman, Lubjuhn, & Singhal, 2014).

Despite valiant efforts within the field of psychiatric rehabilitation to improve the employment rate for individuals with psychiatric disabilities, the sober fact remains that 33.5% of individuals with disabilities in the United States are employed, versus 76.3% of individuals without disabilities (Erickson, Lee, & von Schrader, 2014). Health professionals often struggle with the challenge of finding solutions to complex problems presenting barriers to health, wellness, and quality of life. Traditionally, we approach these issues by asking, “What risk factors are associated with poor outcomes?” Once these factors are identified, we use this data to design solutions to remedy the problem. The Oklahoma Department of Rehabilitation Services, in partnership with Dr. Arvind Singhal (University of Texas at El Paso), Ms. Lauren Perez (PD Ambassador), and Dr. Kristin Kosyluk (University of South Florida, formerly at UTEP) used PD to address this intractable problem.

Monograph reporting on this project:

Singhal, Perez, & Kosyluk (2019). Finding Employment for Clients with a Mental Illness: A Positive Deviance Inquiry at the Oklahoma Department of Human Services. Social Justice Initiative, Department of Communication The University of Texas at El Paso, 6.

The free Kindle version of the monograph describing this project can be accessed on Amazon.