Journal of Occupational Rehabilitation

, Volume 27, Issue 4, pp 498–506 | Cite as

Supported Decision-Making: Implications from Positive Psychology for Assessment and Intervention in Rehabilitation and Employment

  • Hatice UyanikEmail author
  • Karrie A. Shogren
  • Peter Blanck


Purpose This article reviews existing literature on positive psychology, supported decision-making (SDM), employment, and disability. It examines interventions and assessments that have been empirically evaluated for the enhancement of decision-making and overall well-being of people with disabilities. Additionally, conceptual themes present in the literature were explored. Methods A systematic review was conducted across two databases (ERIC and PsychINFO) using various combination of keywords of ‘disabilit*’, work rehabilitation and employment terms, positive psychology terms, and SDM components. Seven database searches were conducted with diverse combinations of keywords, which identified 1425 results in total to be screened for relevance using their titles and abstracts. Database search was supplemented with hand searches of oft-cited journals, ancestral search, and supplemental search from grey literature. Results Only four studies were identified in the literature targeting SDM and positive psychology related constructs in the employment and job development context. Results across the studies indicated small to moderate impacts of the assessment and interventions on decision-making and engagement outcomes. Conceptually there are thematic areas of potential overlap, although they are limited in the explicit integration of theory in supported decision-making, positive psychology, disability, and employment. Conclusion Results suggest a need for additional scholarship in this area that focuses on theory development and integration as well as empirical work. Such work should examine the potential utility of considering positive psychological interventions when planning for SDM in the context of career development activities to enhance positive outcomes related to decision-making, self-determination, and other positive psychological constructs.


Supported decision-making Positive psychology Rehabilitation Employment Disability 



Valuable assistance and comments were received from Peter Blanck and Meera Adya. The research reported here was supported by the U.S. Department of Health and Human Services, Administration on Community Living, Administration on Intellectual and Developmental Disabilities, through Cooperative Agreement #90DM0001-01-00, National Resource Center for Supported Decision Making, awarded to Quality Trust, with a subcontract to the University of Kansas. The research was also supported by the U.S. Department of Health and Human Services, Administration on Community Living, National Institute on Disability, Independent Living, and Rehabilitation Research through Grant 90DP0076-01-00 awarded to Syracuse University with a subcontract to the University of Kansas. The opinions expressed are those of the authors and do not represent views of the U.S. Department of Health and Human Services. This line of study was also supported in part by Grants from the Administration on Community Living (ACL) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), in the U.S. Department of Health & Human Services for the NIDILRR Southeast ADA Center Grant #90DP0090-01-00, the NIDILRR Community Living and Supported Decision-Making DRRP Grant #90DP0076, and the NIDILIRR Americans with Disabilities Act Participatory Action Research Consortium (ADA-PARC) Grant # H133A120008; and, by the Office for Disability and Employment Policy (ODEP), in the U.S. Department of Labor. For additional information on these projects and related funding, see This paper includes results from analysis of secondary data which were not collected by the authors.

Compliance with Ethical Standards

Conflict of interest

Hatice Uyanik, Karrie Shogren, and Peter Blanck declare that they have no conflict of interest.

Formal Consent

For this type of study formal consent is not required.


  1. 1.
    United Nations. Convention on the Rights of Persons with Disabilities. 2008. Accessed 1 May 2017.
  2. 2.
    Glen KB. Supported decision-making and the human right of legal capacity. Inclusion 2015;3(1):2–16.CrossRefGoogle Scholar
  3. 3.
    Shogren KA, Wehmeyer ML, Palmer SB, Forber-Pratt A, Little TJ, Lopez SJ. Causal agency theory: reconceptualizing a functional model of self-determination. Educ Train Autism Dev Disabil. 2015;50(3):251–263.Google Scholar
  4. 4.
    Martinis JG. “The Right to Make Choices”: how vocational rehabilitation can help young adults with disabilities increase self-determination and avoid guardianship. J Vocat Rehabilit. 2015;42(3):221–227.CrossRefGoogle Scholar
  5. 5.
    Shogren KA, Wehmeyer ML. A framework for research and intervention design in supported decision-making. Inclusion 2015;3(1):17–23.CrossRefGoogle Scholar
  6. 6.
    Dinerstein R. Implementing legal capacity under article 12 of the UN Convention on the Rights of Persons with Disabilities: the difficult road from guardianship to supported decision making. Hum Rights Br. 2012;19(2):8–12.Google Scholar
  7. 7.
    Kohn NA, Blumenthal JA. A critical assessment of supported decision-making for persons aging with intellectual disabilities. Disabil Health J. 2014;7(1):40–43.CrossRefGoogle Scholar
  8. 8.
    Blanck P, Martinis JG. “The Right to Make Choices”: the National Resource Center for Supported Decision-Making. Inclusion 2015;3(1):24–33.CrossRefGoogle Scholar
  9. 9.
    Butterworth J, Hiersteiner D, Engler J, Bershadsky J, Bradley V. National core indicators©: data on the current state of employment of adults with IDD and suggestions for policy development. J Vocat Rehabil. 2015;42(3):209–220.CrossRefGoogle Scholar
  10. 10.
    Seligman ME. Flourish: a visionary new understanding of happiness and well-being. New York: Free Press, Simon and Schuster; 2011.Google Scholar
  11. 11.
    Shogren KA, Wehmeyer ML, Singh N. Handbook of positive psychology in intellectual and developmental disabilities: translating research into practice. New York: Springer; 2017.CrossRefGoogle Scholar
  12. 12.
    Wehmeyer ML. The Oxford handbook of positive psychology and disability. Oxford: Oxford University Press; 2013.CrossRefGoogle Scholar
  13. 13.
    Blanck P. The first “A” in the ADA: and 25 more “A”s toward equality for Americans with disabilities. Inclusion. 2016;4(1):46–51.CrossRefGoogle Scholar
  14. 14.
    The Grey Literature Report. What is grey literature? 2017. Accessed 2 Mar 2017.
  15. 15.
    U.S. Department of Labor, Office of Disability and Employment Policy (OSEP). 2017. Customized employment. Accessed 1 Apr 2017.
  16. 16.
    U.S. Department of Labor, Office of Disability and Employment Policy (OSEP). 2013. Self-employment for people with disabilities. Accessed 1 Apr 2017.
  17. 17.
    Brady MP, Rosenberg H, Frain MP. A self-evaluation instrument for work performance and support needs. Career Dev Except Individ. 2008;31(3):175–185.CrossRefGoogle Scholar
  18. 18.
    Lusk SL, Cook D. Enhancing career exploration, decision making, and problem solving of adolescent girls with disabilities. J Vocat Rehabil. 2009;31(3):145–153.Google Scholar
  19. 19.
    Henderson C, Brohan E, Clement S, Williams P, Lassman F, Schauman O, et al. Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial. Br J Psychiatry. 2013;203(5):350–357.CrossRefPubMedGoogle Scholar
  20. 20.
    Mackey M, Nelson G. Twins with autism: utilising video feedback to improve job-related behaviours. Br J Spec Educ. 2015;42(4):390–410.CrossRefGoogle Scholar
  21. 21.
    Escorpizo R, Reneman MF, Ekholm J, Fritz J, Krupa T, Marnetoft S-U, et al. A conceptual definition of vocational rehabilitation based on the ICF: building a shared global model. J Occup Rehabil. 2011;21(2):126–133.CrossRefPubMedGoogle Scholar
  22. 22.
    Soresi S, Nota L, Ferrari L, Sgaramella TM. Career development and career thoughts. In: Wehmeyer ML, editor. The Oxford handbook of positive psychology and disability. New York: Oxford University Press; 2015. p. 239–264.Google Scholar
  23. 23.
    Patton W, McMahon M. Career development and systems theory connecting theory and practice. Rotterdam: Sense Publishers; 2014.CrossRefGoogle Scholar
  24. 24.
    Fritzsche BA, Dhanani LY, Spencer JM. Empowerment through employment: job satisfaction theories and research. In: Strauser DR, editor. Career development, employment, and disability in rehabilitation. New York: Springer; 2014. p. 139–159.Google Scholar
  25. 25.
    Wehman P, Brooke V, Lau S, Targett P. Supported employment. In: Wehmeyer ML, editor. The Oxford handbook of positive psychology and disability. New York: Oxford University Press; 2015. p. 338–364.Google Scholar
  26. 26.
    Palmer C, Schriner K, Getch Y, Main D. Working for yourself: how people with disabilities choose self-employment. J Appl Rehabil Couns. 2000;31(3):30–37.Google Scholar
  27. 27.
    Rizzo DC. With a little help from my friends: supported self-employment for people with severe disabilities. J Vocat Rehabil. 2002;17(2):97–105.Google Scholar
  28. 28.
    Morris M, Rodriguez C, Blanck P. ABLE accounts: a down payment on freedom. Inclusion 2016;4(1):21–29.CrossRefGoogle Scholar
  29. 29.
    Kregel J, O’Mara S. Work incentive counseling as a workplace support. J Vocat Rehabilit. 2011;35(2):73–83.Google Scholar
  30. 30.
    Noel VA, Oulvey E, Drake RE, Bond GR. Barriers to employment for transition-age youth with developmental and psychiatric disabilities. Adm Policy Ment Health Ment Health Serv Res. 2016;44(3):354–358.CrossRefGoogle Scholar
  31. 31.
    Schur L, Kruse D, Blanck PD. People with disabilities: sidelined or mainstreamed? New York: Cambridge University Press; 2013.CrossRefGoogle Scholar
  32. 32.
    Enright MS. The relationship between disability status, career beliefs, and career indecision. Rehabil Couns Bull. 1996;40(2):134–152.Google Scholar
  33. 33.
    Lustig DC, Zanskas S. The relationship between work values and psychological problems for individuals with disabilities. Rehabil Res Policy Educ. 2013;27(4):261–270.CrossRefGoogle Scholar
  34. 34.
    Toth KE, Dewa CS. Employee decision-making about disclosure of a mental disorder at work. J Occup Rehabil. 2014;24(4):732–746.CrossRefPubMedGoogle Scholar
  35. 35.
    Fraser RT, Johnson K, Hebert J, Ajzen I, Copeland J, Brown P, Chan F. Understanding employers’ hiring intentions in relation to qualified workers with disabilities: preliminary findings. J Occup Rehabil. 2009;20(4):420–426.CrossRefGoogle Scholar
  36. 36.
    Pagan-Rodriguez R, Sanchez-Sanchez N. Evidence on the occupational segregation of older people with disabilities in Europe. Disabil Rehabil. 2011;33(25–26):2656–2661.CrossRefPubMedGoogle Scholar
  37. 37.
    Chan F, Wong DW, Rosenthal DA, Kundu MM, Dutta A. Eligibility rates of traditionally underserved individuals with disabilities revisited: a data mining approach. J Appl Rehabil Couns. 2005;36(3):3–10.Google Scholar
  38. 38.
    Phillips BN, Robison LJ, Kosciulek JF. The influence of social capital on starting wage for people with and without disabilities. Rehabil Couns Bull. 2014;58(1):37–45.CrossRefGoogle Scholar
  39. 39.
    Condon E, Callahan M. Individualized career planning for students with significant support needs utilizing the Discovery and Vocational Profile process, cross-agency collaborative funding and Social Security Work Incentives. J Vocat Rehabil. 2008;28(2):85–96.Google Scholar
  40. 40.
    O’Brien D, Ford L, Malloy JM. Person centered funding: using vouchers and personal budgets to support recovery and employment for people with psychiatric disabilities. J Vocat Rehabil. 2005;23(2):71–79.Google Scholar
  41. 41.
    Wehman P, Revell G. Lessons learned from the provision and funding of employment services for the MR/DD population. J Disabil Policy Stud. 2005;16(2):84–101.CrossRefGoogle Scholar
  42. 42.
    Blanck P. eQuality: the struggle for web accessibility by persons with cognitive disabilities. New York: Cambridge University Press; 2014.CrossRefGoogle Scholar
  43. 43.
    Blanck P. eQuality: the right to the web. In: Blanck P, Flynn E, editors. Routledge handbook of disability law and human rights. London: Routledge; 2017. p. 166–194.Google Scholar
  44. 44.
    Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Perilli V, et al. People with multiple disabilities learn to engage in occupation and work activities with the support of technology-aided programs. Res Dev Disabil. 2014;35(6):1264–1271.CrossRefPubMedGoogle Scholar
  45. 45.
    Lysaght R, Ouellette-Kuntz H, Morrison C. Meaning and value of productivity to adults with intellectual disabilities. Intellect Dev Disabil. 2009;47(6):413–424.CrossRefPubMedGoogle Scholar
  46. 46.
    Scott M, Foley K-R, Bourke J, Leonard H, Girdler S. “I have a good life”: the meaning of well-being from the perspective of young adults with Down syndrome. Disabil Rehabil. 2013;36(15):1290–1298.CrossRefPubMedGoogle Scholar
  47. 47.
    Robitschek C, Woodson SJ. Vocational psychology: using one of counseling psychologys strengths to foster human strength. Couns Psychol. 2006;34(2):260–275.CrossRefGoogle Scholar
  48. 48.
    Shogren KA, Wehmeyer ML, Uyanik H, Heidrich M. The development of the Supported Decision Making Inventory System. Intellect Dev Disabilit (in press).Google Scholar
  49. 49.
    Jeste D, Eglit G, Palmer B, Martinis J, Blanck P, Saks E. Supported decision-making by people with serious mental illnesses: an overview. Psychiatry (in press).Google Scholar
  50. 50.
    Woudzia LA. Supported decision-making and positive psychology. Res Pract Intellect Dev Disabil. 2016;4(1):61–68.CrossRefGoogle Scholar
  51. 51.
    Tilson GP. Enhancing cross-agency collaboration through the use of a universal discovery instrument: introducing the Life and Career Assessment Matrix. J Vocat Rehabil. 2016;44(3):257–271.CrossRefGoogle Scholar
  52. 52.
    Flannery KB, Slovic R, Treasure T, Ackley D, Lucas F. Collaboration and partnership to improve employment outcomes. J Vocat Rehabilit. 2002;17(3):207–215.Google Scholar
  53. 53.
    Cramm JM, Finkenflügel H, Kuijsten R, van Exel NJA. How employment support and social integration programmes are viewed by the intellectually disabled. J Intellect Disabil Res. 2009;53(6):512–520.CrossRefPubMedGoogle Scholar
  54. 54.
    Arstein-Kerslake A, Watson J, Browning M, Martinis J, Blanck P. Future directions in supported decision-making. Disabil Stud Q. 2017.
  55. 55.
    Blanck P. Disability in prison. Univ South Calif Interdiscip Law J. 2017;26(2):309–322.Google Scholar
  56. 56.
    Blanck PD. The Americans with Disabilities Act and the emerging workforce: employment of people with mental retardation. Washington, DC: American Association on Mental Retardation; 1998.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Special EducationUniversity of KansasLawrenceUSA
  2. 2.Burton Blatt Institute, Syracuse UniversitySyracuseUSA

Personalised recommendations