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Day Program Transition: A Life of Purpose

Individuals with a dual diagnosis (chronic mental illness and an intellectual disability) who were denied normative childhood experiences are likely unprepared for the world of work.  The childhood experiences of delivering newspapers, selling raffle tickets for a school fund raiser or operating a lemonade stand all serve to teach critical work adjustment skills.  The challenge for adults with a dual diagnosis is further exacerbated by spending years in an anormative institutional environment.  When combined with the chronic symptoms of their disabilities, employment and volunteering are seldom seen as reasonable options. In this pragmatic presentation, Dr. Tom Pomeranz drives home the point that “work” or expenditure of meaningful effort is the great equalizer.  Tom will share best practice examples of how organizations have designed meaningful work experiences, for this population, through cottage industries, micro-enterprises, mobile work crews and alliances with community businesses.  Most importantly this session provides attendees with the tools to transition programs from a train then place paradigm to a train in place paradigm; a program focused on teaching the skills in the environment where they are to be exercised. As a part of this training, participants will be able to:

  • Explain the implications of Olmstead and its potential impact on sheltered employment programs and traditional adult day programs.
  • Describe the historical evolution of traditional day program services.
  • Explain the limitations of the employment continuum.
  • Define the components of meaningful work.
  • Describe the elements for best practice adult day services.
  • Describe those situations when cottage industries and micro enterprises may be a preferred approach to meaningful employment.


California Endowment Center for Healthy Families and Communities
1000 North Alameda Street
Los Angeles, CA 90012