title: Residential immersive life skills programs for youth with disabilities: service providers' perceptions of change processes.
abstract: BACKGROUND
  Residential immersive life skills (RILS) programs are designed to equip youth with physical disabilities with the foundational life skills required to assume adult roles. The objective was to determine RILS service providers' perceptions of the active ingredients of the intervention change process.
  
  
  METHODS
  Thirty-seven service providers from various disciplines completed measures to assess expertise status and participated in qualitative interviews. Qualitative themes were derived, and similarities and differences in themes were identified for blinded groups of novices, intermediates, and experts.
  
  
  RESULTS
  The three main themes, reflecting change processes, were: (a) creating a supportive program atmosphere with multiple opportunities for learning, (b) using strategies to support, encourage, and engage youth, and (c) intentionally fostering youth experiences of skill development, social interaction, and pride in accomplishment. In contrast to the novices, experts displayed a more holistic perspective and paid attention to higher-order issues such as providing opportunities and enabling youth.
  
  
  CONCLUSIONS
  The findings indicate how RILS service providers work to create a program atmosphere and employ strategies to intentionally foster particular youth experiences. The findings explicate service providers' theories of practice, the intentional design of RILS program environments to bring about client change, and the value of service provider expertise. Implications for Rehabilitation Service providers of youth independence-oriented life skills programs can intentionally create a learning-oriented and supportive program atmosphere by using non-directive, coaching/guiding, and engagement strategies Youth experiences of skill development, shared experience with others, and pride in accomplishment can be cultivated by providing a range of learning opportunities, including choice making, problem-solving, and skill mastery Compared to more novice service providers, experts discussed managing the program conditions and context, creating opportunities for choice and new experiences, and adopting a facilitating and enabling role (coaching and capitalizing on teachable moments).
authors: a Bloorview Research Institute , Toronto , Ontario , Canada.|b Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.
authors: Gillian
authors: G
authors: King
authors: a Bloorview Research Institute , Toronto , Ontario , Canada.|c Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada.
authors: Amy
authors: A
authors: McPherson
authors: a Bloorview Research Institute , Toronto , Ontario , Canada.|b Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.
authors: Shauna
authors: S
authors: Kingsnorth
authors: d CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University , Hamilton , Ontario , Canada.
authors: Debra
authors: D
authors: Stewart
authors: e ErinoakKids Centre for Treatment and Development , Mississauga , Ontario , Canada.
authors: Tanya
authors: T
authors: Glencross-Eimantas
authors: f Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada , and.
authors: Kimberlea
authors: K
authors: Jones-Galley
authors: g Children's Developmental Rehabilitation Program, McMaster Children's Hospital , Hamilton , Ontario , Canada.
authors: Andrea
authors: A
authors: Morrison
authors: e ErinoakKids Centre for Treatment and Development , Mississauga , Ontario , Canada.
authors: Ana Maria
authors: AM
authors: Isihi
authors: d CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University , Hamilton , Ontario , Canada.
authors: Jan Willem
authors: JW
authors: Gorter
keywords: Adolescents; change processes; disabilities; independence program; intervention strategies; life skills; service providers; youth 