Journal of Occupational Rehabilitation

, Volume 10, Issue 1, pp 85–98 | Cite as

Workplace Accommodation as a Social Process

  • Lauren B. Gates


Successful sustained employment for people with disabilities is a function of a complex array of factors. Key among these factors is appropriate accommodation at the workplace. Current approaches to accommodation, however, are often unsuccessful. Research suggests that this is due, in part, to the limited view of accommodation as technical changes to the job. An approach to accommodation that does not take into account the social context ignores the consequences of the process on work group morale and individual self-esteem and well-being. This has repercussions for individual job performance, job satisfaction and work retention, as well as overall work group productivity. An intervention was designed to take into account the social nature of the accommodation process and pilot tested with 12 workers who were out on a short term disability leave with a psychiatric diagnosis and their work groups. Based on a psychoeducational model, the intervention educates the work group about what it means to work with a disability, provides a safe environment where the worker with disability and coworkers can share concerns about the impact of accommodation on the group, informs about the accommodation process and specifies strategies to help the worker with disability best meet job requirements. Key intervention components include 1) the development of a disclosure plan since workplace intervention cannot occur without disclosure, 2) a systematic method for identifying the work group members, 3) a formal psychoeducation training that includes the supervisor, identified work group members, and the individual in the work organization who has the authority to approve accommodations, and 4) on-going follow up support to the supervisor and worker with disability. Although generalizability of the findings is limited because of the small sample size and its application only to those with mental health conditions, they support the importance of this approach to employment outcomes for people with disabilities. First, findings suggest that the rehabilitation process cannot stop at placement. Providers must be willing and able to enter the workplace with their clients. This requires providers to take on new roles such as educators, interpreters, negotiators and trainers. Disclosure must lose its status as a taboo topic. Providers and workers with disabilities must come to understand the risks and benefits of disclosure, and, when the decision is made to disclose, must have a formal, structured plan for carrying it out. Finally, workplace intervention must take into account the social context and provide the opportunity for communication and interaction in order to insure the success of the accommodations.

accommodation psychoeducation employment return to work 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Akabas SH, Gates LB. Mental health disorders with workplace consequences: Accommodation through a disability management model. Final Report, Center for Social Policy and Practice in theWorkplace, Columbia University, New York, 1998.Google Scholar
  2. 2.
    Anthony WA, Cohen MR, Farkas MD. Psychiatric rehabilitation. Boston: Boston University, Center for Psychiatric Rehabilitation, 1990.Google Scholar
  3. 3.
    Mancuso LL. Reasonable accommodation for workers with psychiatric disabilities. Psychosoc Rehab J 1990; 14(2): 3–19.Google Scholar
  4. 4.
    Pati GC, Baily EK. Empowering people with disabilities: Strategy and human resource issues in implementing the ADA. Organiz Dynam 1995; 23(3): 52–69.Google Scholar
  5. 5.
    Roessler RT, Gottcent J. The work experience survey: A reasonable accommodation/career development strategy. J Appl Rehab Counsel 1994; 25(3).Google Scholar
  6. 6.
    McFarlin DB, Song J, Sonntag M. Integrating the disabled into the workforce: A survey of fortune 500 company attitudes and practices. Employee Responsibilities and Rights J 1991; 4(2).Google Scholar
  7. 7.
    Holmes GE. The historical roots of the empowerment dilemma in vocational rehabilitation. J Disabil Policy Stud 1993; 4(1): 2–20.Google Scholar
  8. 8.
    Altman BM, Barnatt SN. Moral entrepreneurship and the promise of the ADA. J Disabil Policy Stud 1993; 4(7): 21–40.Google Scholar
  9. 9.
    Akabas SH. Workplace responsiveness:Key employer characteristics in support of job maintenance for people with mental illness. Psychosoc Rehab J 1994; 17(3): 91–101.Google Scholar
  10. 10.
    Peters TJ, Waterman RH. In search of excellence: Lessons from America's best run companies. New York: Harper and Row, 1982.Google Scholar
  11. 11.
    Ouchi W. Theory Z. Massachusetts: Addison-Wesley Publishing Co., Inc, 1981.Google Scholar
  12. 12.
    Habeck RV, Leahy MJ, Chang F, Welch EM. Employer factors related to workers' compensation claims and disability management. Rehab Counsel Bull 1991; 34(3): 210–226.Google Scholar
  13. 13.
    Neff WS. Work and human behavior, 3rd Ed. New York: Aldine, 1985.Google Scholar
  14. 14.
    Kahn RL. Work and health. New York: John Wiley and Sons, 1981.Google Scholar
  15. 15.
    Hester EJ, Decelles P, Planek T. Attitudes of employers and rehabilitation professionals toward employees who become disabled, Topeka, KA: Menninger Foundation, 1988.Google Scholar
  16. 16.
    Mitchell K, LeClair S. Work disability, disability management and the olderworker–Thepolitics of negotiated disability. Final Report, International Center for Industry, Labor and Rehabilitation, Worthington, OH, 1988.Google Scholar
  17. 17.
    Akabas SH, Gates LB. Disability management: Labor management initiatives in early intervention. Final Report, Center for Social Policy and Practice in the Workplace, Columbia University, New York, 1991.Google Scholar
  18. 18.
    Akabas SH, Gates LB. Stress and disability management project. Final Report, Center for Social Policy and Practice in the Workplace, Columbia University, New York, 1993.Google Scholar
  19. 19.
    Gates LB, Akabas SH, Kantrowitz W. Supervisors' role in successful job maintenance: A target for rehabilitation counselor efforts. J Appl Rehab Counsel 1996; 27(3).Google Scholar
  20. 20.
    Kirchner KA, Tanasichuk KA (eds.). The Annual Review of Disability Management 1992. Washington business group on health. Washington D.C.: Institute for Rehabilitation and Disability Management, 1992.Google Scholar
  21. 21.
    Akabas SH, Gates LB, Galvin DE. Disability management: A complete system to reduce costs, increase productivity, meet employee needs and ensure legal compliance, New York: AMACOM Press, 1992.Google Scholar
  22. 22.
    Akabas SH, Gates LB. Planning for disability management: An approach to controlling costs while caring for employees. Scottsdale, AZ: American Compensation Association, 1995.Google Scholar
  23. 23.
    Gates, Lauren B. The role of the supervisor in successful adjustment to work with a disabling condition: Issues for disability policy and practice. J Occup Rehab 1993; 3(4): 179–190.Google Scholar
  24. 24.
    Kadushin A. Supervision in social work. New York: Columbia University Press, 1976.Google Scholar
  25. 25.
    El-Bassel N. Correlates of return to work after an onset of short-term disability among female union members. Employee Assist Q 1996; 12(1): 47–72.Google Scholar
  26. 26.
    Mitchell RE, Moos RH. Deficiencies in social support among depressed patients: Antecedents or consequences of stress? J Health Soc Behav 1984; 25: 438–452.Google Scholar
  27. 27.
    Pearlin LI. et al. The stress process. J Health Soc Behav 1981; 22: 337–356.Google Scholar
  28. 28.
    Cronkite RC, Moos RH. The role of predisposing and moderating factors in the stress-illness relationship. J Health Soc Behav 1984; 25: 372–393.Google Scholar
  29. 29.
    Kasl SB, Gore S, Cobb S. The experience of losing a job: Reported changes in health, symptoms and illness behavior. Psychosom Med 1975; 37: 106–122.Google Scholar
  30. 30.
    LaRocco JM, House J, French JRP. Social support, occupational stress and health. J Health Soc Behav 1980; 21: 202–218.Google Scholar
  31. 31.
    House JS. Work stress and social support. Reading, MA: Addison-Wesley Publishing Company, 1981.Google Scholar
  32. 32.
    Dohrenwend BS, Dohrenwend BP, Dodson M, Shrout PE. Symptoms, hassles, social supports and life events: The problem of confounded measures. J Abnorm Psychol 1984; 93: 222–230.Google Scholar
  33. 33.
    Akabas SH. Mental health program models: Their role in reducing occupational stress. In: McLean A. ed. Proceedings: Reducing Occupation Stress. Cincinnati, OH: National Institute for Occupational Safety and Health pp. 186–195, DHEW-NIOSH Publication #78-140.Google Scholar
  34. 34.
    Mansfield PK, Losi L, Vicary JR, Koch PB. Social support and job satisfaction of female clerical workers. J Employment Counsel 1992; 29: 113–116.Google Scholar
  35. 35.
    Hurlbert JS. Social networks, social circles and job satisfaction, Work Occups 1991; 18: 415–430.Google Scholar
  36. 36.
    Parkes K, Mendham CA, von Rabenau C. Social support and the demand-discretion model of job stress: Tests of additive and interactive effects in two samples. J Vocat Behav 1994; 44: 91–113.Google Scholar
  37. 37.
    Poulin JE, Walter CA. Retention plans and job satisfaction of gerontological social workers. J Gerontol Soc Work 1992; 19: 99–114.Google Scholar
  38. 38.
    Freddolino PP, Heaney CD. Staffing issues in group homes for people labeled mentally ill an empirical investigation of job satisfaction and intention to quit. Adult Resident Care J 1992; 6: Special issue: Group homes for persons labeled mentally ill. 115–129.Google Scholar
  39. 39.
    Himle DP, Jayaratne S, Thyness PA. The buffering effects of four types of supervisory support on work stress. Admin Soc Work 1989; 13: 19–34.Google Scholar
  40. 40.
    Carrell R, Kuzmits FE, Elbert NF. Personnel/human resource management. New York: Macmillan Publishing Company, 1992.Google Scholar
  41. 41.
    Schmidt SH, Meiyman TF, Scholten A, Van Oel DJ, Oort-Marburger D. Factors contributing to job satisfaction following rehabilitation for musculoskeletal impairments. J Occup Rehab 1993; 3(4): 213–222.Google Scholar
  42. 42.
    Mott PE. The characteristics of effective organizations. New York: Harper and Row, 1972.Google Scholar
  43. 43.
    Packard T. Participation in decision making, performance, and job satisfaction in a social work bureaucracy. Admin Soc Work 1989; 13(1): 59–73.Google Scholar
  44. 44.
    Shelton CS, Lipton R. An alternative employment model. Mental Retard 1983; 33(2): 12–16.Google Scholar
  45. 45.
    Vandergoot D. Using natural worksite supports to enhance supported employment outcomes. Albertson, NY: Research and Training Institute, National Center for Disability Services, 1991.Google Scholar
  46. 46.
    Akabas SH, Gates LB. A social work role: Promoting employment equity for people with serious and persistent mental illness. Admin Soc Work, 2000.Google Scholar
  47. 47.
    McFarlane WR. Family psychoeduational treatment. In: Gurman AS, Kniskern DP eds., Handbook of family therapy(Vol 2). New York, NY: Brunner/Mazel, Inc, 1991.Google Scholar
  48. 48.
    Simon, McNeil, Franklin and Cooperman (1991). The family and schizophrenia: Toward a psychoeducational approach. Families in Society: J Contemp Human Serv 1991; 72(2): 323–334.Google Scholar
  49. 49.
    Anderson CM, Hogary GE, Reiss DJ. Schizophrenia and the family. New York: Guilford Press, 1986.Google Scholar
  50. 50.
    Leff JP, Hirsh SR, Gaind R, Rohde, Stevens BC. Life events and maintenance therapy in schizophrenia relapse. Br J Psychiatry 1973; 123.Google Scholar
  51. 51.
    Gates, Lauren B, Akabas, Sheila H, Virginia Oran-Sabia. Relationship accommodations involving the work group: Improving work prognosis for persons with mental health conditions. Psychiatric Rehab J 1996; 21(3): 264–272.Google Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Lauren B. Gates
    • 1
    • 2
  1. 1.Workplace CenterColumbia University School of Social WorkNew York
  2. 2.Workplace CenterColumbia University School of Social WorkNew York

Personalised recommendations