A Job-Specific Social Skills Training program for people with severe mental illness: a case study for those who plan to be a security guard

Aplethora of literature has documented that people with severe mental illness (SMI) lack the social skills and social competence necessary in the workplace which was a hindrance for them to get and keep a job (Cook & Razzano, 2000; Rudrud, Ziarnik, Bernstein, & Ferrara, 1984; Solinski, Jackson, & Bell, 1992; Tsang & Pearson, 2000; Tsang, Lam, Dasari, Ng, & Chan, 2000; Tsang, Lam, Ng, & Leung, 2000; Tsang, 2003). Several research studies have shown that there was a relationship between social skills deficits and poor vocational outcomes in people with SMI (Charisiou, Jackson, Boyle, Burgess, Minas, & Joshua, 1989a & 1989b; Cook & Razzano, 2000; Johnstone, Macmillan, Frith, Benn, & Crow, 1990; Lysaker, Bell, Milistein, Bryson, Shestopal, & Goulet, 1993; Mueser, Salyers, & Mueser, 2001). Previous research indicated that 75% to 90% of adults with SMI are unemployed (Bond, Becker, Drake et al., 2001; Dion & Anthony, 1987; Mueser et al., 2001; Trupin, Sebesta, Yelin et al., 1997; Unger & Anthony, 1984).

In order to help mental health consumers equip the essential social skills necessary in the workplace and facilitate mental health consumers for competitive employment, both foreign and local studies have shown the potential of implementing social skills training in the vocational rehabilitation context (Mueser & McGurk, 2004; Tsang & Pearson, 2001; Tsang, 2003; Wallace, Tauber, & Wilde, 1999; Wallace & Tauber, 2004). Wallace and colleagues (1999) developed a module which focused on workplace fundamentals and aimed to teach people with SMI how to maintain their jobs and facilitate their job adjustment. Tsang and Pearson (1996) developed and validated a conceptual framework to apply social skills training in the context of vocational rehabilitation for people with SMI. The results of randomized clinical trials showed the positive effect of such efforts to facilitate people with SMI in getting and keeping a job (Tsang & Pearson, 2001; Tsang, 2001; Wallace & Tauber, 2004).

Both Wallace et al.'s (1999) and Tsang & Pearson's (1996) models focused only on social skills which are generic in nature and applicable to various types of jobs. According to the conceptual model of Tsang and Pearson (1996), social skills in specific work-related situation are an important part of the core skills for successful employment. Researchers buttressed that tailoring job development and specific skills training for a specific job to the consumer's job preference is the key to improving the vocational outcomes for consumers (Becker, Drake, Farabaugh, & Bond, 1996; Becker, Drake, Bond, Xie, Dain, & Harrison, 1998a; Becker, Bebout, & Drake, 1998b; Cook & Razzano, 2000; Dauwalder & Hoffmann, 1992; Pratt, Gill, Barrett, & Roberts, 2002; Stuve, Erickson, & Spaulding, 1991; Tsang & Pearson, 1996; Tsang & Pearson, 2001; Tsang, Ng, & Chiu, 2002; Twamley, Jeste, & Lehman, 2003). Pratt, Gill, Barrett and Roberts (2002) suggested that effective vocational services for consumers should focus on the consumers' choice and the skills training should be client-centered and specific to the real work situation. However, there is lack of training module to facilitate consumers to equip the social skills specific to a job (Cheung & Tsang, 2005).

Studies (Tsang et al., 2002; Wong, Chiu, Chiu, & Tang, 2001) showed that service-oriented jobs and clerical-related jobs are the major job categories for people with SMI in Hong Kong. According to these two relevant studies (Tsang et al., 2002; Wong et al., 2001) and statistics from the Selective Placement Division of the Hong Kong Labour Department, six jobs (salesperson, security guard, waitperson, cleaning worker, delivery worker, and clerk) were identified as most commonly held by people with SMI in Hong Kong. Cheung and Tsang (2005) selected salesperson as the pioneering project to identify the factor structure of essential social skills for this job and developed a Job-specific Social Skills Training (JSST) module to help consumers gain employment based on their job preferences. Cheung and Tsang's study (2005) has identified the factor structure of essential job-specific social skills that could be used develop relevant training package. A clinical trial bolstered that JSST used together with Work-related Social Skills Training (WSST; Tsang, 2001) to form an Integrated Social Skills Training (ISST) for people with SMI resulted in 70.3% of participants who were successful in getting employment (Cheung & Tsang, under review).

The same methodology was used in this study as demonstrated in Cheung and Tsang's study (2005) to investigate social skills necessary for the post as security guard. Security guard work is considered one of the most popular jobs among mental health consumers in Hong Kong (Tsang et al., 2002; Wong et al., 2001). Literature shows that an array of social skills is important to persons who are working as security guards (Farr, Ludden, & Shatkin, 2002; Stiel, 2001). The job description in O*Net, a computerized database of information on occupations, stated that active listening skills, skills for answering questions and providing information to customers are essential to the work of a security guard (Farr, Ludden, & Shatkin, 2002). Stiel (2001) posited several key points that security guard must learn when interacting with customers, for instance, keeping smile, showing empathy, apologizing for inconvenience, etc. However, the above suggested social skills are not specific and comprehensive enough for rehabilitation purposes. Silva and colleagues (1993) conducted a study and analyzed a small sample of security guards who lived with mental illness, and found that job stress caused by high responsibility and the role of authority may have been a factor affecting the work performance of consumers. They suggested that consumers who are interested in working as security guard could be benefited from realistic information about potential stresses specific to this job.

This study identifies the factor structure of job-specific social skills necessary for security guard. These factors could be used for the development of a JSST program for people with SMI who have a vocational plan to work as security guards.

Method

Participants

A self-administered questionnaire survey was conducted among currently employed security guards in order to identify the factor structure of job-specific social skills required. The respondents for the survey were recruited through convenient sampling. The respondents were security guards who had at least one year of experience working in the residential, commercial, industrial, and public service settings.

Two hundred and forty questionnaires with a cover letter stating the purpose of the survey were distributed. A total of 102 validly completed questionnaires were returned which constituted a response rate of 42.5 percent. Respondents had a mean age of 52.01 (S.D. = 4.70) and working experience of 6.42 (S.D. = 5.44). According to the survey conducted by Nalla (2005) in Singapore, 96% are males and more than 60% of security guards are aged above 50. Demographic data of our sample suggested that the respondents conformed to the norm of security guard in Asian society. The value of the Kaiser-Meyer-Olkin was 0.708 which indicated that the sample size was adequate for a meaningful factor analysis to be conducted. Significant results from the Bartlett's test of sphericity ([c.sup.2] = 3515.137, p < 0.001) further supported the usefulness of factor analysis in the statistical procedure. Table 1 describes the characteristics of the respondents.

Instrument

Questionnaire on Job-specific Social Skills Components (Securirty Guard). A self-administered questionnaire was designed for this study to tap relevant and essential job-specific social skills from the workers' points of view. Items were first gathered by a review of the Vocational Social Skills Assessment Scale (VSSAS; Tsang & Pearson, 2000), literature (Farr, Ludden, & Shatkin, 2002; Hong Kong Labour Department, 2004; Silva, Leong & Weinstock, 1993; Stiel, 2001), and interviews of four rehabilitation professionals, two security guards and two supervisors in the property management sector. As the questionnaire and training program are designed for consumers in Hong Kong and Chinese society, the items were selected based on their relevance to Hong Kong and Chinese culture. A pool of 101 items was generated and screened by the first author who had a master degree in rehabilitation sciences and the corresponding author who had a PhD and is a seasoned researcher in psychiatric rehabilitation. Fifty seven repetitive items were deleted from the pool leaving behind 44 items in the questionnaire.

The 44-item questionnaire was then translated from Chinese to English, and back-translated by another independent translator to ensure that the Chinese and English versions of the items were linguistically equivalent. The respondents were required to read the instructions and rate each item regarding its relevance to security guard on the job using a 7-point Likert-type scale. Rating of 1 indicated "absolutely irrelevant" and 7 indicated "very relevant". The purpose of the questionnaire was to develop a job-specific social skills training program for people with SMI in the field of security guard which was stated as the instructions to the respondents. The respondents were also required to provide basic demographic information and identify any additional job-specific social skills that were important to their jobs.

Pre-testing of the questionnaire with three security guards was conducted to ensure smooth completion by the actual target respondents. The pre-testing subjects were asked to fill in the questionnaire and give feedback as to the meaning and clarity of the wordings and instructions. Responses received showed that the instructions and most of the items in the questionnaire were clear and easy to understand. Some items found to be unclear were revised. The revised questionnaire was pre-tested again with another three security guards and found to be good enough for the purpose and ensure smooth completion by the actual target respondents. The final questionnaire for use with targeted respondents consisted of 44 items on job-specific social skills components needed for the post as security guard.

Procedure

The self-administered questionnaire was sent with a cover letter explaining the purpose of the study. Respondents were asked to send the completed questionnaire back by using the attached envelop within one month.

Data Analyses

Questionnaires found to be incorrectly rated were excluded for analyses. A few questionnaires which contained incomplete items were treated as missing data. The data were then analyzed using the Statistical Package for the Social Science (SPSS) version 11.0. Descriptive statistics were computed for all variables. Based on the rating scores of the 44 items from the respondents, an exploratory factor analysis (EFA) using the varimax rotation was conducted to identify major factors in job-specific social skills. The Kaiser-Guttman rule (eigenvalue greater than one) and the Cattell's scree test were then applied to determine the number of factors to be retained (Gorsuch, 1983).

Results

Exploratory Factor Analysis

A principal components analysis was performed on the 44 items. Eleven factors were indicated with several trivial factors toward the end with eigenvalue greater than 1.0. Cattell's scree test suggested a six-factor solution which accounted for 59.9% of the total variance. Most of the items had factor loading of at least .40 in one of the six factors to which they belonged and had very little overlapping with other factors. By comparing results of similar studies using exploratory factor analysis (Gerber & Prince, 1999; Jette & Portney, 2003; Tsang et al., 2003), the total percentage of variance being explained by the six factors is fairly high (59.9%). The final rotated solution was found to be in good structure and could be meaningfully interpreted (Table 2).

Factor 1: Knowledge and Attitudes. There were nine items within this factor. This factor explained 27.2% of the variance and represented the knowledge and attitudes necessary as a security guard. The alpha coefficient for this factor was .88, and the mean score for this factor was 5.75 (S.D. = .69). Respondents rated this factor as the second in terms of its relevance as to the skills required in property management sector.

Factor 2: Communication in Professional Manners. Ten items were included within this factor. This factor represented the skills needed for a security guard to communicate with others in a professional manner. Some 9.6% of the variance was accounted by this factor. The alpha coefficient was .87, indicating again a high internal consistency within this factor. The mean degree of relevancy among the respondents was 5.72 (S.D. =.59).

Factor 3: Social Skills when Interacting with Customers. Eight items were found belonging to this factor which explained 8.5% of the variance and reflected the social skills needed by a security guard to interact with customers. The alpha coefficient for the total sample was .85, indicating high internal consistency of these items within this factor. The mean degree of relevancy among the respondents was 5.61 (S.D. = .74).

Factor 4: Arrangement of Duties. There were six items within this factor which expounded 5.4% of the total variance. This factor had an alpha coefficient of .85. The mean degree of relevancy among the respondents was 4.93 (S.D. =.86).

Factor 5: Problem Solving Skills. There were five items contained in this factor which are related to the problem solving skills a security guard needs to possess. This factor explained 4.7% of the total variance. The alpha coefficient for the total sample was .83 which implied high internal consistency of the items constituting this factor. The mean degree of relevancy was 6.00 (S.D. = .74). Respondents rated this factor as the most relevant as to the skills required in property management sector.

Factor 6: Skills for Conflict Prevention. There were six items within this factor. This factor explained 4.5% of the variance and represented skills for conflict prevention. The alpha coefficient for this factor was .74 and the mean score for this factor was 5.74 (S.D. =.58).

Discussion

The results of this study suggested a six-factor solution of essential social skills for security guards. The results showed that factor 5 Problem Solving Skills is the most important factor. Items in this factor such as Handle visitors 'recording procedure appropriately, Interact and record information from strangers politely, and Recognize residents clearly to avoid making mistake are regarded as highly relevant. This is consistent with the job description in O*Net (Farr, Ludden, & Shatkin, 2002) and the Hong Kong Labour Department (2004) which stated that skills for making decisions, solving problems, and handling emergencies are essential to good security guards. Stiel (2001) stated that problem solving skills are important to good security guards, especially thinking available alternatives for solving problems and enquiries. Stiel (2001) further suggested that their customer relations could be improved by providing of problem solving skills training. Previous studies in psychiatric rehabilitation found that problem solving is a key element of success in social skills training modules for people with SMI (Liberman, Eckman, & Marder, 2001; Tsang, 2001; Tsang, 2002).

Factor 1 Knowledge and Attitudes ranked second in terms of its importance. Items in this factor such as Endure unreasonable complaints from residents and visitors, Develop good relationship between residents and visitors, Interact with residents with kindly attitude, Understand that residents' are always right, and Handle and answer people's enquiries are regarded as highly relevant. Literature (The Hong Kong Labour Department, 2004; Stiel, 2001) suggested that having positive attitudes and relevant knowledge are important for security guards to develop good relationship with customers.

Factor 3 Social Skills when Interacting with Customers represents basic social skills and behaviours that security guards should be aware of in order to present themselves courteously to customers (e.g., Develop conversation with residents', Open the door and hold the lift for residents actively, Try your best to help residents, etc.) According to information from the Hong Kong Labour Department (2004), qualifications needed to be a security guard included being courteous, friendly and responsible. This is in line with the feedback obtained from respondents of the interview who worked in the property management sector. They opined that security guards should present themselves friendly and politely so as to develop a better relationship with customers.

The results of other factors further alluded to the fact that consumers with a career goal as security guard should pay attention to Communication in Professional Manners, Arrangement of Duties, and Skills for Conflict Prevention. Clinical experiences and literature show that competent security guard should present themselves in professional manners and arrange working schedule and duties accordingly. Skills for conflict prevention are considered relevant component which contributes to working successfully as a security guard.

Development of a Job-Specific Social Skills Training Program (JSST)

Using similar methodology in Cheung and Tsang's study (2005), the six-factor solution and the related items in each factor resulting from this study may be used as the framework for the development of a Job-specific Social Skills Training for mental health consumers who show a preference to work as security guard. In order to better organize the content of the training program, some items and factors have been merged and rescheduled based on their nature and relevance. The training program covers five skill areas which is developed based on the conceptual framework of work-related social skills in psychiatric rehabilitation (Tsang & Pearson, 1996) for individuals with SMI. An Integrated Social Skills Training protocol (ISST; Cheung & Tsang, under review) may be developed which consists of WSST (Tsang & Pearson, 2001) followed by the JSST module. Participants first of all need to receive the ten-session WSST which addresses social skills generic to all kinds of workplace. The JSST module will then be introduced to the participants after its completion (Figure 1).

[FIGURE 1 OMITTED]

With the factor solution, the JSST could be developed to help consumers to be security guards. The training format parallels the hierarchical structure of the constructs of the Work-related Social Skills model (Tsang & Pearson, 1996). The training format of each skill area session follows the standard components of social skills training: warm-up activities, instruction, demonstration, role-play, feedback, and homework assignments (Wallace, Nelson, Liberman, Aitchison, Elder, & Ferris, 1980; Wilkinson & Canter, 1982; Shepherd, 1983). The module will include a trainer's manual, a demonstration video-disc, and a participant's workbook to help participants learn the content. For example, skill area 1 Social Skills when Interacting with Customers will begin with a warm-up activity. A video on poor performance of security guard will be shown to the participants. The video scene will present a security guard interacting impolitely with a customer in a residential building. The security guard was not polite, did not greet residents politely, and did not open the door or hold the lift actively for the residents. After watching the video, participants are required to identify the inappropriate behaviours of the security guard. The training contents and key points necessary to be a good security guard, including being polite to customer, greeting residents or visitors actively, opening the door or holding the lift for residents actively, and active use of non-verbal communication skills, will be presented to the participants through teaching and discussion. A video demonstration of good performance will later be shown to the participants. They are then required to practice the skills through role-play exercise and their performance will be recorded by video-camera. Trainer and participants will give feedback to the role-player afterwards. At the end of the session, homework assignment will be given to them for practice which helps them generalize skills to their daily situations. The homework consists of two tasks. First, participants are required to observe a real-life situation in which a security guard is interacting with customers and rate the performance of the security guard from a customer's perspective with reasons. Second, they have to pair up with other participants to perform a" role-play without trainer's guidance, and report the performance according to a checklist in next session. The training format of skill area one is illustrated by Figure 2.

[FIGURE 2 OMITTED]

The JSST module is packaged in a way that parallels the format of the modules developed at the UCLA Centre for Research on Treatment and Rehabilitation of Psychosis (Liberman, Wallace, Blackwell, Eckman, Vaccaro & Kuehnel, 1993) and could be made available to clinicians and rehabilitation professionals around the world. However, when implementing the module, caution must be taken to its potential cultural sensitivity. Although there have been attempts at adaptation of the training module from the U.S. to Chinese population (Lak & Tsang, 2004), it is suggested that more research should be conducted so as to formulate mechanisms to guide the cultural and linguistic modification of the modules when applied cross-culturally (Tsang, 2001).

A clinical trial bolstered that the Integrated Social Skills Training (ISST) with salesperson module for people with SMI resulted in 70.3% of participants who were successful in getting employment (Cheung & Tsang, under review). If the security guard module is used in ISST, it is expected that the results and vocational outcome of participants would be as positive as Cheung and Tsang's study (under review). In order to evaluate the effectiveness of this new module, another clinical trial is suggested to be conducted in Hong Kong when the training package is ready for use.

Conclusion

A training package of JSST security guard module for people with SMI in Hong Kong is ready to be developed based on the empirical information made available by the present study which has identified the factor structure of essential social skills required by security guard. According to previous experience of Cheung and Tsang (under review) on salespersons, we hypothesize that this package will facilitate mental health consumers to get a job if their preference is on this sector.

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Leo C. C. Cheung

The Hong Kong Polytechnic University

Hector W. H. Tsang

The Hong Kong Polytechnic University

Christopher U. Tsui

The Hong Kong Polytechnic University

Hector W. H. Tsang, Ph.D., Associate Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Horn, Hong Kong. Email: rshtsang@polyu.edu.hk