210 (210)    MH REPORT (601.93)

|Perceived Employment Barriers Scale (PEBS-27)
|   Gender: <.Patient_Gender.>
|<*Answer_7771*>  
| 
|   The range for the total score and each subscale is 1-5.  
|   Higher scores indicate higher perception of Employment Barriers.
|  
|   If the Veteran completed the Employment Hope Scale (EHS-14) today, you
|   can use that to calculate the Psychological Self-Sufficiency Score by 
|   subtracting the PEBS total score from the EHS total score.
|  
|  
|  
|Questions and Answers:
|  
|   1.  Having less than high school education
|       <*Answer_8665*>
|   2.  Work limiting health conditions (illness / injury)
|       <*Answer_8666*>
|   3.  Lack of adequate job skills
|       <*Answer_8667*>
|   4.  Lack of job experience
|   Date Given: <.Date_Given.>
|       <*Answer_8668*>
|   5.  Transportation
|       <*Answer_8669*>
|   6.  Child care
|       <*Answer_8670*>
|   7.  Racial discrimination
|       <*Answer_8671*>
|   8.  Lack of information about jobs
|       <*Answer_8672*>
|   9.  Lack of stable housing
|   Clinician: <.Staff_Ordered_By.>
|       <*Answer_8673*>
|  10.  Drug / alcohol addiction
|       <*Answer_8674*>
|  11.  Domestic violence
|       <*Answer_8675*>
|  12.  Physical disabilities
|       <*Answer_8676*>
|  13.  Mental illness
|       <*Answer_8677*>
|  14.  Fear of rejection
|   Location:  <.Location.>
|       <*Answer_8678*>
|  15.  Lack of work clothing
|       <*Answer_8679*>
|  16.  No jobs in the community
|       <*Answer_8680*>
|  17.  No jobs that match my skills / training
|       <*Answer_8681*>
|  18.  Being a single parent
|       <*Answer_8682*>
|  19.  Need to take care of young children
|  
|       <*Answer_8683*>
|  20.  Cannot speak English very well
|       <*Answer_8684*>
|  21.  Cannot read or write very well
|       <*Answer_8685*>
|  22.  Problems with getting to job on time
|       <*Answer_8686*>
|  23.  Lack of confidence
|       <*Answer_8687*>
|  24.  Lack of support system
|   Veteran:  <.Patient_Name_Last_First.>
|       <*Answer_8688*>
|  25.  Lack of coping skills for daily struggles
|       <*Answer_8689*>
|  26.  Anger management
|       <*Answer_8690*>
|  27.  Past criminal record
|       <*Answer_8691*>
|  
|Information contained in this note is based on a self-report assessment 
|and is not sufficient to use alone for diagnostic purposes. Assessment 
|   SSN: <.Patient_SSN.>
|results should be verified for accuracy and used in conjuncion with 
|other diagnostic activities.
|
|Copyright @2017 Loyola University Chicago  All Rights Reserved
|   DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)