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Completed Research

Research Studies

The research studies below were funded by the US Department of Education, National Institute on Disability and Rehabilitation Research, and the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration (NIDRR grant H133B090018).  The research does not necessarily reflect the views of the funding agencies and you should not assume endorsement by the Federal Government.

The Transition to Adulhood Center for Research (Transitions ACR) focuses on the school-to-work transition for transition age youth and young adults with serious mental health conditions, thus our studies inform interventions that support successes in this critical transition.  Because this field of research is in its infancy there is little research upon which to base the design of new interventions. Additionally, system issues often present many barriers to offering appropriate interventions for this population. Thus, part of our research framework is to conduct studies that simultaneously contribute to intervention development from three approaches;

  1. population studies of transition age youth and young adults with serious mental health conditions and their circumstances,
  2. studies of systems in which interventions are placed, and
  3. direct studies of interventions themselves

Our studies also reflect recognition that within the school-to-work transition there are many smaller and often overlapping steps. Therefore this program of research examines two stages of education/training:

  • completion of secondary education and postsecondary schooling/training, and
  • two stages of employment: initiation of work life, and establishment of work life

Feasibility Study for Demonstration of Supported Education to Promote Educational Attainment & Employment among Individuals with Serious Mental Illness

PI: Marsha Ellison, PhD

Co I: Kathleen Biebel, PhD

Time Frame: 9/1/2014 - 9/30/2015

Funded By:  Office of the Assistant Secretary of Planning and Evaluation (ASPE), US Department of Health and Human Services to RTI, International

Description:
This project was designed to characterize the current state of knowledge about Supported Education as a way to assess the feasibility of conducting a demonstration of SEd for individuals with serious mental illness. This project sought to identify key considerations in planning and preparing for a larger-scale demonstration of SEd by compiling evidence on SEd programs, identifying gaps in the knowledge base about SEd, and describing possible approaches for addressing unanswered questions about SEd. The project focused on answering a series of research questions about SEd program composition, implementation, service context, the experiences of individuals involved in SEd programs, available SEd data sources and ongoing evaluations, SEd policies, financing, and gaps in the SEd knowledge base. Three key tasks were associated with this project: (1) a literature review; (2) an environmental scan of SEd researchers, program managers, and other key informants; and (3) site visits to three programs implementing SEd service delivery models. The final project report includes chapters describing the results from each task, as well as a final synthesis chapter that identifies future SEd needs and opportunities.

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Report

Feasibility Study for Demonstration of Supported Education to Promote Educational Attainment and Employment among Individuals with Serious Mental Illness: Final Report
June, 2015
Marsha Ellison, Sloan Huckabee, Michelle Mullen, Rachel Stone, Judy Thompson

Issue Brief

Supported Educaton (SEd): State of the Science
November, 2016
Shums Alikhan, Deirdre Logan, Marsha Ellison, Kathleen Biebel

Specifying the Maryland Transition-age Youth Program Model

PI: Mason Haber, PhD
Project Coordinator: Lauren Davis, BA
Time Frame: 5/1/15 - 9/30/15
Funded By: SAMHSA Prime 14-027G / subaward 101846D from University of Maryland

Description:
The project was designed to assist the Maryland Behavioral Health Administration in efforts to specify its statewide model for serving transition-age youth and young adults with serious mental health conditions as developed through its federally funded Healthy Transition Initiative (HTI) and locally funded programs for the population. The Maryland Model included an array of core services delivered to all youth and young adults, including person-centered planning, intensive case management, and skills training activities, as well as ancillary evidence-based psychiatric rehabilitation interventions delivered to address needs of individual youth where indicated, including interventions to assist with employment,
education, and independent living in the community as well as treatment for specific psychiatric and co-occurring disorders.  Activities included a synthesis of the current literature and expert panel reviews of best practices for the population, site visits to collect data on current HTI-funded sites, and development of a manual and fidelity instrument to help Maryland better describe and assess implementation of its model.

Support of Schooling & Early Employment in Justice-System Involved Emerging Adults

The goal of this study was to complete the early steps of the scientific process of establishing a vocational support model for transition age youth and young adults (TAYYA) with juvenile or criminal justice system histories. The study  conducted the feasibility work for developing a “Life Coaches” vocational support component to address the vocational needs of TAYYA with serious mental health conditions and a recent arrest or release from incarceration. Consumer input on how to modify the already existing “Life Coach” adaptation of Multisystemic Therapy (MST; Henggeler, 1996) guided this research. The study specified the adaptations in a manual, develop a fidelity measure, examine the ability of the intervention to recruit and retain clients, and conducted a pilot randomized control trial. 

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Manuals

Trauma Pamphlet

Presentation Slides

Multisystemic Therapy for Emerging Adults (MST-EA): Treating Emerging Adult Offenders who have Mental Health Conditions
March 3, 2014
Maryann Davis, Ashli Sheidow, and Michael McCort

Using LIfe Coaches to Provide Vocational Support to Emerging Adults
March 6, 2012
Maryann Davis and Ashli Sheidow

Individual Fidelity Measure Development for Multisystemic Therapy for Emerging Adults
March 6, 2012
Maryann Davis and Ashli Sheidow

Multisystemic Therapy for Emerging Adults: Recidivism Reduction for Those with Mental Illness
March 21, 2011
Ashli Sheidow, Maryann Davis, Charles Lidz, and Michael McCart

Appealing Features of Vocational Supports for Latino and non-Latino TAYYA

The goal of this study was to provide information to help form a better foundation for the next version of culturally informed employment programs for transition age youth and young adults (TAYYA) with serious mental health conditions with a particular focus on Latinos.The qualitative study investigated consumer perspectives concerning what programmatic, cultural, developmental and contextual factors encourage participation in three prominent adult employment support models (Clubhouses, IPS programs, or vocational rehabilitation delivered through state agencies of VR) among Latino and Non-Latino (TAYYA) with serious mental health conditions. In many cases, the qualitative interviews were conducted by trained TAYYA consumers working as Project Associates on the RTC.

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Research Brief

Supported Employment Adapted for Young Adults With Peer Mentors: A Feasibility Study 

Presentation Slides

Transition Aged Youth and Young Adult (TAYYA) Men and Women with Serious Mental Health Conditions and Vocational Rehabilitation
March 22, 2011
Rosalie Torres Stone and Lisa Smith

Young Adult Employment and Mental Health (YEAS) Study
March 6, 2012
Rosalie Torres Stone

Journal Article

Appealing Features of Vocational Support Services for Hispanic and non-Hispanic Transition Age Youth and Young Adults with Serious Mental Health Conditions
Torres Stone, R., Delman, J., McKay, C., & Smith, L. M. (2015). Appealing features of vocational support services for Hispanic and non-Hispanic transition age youth and young adults with serious mental health conditions.  The Journal of Behavioral Health Services & Research, 42, (4) 452-465.

Poster

The Role of Supportive Relationships in Finding and Keeping a Job: A Study of Transition Age Youth and Young Adult Mental Health Consumers Enrolled in Vocational Support Programs
Rosalie A. Torres Stone, PhD, Lisa M. Smith, BA, Jonathan Delman, JD, MPH, PhD, Jennifer Whitney, Amanda Costa, and Alicia Dinn

Program Factors that Enhance or Deter Innovative Approaches to Improve Child & Adult mental Health Services Coordination

The goal of the study was to provide information to enhance future innovative efforts to improve child-adult mental health systems coordination. This study examined mental health (MH) programs to identify program-based risk markers for poor child-adult MH program coordination and malleable factors in programs that do and do not have good child-adult coordination. The study used social network analysis, an innovative services research method, to measure child-adult MH service coordination. Risk markers and malleable factors from the perspective of key stakeholders within child and adult MH providers were assessed. The study was conducted in one of the states that received a Substance Abuse and Mental Health Services Administration Healthy Transitions grant to improve services for transition age youth through improved service provision and infrastructure change 

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Presentation Slides

Measuring Collaboration between Child and Adult Serving Programs
March 24, 2015
Maryann Davis, Nancy Koroloff, Kathryn Sabella, and Marianne Sarkis

Assessing Coordination Between Child and Adult Mental Health Systems
March 24, 2013
Nancy Koroloff, Maryann Davis, and Kathryn Sabella

Interdisciplinary Collaboration and Connections Between Child and Adult Programs
March 6, 2012
Maryann Davis, Nancy Koroloff, and Kathryn Sabella

Webinar Slides

Collaboration Between Child and Adult Programs in Systems for Transition Aged Youth
May 20, 2015
Maryann Davis, Nancy Korololoff, Kathryn Sabella and Marianne Sarkis

Adapting Evidence-Based Supported Employment for Transition Age Youth

This study begins to develop a supported employment model tailored for transition age youth and young adults (TAYYA) with serious mental health conditions. This was a feasibility study of an adaptation to the Individualized Placement and Support (IPS) model, which is an evidence-based supported employment approach for adults with serious mental health conditions. This adaptation for TAYYA builds on a previous adaptation of IPS that is a combined Supported Employment-Supported Education (SE/SEd) model for use with adults with first episode psychosis, who are typically young adults.  The TAYYA adaptation adds a peer mentoring component to the SE/SEd IPS model.  Feasibility work included manual development, a small trial to work out clinical issues, then a small pilot study to assess the clinical approach, research design, and the appropriateness of the research measures.

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Research Brief

Supported Employment Adapted for Young Adults With Peer Mentors: A Feasibility Study 

Tip Sheet

Making it Work: Vocational Peer Mentors for Emerging Adults with Serious Mental Health Conditions 

Presentation Slides

Vocational Peer Mentors: Perspectives of Early Emerging Adults with Serious Mental Health Conditions
March 3, 2014
Vanessa Vorhies, Kathryn Sabella, Marsha Ellison, and Marc Fagan

PRA Recovery Workforce Summit: 2014 Annual Conference: Adapting the Individual Placement and Support (IPS) Model of Supported Employment for Early Emerging Adults with Serious Mental Health Conditions
June 22-24, 2014
Marsha Ellison, Mark Fagan, and Vanessa Vorhies-Klodnick

Supporting the Education and Employment of Transition Aged Youth and Young Adults with Serious Mental Health Conditions: Results from 3 studies by the Transitions RTC
April 2014
NARRTC 36th Annual Meeting and Conference
Marsha Ellison

Adapted IPS Supported Employment for Transition Age Youth
March 24, 2013
Marc Fagan and Susan Kaiser

The Nuts, Bolts and Lessons Learned from the Implementation of the Adapted IPS Model
March 24, 2013
Vanessa Klodnick and Susan Kaiser

Evaluation of the Adapted IPS Model
March 24, 2013
Marsha Ellison, Susan Kaiser, and Izabella Krzos

Adapting and Implementing IPS Supported Employment for Transition Age Youth
March 21, 2011
Maryann Davis, Rochelle Frounfelker, Marc Fagan, Susan Kaiser, and Vanessa Vorhies

Webinar

Transitions RTC Research Webinar Series: IPS Supported Employment for Young Adults with Serious Mental Illness: Four RCTs
May 7, 2013
Gary Bond, Dartmouth Psychiatric Research Center

Adapting IPS for Young Adults: The Thresholds Study 
Aug 13, 2015
A webinar by  Marsha Ellison, Gary Bond, and Vanessa Vorhies-Klodnick
Transcript

Journal Articles

Adapting Supported Employment for Emerging Adults with Serious Mental Health Conditions
Abstract
Ellison, M. L., Klodnick, V. V., Bond, G., Krzos, I. M., Kaiser, S. M., Fagan, M. A. & Davis (2015). Adapting supported employment for emerging adults with serious mental health conditions,The Journal of Behavioral Health Services & Research, 42(2), 206-222.

Perspectives of Young Emerging Adults with Serious Mental Health Conditions on Vocational Peer Mentors
Abstract
Klodnick, V. V., Sabella, K., Krzos, I. M., Brenner, C., Kaiser, S. M., Ellison, M. L, Davis, M. & Fagan, M. A. (2014). Perspectives of early emerging adults with serious mental healthc on vocational peer mentors. Journal of Emotional & Behavioral Disorders, 1-12. doi: 10.1177/1063426614565052

Supported Employment/Supported Education Fidelity Scale for Young Adults with Mental Health Challenges
Frounfelker, Bond, Fraser, Fagan, and Clark. (2014).

 

 

 

Making a Difference in High School

This study sought to identify high school interventions and family and individual factors that are associated with a higher likelihood of high school completion, preparation for employment through post-secondary education and/or training, and post-secondary employment in students with emotional disturbance. The study analyzed data from the National Longitudinal Study-2 (NLTS-2).  The NLTS-2 followed, for seven years, a nationally representative sample of middle and high school students receiving special education in all disability categories, including emotional disturbance, at ages 13-16. It captured key characteristics of the students, their families, their school programs, their experiences, and their secondary and post-secondary school and work outcomes.

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Presentation slides

Longitudinal Transition Outcomes of Youth with Emotional Disturbances
March 6, 2012
Mary Wagner and Lynn Newman

Webinar

Promoting Successful Transitions for Youth with Serious Mental Health Conditions
October 9, 2014
Mary Wagner and Lynn Newman

Journal Article

Accessing Service for Youth with Emotional Disturbances in and After High School
Abstract
Wagner, M., Wei, X., Thornton, S. P., & Valdes, K. (2015).  Accessing services for youth with emotional disturbances in and after high school. Career Development and Transition for Exceptional Individuals.

 

Age-Associated Need, Services, & Outcomes of Participants Enrolled in Supported Education

The goal of this study was to find ways to modify a current supported education program for adults that would result in greater success with transition age youth and young adults with serious mental health conditions.  By adding transition age youth and young adults to an already existing randomized clinical trial of a supported education program for adults with serious mental illness, the study sought to determine how younger adults differ from each other and the older adults (>30) in their needs, use of different intervention components, intervention participation (e.g. duration of intervention), and outcomes.

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Presentation Slides

Supported Education: Interim Results from an RCT
March 6, 2012
Michelle Mullen

Job Seeking Experiences and Employers' Perceptions of TAYYA with Serious Mental Health Conditions

The goal of this study was to provide information that interventions can use to enhance the likelihood of successful, affirming job-seeking experiences among transition age youth and young adults (TAYYA) with serious mental health conditions (SMHC). This innovative qualitative study explored the interaction between employers and job-seeking TAYYA with SMHC with and without justice system records. Researchers interviewed TAYYA to elicit their experiences and outcomes from job-seeking experiences.  Based on these findings they interviewed employers that were representative of the kinds of jobs for which TAYYA apply to elicit their experiences with hiring TAYYA with SMHC,  and processes used to screen job applicants regarding criminal history and other factors.

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Presentation Slides

Practical Issues in Implementing Supported Employment with Young Adults: The Persepective of Employment Specialists
March 3, 2014
Charles Lidz and Lisa Smith

Supporting the Education and Employment of Transition Aged Youth and Young Adults with Serious Mental Health Conditions: Results from 3 studies by the Transitions RTC
April 2014
NARRTC 36th Annual Meeting and Conference
Marsha Ellison

Webinar Slides

The Employment Market for Young Adults with Serious Mental Health Conditions: Barriers and Solutions
February 10, 2015

Poster

The Employment Market for Young Adults with Mental Health Conditions: Obstacles & Innovative Strategies for Implementing Supported Employment
Lisa M. Smith & Charles W. Lidz
Presented at UMMS Dept of Psychiatry Research Day, October 2013  & 2014;
Massachusetts Department of Mental Health Centers of Excellence Conference, 2014

Young Adults as Peer Recovery Workers: Perspectives of Workers and Supervisors

Young adults (between ages 18-30) with mental health conditions experience high rates of unemployment, even though a majority of them want to work and have careers. Like their age-related peers, they perceive employment and career development as opportunities to be self-sufficient and become valued members of society. Unfortunately, research has not identified any vocational intervention and support that effectively promotes these employment outcomes. 

Young adults with mental health conditions are increasingly finding rewarding work as peer recovery workers/mentors (PRW). PRW is a general term referring to people in recovery from mental health and/or addictions issues who use self-disclosure to provide people with direct emotional support, aid in developing a recovery plan, and help navigating the health system. Employment as PRWs appear to introduce young adults PRWs to various career paths, as evidenced by those who have moved on to different jobs in mental health (as a peer or not), other health-related jobs, and/or higher education. 

 

Transition Age Youth Psychotherapy Experiences Study (TYPE)

PI: Maryann Davis, PhD 

Project Director: Kathryn Sabella, MA

Time Frame: February 1, 2015 - January 31, 2016

Funded By: University of Massachusetts Medical School Department of Psychiatry - SHINE Collaborative Research Program, Internal Funds

Description: 
This study will investigate the relationship of treatment attrition (TA) to factors that are the intermediate targets of the major existing adult TA interventions, and factors that likely contribute either uniquely or more strongly to TA in young adults than mature adults. The study will examine differences in treatment expectations, psychological distress, therapeutic alliance, self-determination, and social network stigma between young adults who are low and high attenders in outpatient psychotherapy from outpatient psychotherapy clinics in Massachusetts.

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Poster

Transition Age Youth Psychotherapy Experiences (TYPE) Study
March 2017 
Kathryn Sabella, Amanda Costa, Tania Duperoy & Mark Salzer

Helping Youth on the Path to Employment (HYPE 1.0)

PI: Michelle Mullen
Co-PI:
Marsha Ellison
Project Director: Kathryn Sabella
Time Frame: October 1, 2012 to March 30, 2018
Funded by: National Institute on Disability, Independent Living, and Rehabilitation Research, United States Department of Health and Human Services (NIDILRR; grant number A-90DP0063 ). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).


Want to learn more about HYPE?  Click here


Description:  
A Manual and Training Program to Promote Careers among Transition Age Youth and Young Adults with Psychiatric Conditions    

The Rutgers University Department of Psychiatric Rehabilitation and Counseling Professions and UMass Medical School Transitions Research and Training Center (RTC) will be developing an innovative career development intervention, Helping Youth on the Path to Employment (HYPE). HYPE will be delineated and refined into a manual and training program to integrate Supported Education (SEd) with Supported Employment (SE) and other vocational services in order to adequately support transition age youth and young adults (TAYYA) with psychiatric conditions in achieving self-sufficient lives. In collaboration, both organizations are uniquely positioned to develop this intervention and the accompanying manual to assist SE services in integrating employment and educational supports. Such an approach will anticipate common barriers and issues these individuals face, including the development of adequate supports for all of their vocational goals. The new manualized HYPE intervention will address the specific needs of TAYYA by helping them to positively launch their careers and develop an early employment history. The integration of educational pursuits with SE is integral, as it is relevant to this developmental period in which it is common for TAYYA to pursue both employment and education simultaneously. It is also necessary to prepare them for the demands of today’s workforce, requiring advanced vocational, technical and/or post-secondary education.

HYPE will be a comprehensive, integrated career development intervention for TAYYA with psychiatric conditions that can be implemented across a variety of settings. A manualized model,  that  is  guided  by  a  National  Advisory  Council  (NAC) and  Participatory  Action Committee (PAC) consisting of young adults and youth with lived experiences, will be informed by the findings of four activities of the proposed development program: (1) a scoping literature review; (2) an innovative practices survey; (3) qualitative interviews with TAYYA to learn about the practices that promote career development, obstacles commonly faced, and critical times for service delivery; (4) activity synthesis and consensus conference where all activity findings will be integrated and vetted through the NAC and PAC in order to reach consensus agreement regarding the critical features of career development for TAYYA. After these four activities, the HYPE manual will be created. It is anticipated that the following information will be addressed: strategies for meeting common challenges such as cognitive deficits, substance abuse, and legal involvement, as well as how to integrate SE and SEd interventions that specifically target TAYYA. The manual will also feature a training materials section to prepare staff in providing career development services for young adults and youth.

The last activity will be to conduct a 12-month implementation assessment of the manual.

The implementation will be conducted at SE sites. Practitioner and TAYYA feedback will be collected to further refine the manual in order to prepare for dissemination. In an effort to ensure quality services, a quality assurance tool will be created to measure agencies’ adherence to and use of the manual’s content. A multi-media training platform, including video instruction of how to use the manual, will be developed to accompany the manual in an effort to reduce the need for costly technical assistance during later implementation. Sites will participate in a Community of Practice as a method of providing technical assistance throughout the trial of the manual. Dissemination and knowledge translation activities will occur throughout the grant.

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Presentation Slides

PRA Recovery Workforce Summit: 2015 Annual Conference: Barriers, Supports, and Innovative Services from the Perspectives of Transition Age Youth and Service Providers
June, 2015
Marsha Ellison, Sloan Huckabee, Michelle Mullen, Rachel Stone, Judy Thompson

Innovative Services to Support Learning and Working Goals of Young Adults with Serious Mental Health Conditions
March, 2015
Marsha Ellison, Sloan Huckabee, Rachel Stone, and Michelle Mullen

Webinars 

Helping Youth on the Path to Employment (HYPE)
March 2015
Marsha Ellison, Sloan Huckabee, Rachel Stone, and Michelle Mullen

Publication

Innovative Practices to Support Young Adults with Mental Health Conditions
2017
Rachel Stone, Marsha Ellison, Sloan Huckabee, & Michelle Mullen

Promoting Mental Health in the Transition from College to the Workplace

Title: Promoting Mental Health in the Transition from College to the Workplace 

Time Frame: 12/2/2016-11/30/2017 

Funder: The Jed Foundation (JED) 

Grant: JED Fdn/Promoting Mental Health Trans 

Personnel: Kathleen Biebel, Ph.D., Leonard Levin, M.A. Laura Golden, B.A., & Raphael Mizrahi, B.S. 

Description: The transition from college to the workplace can be a high-risk time fraught with emotional/developmental challenges and stressors that can lead or contribute to mental health problems such as depression. Graduating students who have a positive history of depression may be at particularly high risk of relapse. Moreover, individuals without a history of emotional challenges may experience a first episode of depression as they attempt to navigate this potentially stressful transition.  This project has two aims: (1) to forward our knowledge as a field by developing a rich understanding of the emotional needs of students during the transition from college into the workforce, and (2) to utilize the insights gleaned from Aim 1 to develop a comprehensive framework including a set of recommended practices and considerations that describe how colleges can best emotionally prepare students for the transition out of college and into the workplace.

Read the Press Release Here

Reports

College to Career: Supporting Mental Health
Golden, L., Levin, L., Mizrahi, R., Biebel, K. - 2018

 

Now Is the Time - Healthy Transitions

Now Is the Time - Healthy Transitions

PI: J. Trudeau at RTI International

Project Director: Kathryn Sabella, MA

Timeline: March 2, 2015 - February 28, 2020

Funded by: Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services to RTI International. SAMHSA Contract # 283-12-0608

Description:
The purpose of the NITT-HT program is to improve access to treatment and support services for young and young adults 16–25 years that either have, or are at risk of developing a mental illness or substance use disorder, and are at high risk of suicide. 

The NITT-HT evaluation design will include a proposed Youth Voices Special Study to focus on understanding the role of youth voice in all levels of the system. The substudy, designed and conducted by youth with lived experience, will gather data through focus groups of youth involved in the grant activities at the system change level and service receipt level, and through social media. The substudy will assess experiences of youth involvement in system change and individual-level services from youth perspectives.

The NITT-HT evaluation plan will include multiple ways to understand the development, improvement and expansion of youth/young adult services and supports designed to increase access to care.

Related Products and Materials

Presentation Slides

PRA Recovery Workforce Summit: 2015 Annual Conference: Barriers, Supports, and Innovative Services from the Perspectives of Transition Age Youth and Service Providers
June, 2015
Marsha Ellison, Sloan Huckabee, Michelle Mullen, Rachel Stone, Judy Thompson

Innovative Services to Support Learning and Working Goals of Young Adults with Serious Mental Health Conditions
March, 2015
Marsha Ellison, Sloan Huckabee, Rachel Stone, and Michelle Mullen

Webinars

Helping Youth on the Path to Employment (HYPE)
March 2015
Marsha Ellison, Sloan Huckabee, Rachel Stone, and Michelle Mullen

Additional Resources
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