Predicting client employment outcomes from personal history, functional limitations, and rehabilitation services

Authors: 
Bond, G. R. & Drake, R.
Year Published: 
2000
Publication: 
Rehabilitation Counseling Bulletin
Volume: 
44
Number: 
1
Pages: 
10-21
Publisher: 
Rehabilitation Counseling Bulletin
Background: 

Since the 1950‚ rehabilitation research has been try to find out which variables influence or predict successful employment outcomes for rehabilitation clients. The rationale behind such an investigation is that if we understand the determinants of successful outcomes, we can intervene to increase the likelihood of success for vocational rehabilitation (VR) clients. Consequently, research on the prediction of rehabilitation outcomes has been extensive, including examinations of numerous demographic, psychological, social, and service variables for a wide variety of client populations. The VR process consists of three service phases: (a) referral, (b) diagnostic evaluation and rehabilitation planning, and (c) service provision, all of which lead to some type of vocational outcome at case closure. Despite the fact that rehabilitation outcomes have been extensively researched, very few studies have attempted to assess the predictability of outcomes from variable sets that reflect the multiple phases of the VR service process while controlling for the effects of disability. Ideally, a comprehensive, quantitative investigation of rehabilitation outcomes should include, at minimum, the following data elements: (a) personal history information collected using the application for services form (referral phase), (b) diagnostic information summarized in a functional limitations profile (evaluation and planning phase), and (c) specific rehabilitation services provided to clients as stipulated in the rehabilitation plan. Despite efforts not one single investigation of the prediction of vocational outcomes has been reported in the rehabilitation literature that used data from all three phases of the VR process.This study was the first.

Purpose: 

The purpose of the study was to quantify the major phases of the VR service process, using large samples of clients that enabled control for the influence of disability and statistical analysis of all variables simultaneously, thereby quantifying the VR service system. The research questions were: How much variance in employment outcomes can be explained by three sets of predictor variables that represent the three major phases of the VR service process? Which variables made the largest contributions to the explanation of employment outcomes? The study assessed vocational outcome at closure in two ways (a) Competitively employed clients were compared to clients who were not working, and (b) weekly salary was analyzed for the competitively employed clients.

Setting: 

This study included individuals with disabilities served by the state of Arkansas' vocational rehabilitation agency in various settings.

Sample: 

Participants in this study were 25 predominantly Caucasian (n=18, 72%) females (n=19, 76%) between 18 and 64 years of age.

Data Collection: 

Four sets of variables: personal history, functional limitations, rehabilitation services and employment outcomes were measured. The Scale of Social Disadvantage, was developed to predict competitive employment for VR clients from information collected on the application form. The FAI, a behaviorally anchored, counselor rated tool was used to measure a client's functional limitations and key environmental factors that are relevant to VR service planning. Three categories of rehabilitation service variables were used. Two discrete services were job placement and personal adjustment training. Three aggregate service variables were vocational training, restoration, and maintenance. Two global measures of service intensity were time in rehabilitation and total service costs. Various service variables were excluded from the analysis like counseling, diagnosis, support and transportation. Two criteria related to employment success, competitive employment versus not working. Weekly salary for competitive employment were used. Clients closed in other work statuses (i.e.. workshop, student, homemaker etc.) were excluded from the analysis.
Hierarchical multiple regression analysis was used to assess predictive relationships between the variable representing the 3 phases of VR services and the two employment outcomes. The first set only included the SDD total score. The second set included the SSD score and six FAI factor scales. The third set consisted of the SDD score, the six FAI scales, and the seven rehabilitation service variables. The three sets of variables were used to predict the employment outcomes (competitive employment and weekly wages).

Intervention: 

The intervention was various vocational rehabilitation service types and intensity levels.

Control: 

There was a comparison condition. The study compared outcomes across disability groups.

Findings: 

The combination of personal history items in the Scale of Social Disadvantage predicted competitive employment and salary at closure. Job placement services was by far the greatest contributing factor to achieving competitive employment. The authors expected that Functional Assessment Inventory factors would also predict employment outcomes for VR clients. However, this investigation did not uphold this finding. There was a minimal relationship between functional limitations and employment outcomes.

Conclusions: 

The study supported the following conclusions: 1) competitive employment is more predictable and thus more susceptible to improvement than salary at closure; 2) personal history information constitutes a quantitative basis for calculating an estimate of client case difficulty; 3) job placement services, the most important determiner of competitive employment, should receive greater emphasis in VR counselor education programs; and 4) functional limitations should continue to be evaluated by counselors in conjunction with the VR client diagnostic and service planning phase. The results should be used to improve counselor training and service delivery.

URL: 
http://rcb.sagepub.com/content/44/1/10.full.pdf
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Return to work: A comparison of two cognitive behavioral interventions in cases of work-related psychological complaints among the self-employed

Authors: 
Bogenschutz, M., Rumrill, P. D., Seward, H. E., Inge, K. J., & Hinterlong, P. C.
Year Published: 
2006
Publication: 
Work & Stress
Volume: 
20
Number: 
2
Pages: 
129-144
Publisher: 
Taylor & Francis
Background: 

The effectiveness of two cognitive behavioral interventions in cases of work related psychological complaints (such as anxiety, depression and burnout) among the self employed were investigated. One intervention was conducted by psychotherapists and involved extensive cognitive behavioral therapy (CBT). The other intervention was delivered by "labor experts" and consisted of a brief CBT-derived intervention combined with both individual focused and workplace interventions.

Purpose: 

The purpose of the study was to examine the effects of individual focused and workplace interventions.

Setting: 

The setting for the intervention was either in the persons' homes or workplaces.

Sample: 

The study sample included 122 self employed people who had applied for sickness benefit from an insurance company.

Data Collection: 

Data was collected using scale for psychological complaints, return to work, working conditions and social support.

Intervention: 

The interventions were cognitive behavior therapy, workplace and individual-focused techniques.

Control: 

The comparison condition was cognitive behavioral therapy.

Findings: 

Significant effects on partial and full return to work were found in favor of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition, but no significant interaction effects were found.

Conclusions: 

The results suggest that work resumption should be addressed earlier in individuals receiving CBT.

URL: 
http://psycnet.apa.org/psycinfo/2006-13377-003
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Predictors of referral to supported employment among consumers with co-occurring mental and substance us disorders

Authors: 
Birnbaum, H., Shi, L., Pike, C., Kaufman, R., Sun, P., & Cifaldi, M.
Year Published: 
2009
Publication: 
Community Mental Health Journal
Volume: 
45
Number: 
5
Pages: 
427-438
Publisher: 
American Association of Community Psychiatrists
Background: 

Clinical trials demonstrate that Supported Employment is effective in assisting persons with severe mental illness in obtaining competitive employment. However, little is known about the factors related to consumers decisions to pursue employment, especially for consumers with co-occurring substance and mental disorders.

Purpose: 

This study examines the demographic, socioeconomic and illness characteristics of consumers referred for Supported Employment services. Study examines the following research question: What are the effects of consumers demographic and socioeconomic characteristics, mental health and substance use status, functioning and life status, work history and work interest, and agency organizational characteristics on referral of consumers for Supported Employment services?

Setting: 

Consumers were drawn from Integrated Dual Diagnosis Treatment programs in four community mental health agencies.

Sample: 

Study participants included 113 consumers referred for Supported Employment services and 78 randomly selected non-referred consumers as the comparison group. The criteria for consumers in the intervention group were that: (1) they had been diagnosed with co-occurring substance use and mental illness disorders and were receiving IDDT services; (2) they expressed a desire to engage in competitive employment; (3) they were being referred for Supported Employment services; and (4) they had not previously received Supported Employment services. The sampling criteria for the consumers in the comparison group were that: (1) they had been diagnosed with co-occurring substance use and mental illness disorders; (2) they had not received Supported Employment services in the past; and (3) they did not express an interest in competitive employment.

Data Collection: 

Data for the study was generated through four sources: consumer and provider questionnaires already in use by the study agencies, data collection forms designed specifically for this research project which were completed by case managers and Supported Employment staff at the study agencies, data from agency administrative records, and IDDT and supported employment (SE) fidelity scores from a state-funded training and consultation center. Prior to the beginning of data collection, approval of data collection procedures and consent forms was received from the Case Western Reserve University IRB.

Intervention: 

Individual Placement and Support (IPS) is a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice

Control: 

The comparison was Integrated Dual Diagnosis Treatment programs in four community mental health agencies.

Findings: 

Results suggest that consumers who have past work experience are more likely to be referred to Supported Employment, while consumers who perceive themselves as disabled or who are diagnosed as substance dependent are less likely to be referred to Supported Employment.

Conclusions: 

Future research is needed to obtain a fuller understanding of consumer and agency level barriers to referral to Supported Employment suggested by the current study. First, future studies should use larger sample sizes and include a larger number of agency sites. In order to more fully examine the role of fidelity in impacting referrals to supported employment, future studies should include a larger number of agencies representing a fuller range of fidelity scores, including agencies that have reached and maintained high SE fidelity, than was realized in the present study.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/19768541
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Neurocognitive enhancement therapy with vocational services: Work outcomes at two-year follow-up

Authors: 
Berthoud, R.
Year Published: 
2008
Publication: 
Schizophrenia Research
Volume: 
105
Number: 
1
Pages: 
18-29
Publisher: 
Elsevier
Background: 

Neurocognitive enhancement therapy (NET) is a remediation program for the persistent and function-limiting cognitive impairments of schizophrenia. In a previous study in veterans, NET improved work therapy outcomes as well as executive function and working memory.

Purpose: 

The present study aimed to determine whether NET could enhance functional outcomes among schizophrenia and schizoaffective patients in a community mental health center receiving community-based vocational services.

Setting: 

The study setting was a Community Mental Health Center serving individuals with psychiatric disabilities.

Sample: 

Seventy-seven stable outpatients with diagnoses of schizophrenia or schizoaffective disorder were recruited at a large urban community mental health center. Participants met diagnostic criteria based on the Structured Clinical Interview for DSM-IV (First et al., 1996) from the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association & Task Force on DSM-IV, 1994), conducted by research psychologists, and were eligible if they were clinically stable (i.e., GAF > 30, no housing changes, psychiatric medication alterations, or psychiatric hospitalizations in the 30 days prior to intake). Exclusion criteria included history of traumatic brain injury, known neurological diseases, developmental disability, and active substance abuse within the past 30 days

Data Collection: 

The statistical consultant compared hours worked by condition across quarters over the course of the two-year study using mixed models, repeated measures ANOVAs. Analyses were performed separately for total hours of community-based work activity (transitional and competitive payment combined), and hours of community-based work activity paid exclusively by the employer (competitive payment). Because of significant skew introduced by non-working participants in each quarter, analyses were repeated using ranked data as a nonparametric check of the results. Except where corrected for multiple comparisons, alpha was set at .05 and all tests were two-tailed.

Intervention: 

Patients (N = 72) participated in a hybrid transitional and supported employment program (VOC) and were randomized to either NET + VOC or VOC only. NET + VOC included computer-based cognitive training, work feedback and a social information information-processing group. VOC only also included two weekly support groups. Active intervention was 12 months with 12 month follow-up. Follow-up rate was 100%.

Control: 

The control condition was VOC only.

Findings: 

NET + VOC patients worked significantly more hours during the 12 month follow-up period, reached a significantly higher cumulative rate of competitive employment by the sixth quarter, and maintained significantly higher rates of employment.

Conclusions: 

NET training improved vocational outcomes, suggesting the value of combining cognitive remediation with other rehabilitation methods to enhance functional outcomes.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/18715755
Disabilities: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Fidelity of supported employment programs and employment outcomes

Authors: 
Becker, D. R., Xie, H., McHugo, G. J., Halliday, J., & Martinez, R. A.
Year Published: 
2001
Publication: 
Psychiatric Services
Volume: 
52
Number: 
6
Pages: 
834-836
Publisher: 
American Psychiatric Association
Background: 

Employment is a primary goal for the majority of people with severe mental illness. Recent research shows that supported employment is a more effective approach to vocational rehabilitation for this population than traditional methods. However, supported employment is currently implemented in a variety of ways. Bond, Cook and Razzano, among others, have identified several aspects of vocational services that are associated with good employment outcomes. These factors have been incorporated into a fidelity scale for supported employment.

Purpose: 

The purpose of this study was to identify critical components of a supported employment program that were strongly correlated with competitive employment outcomes in a state mental health system.

Setting: 

The setting was 10 community mental health centers in Vermont.

Sample: 

The study sample included 2,639 individuals aged 18 to 64 years who were diagnosed as having severe and persistent mental illness and who were enrolled in community rehabilitation and treatment programs.

Data Collection: 

The case manager or another staff member completed an employment survey for each eligible client that included questions about competitive employment, average number of hours worked, and number of weeks worked in the last quarter of 1999. This data collection method has been validated by the Mental Health Statistics Improvement Project of the Center for Mental Health Services.
Researchers also visited the ten mental health centers to learn how employment services were provided. For each center, the researchers completed the Individual Placement and Support Fidelity Scale.

Intervention: 

The intervention was supported employment.

Control: 

There was no control or comparison condition.

Findings: 

Higher competitive employment rates were strongly correlated with overall program fidelity and with two program components, namely, providing services in the community as opposed to providing them in the clinic and using full-time employment specialists as opposed to staff with mixed roles.

Conclusions: 

This study provides preliminary validation of an overall supported employment fidelity scale. This pilot study suggests that the supported employment components it measured account for about 50 percent of the variance in competitive employment outcomes. Most of the programs scored in the midrange of the supported employment scale, indicating that there is clearly room for improvement. Studies to determine whether improvements result in better employment outcomes are planned.

URL: 
http://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.52.6.834
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Converting day treatment centers to supported employment programs in Rhode Island

Authors: 
Becker, D. R., Bond, G. R., McCarthy, D., Thompson, D., Xie, H., McHugo, G. J., & Drake, R. E.
Year Published: 
2001
Publication: 
Psychiatric Services
Volume: 
52
Number: 
3
Pages: 
351-357
Publisher: 
American Psychiatric Association
Background: 

Day treatment centers were originally designed to provide "partial hospitalization" for patients with serious mental disorders who required intensive, comprehensive, and multidisciplinary treatment that was unavailable in an outpatient setting. These programs began to develop rehabilitative services, rather than "hospital diversion". However, research indicates that these centers do not assist clients in obtaining jobs in the community. Because of the expense involved in maintaining these centers, they are coming under closer scrutiny. As such, several day treatment centers were successfully converted to supported employment programs.

Purpose: 

The intent of the study was to determine if phasing out day treatment centers in support of supported employment and other activities can be implemented statewide.

Setting: 

Three community day care treatment centers in Rhode Island participated in the study. Two were converted to supported employment programs, while the third remained a day treatment center until after the study was complete, for comparison purposes.

Sample: 

The study sample include 28 day treatment clients with severe mental illness in three community mental health centers.

Data Collection: 

"Participants were assessed at baseline and again at follow-up 30 to 36 months later; follow-up for clients in the converted programs took place 18 months after the conversion was completed. An independent research team conducted the interviews and evaluation." (p. 352)

Intervention: 

The intervention related to conversion of two day treatment centers to ones offering supported employment services.

Control: 

One of the centers remained as a rehabilitative day center.

Findings: 

"Former day treatment clients in the converted centers attained higher rates of competitive employment than those in the comparison group (44.2 percent and 56.7 percent versus 19.5 percent). Other employment outcomes also improved, and hospitalization rates and overall social functioning were unchanged." (p. 351)

Conclusions: 

"This study supports findings of previous studies suggesting that replacing rehabilitative day treatment programs with supported employment programs yields improvements in employment outcomes without adverse effects." (p. 351)

URL: 
http://www.worksupport.com/kter/documents/pdf/ConvertingDayCenters.pdf
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Long-term employment trajectories among participants with severe mental illness in supported employment

Authors: 
Bejarano, V., Quinn, M., Conaghan, P. G., Reece, R., Keenan, A.-M., Walker, D., Gough, A., Green, M., McGonagle, D., Adebajo, A., Jarrett, S., Doherty, S., Hordon, L., Melsom, R., Unnebrink, K., Kupper, H., & Emery, P.
Year Published: 
2007
Publication: 
Psychiatric Services
Volume: 
58
Number: 
7
Pages: 
922-928
Publisher: 
American Psychiatric Association
Background: 

The article describes the evidence in support of supported employment for people with psychiatric disabilities. However, most of the studies are limited to a maximum of a 2-year follow-up period.

Purpose: 

The purpose of the study was to evaluate individual work trajectories and generic work patterns over an eight- to 12-year period through a quantitative analysis. Perceived influences by participants of their work-related behaviors were also examined through a qualitative analysis.

Setting: 

A community mental health center in New England was the setting for two studies. One began in 1990. The second began in 1995.

Sample: 

The sample included 38 with severe mental illness eight to 12 years after they enrolled in supported employment studies.

Data Collection: 

Participants in the two original studies who received IPS services were invited to participate in one follow-up interview in 2004.

A modified version of a semi-structured interview developed of a previous study was used. Participants were asked about of all their work activities, including competitive employment, sheltered work, and volunteer work. The pattern of work was coded by the percentage of months worked, excluding recent work history.

Most questions were closed; however, several open-ended questions were included. The analysis was developed using the grounded theory approach developed by Glaser and Strauss.

Intervention: 

The intervention was supported employment services.

Control: 

There was a matched sample of participants who did not receive supported employment services.

Findings: 

During the follow up period, all participants had worked at least one job. Most jobs were competitive, and most participants worked at competitive jobs. Most people worked less than 20 hours per week for any job they held during the follow up period.

Twenty-seven participants had worked more than half of the follow-up period. 71% of the 38 participants were working at the time of the re-interview. The majority of the jobs were in clerical, service, or sales categories.

The majority of participants received some type of benefits at long-term follow-up.

Conclusions: 

The long-term trajectories of participants in supported employment programs, both vocational and non-vocational, appear to be positive.

URL: 
http://www.worksupport.com/kter/documents/pdf/LongtermEmploymentTrajectories.pdf
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

What predicts supported employment program outcomes?

Authors: 
Becker, D., Whitley, R., Bailey, E., & Drake, R.
Year Published: 
2006
Publication: 
Community Mental Health Journal
Volume: 
42
Number: 
3
Pages: 
303-313
Publisher: 
Community Mental Health Journal
Background: 

Research studies have identified supported employment as an evidence-based approach to helping people with serious mental illness gain competitive employment. A dozen randomized controlled trials comparing supported employment to other vocational interventions such as prevocational training, sheltered work, and transitional employment show that supported employment produces better competitive employment outcomes (average 59% in supported employment vs. 21% in traditional programs) (Bond, 2004a,b; Twamley, Bartels,Becker, & Jeste, 2004; Latimer et al., 2005). Two meta-analyses have yielded similar findings (Crowther, Marshall, Bond, & Huxley, 2001; Twamley, Jeste, & Lehman, 2003).

Purpose: 

Although nearly all state mental health systems have endorsed supported employment services as part of their state mental health plan (Ganju, 2004), few studies address factors that affect access (percentage of eligible people receiving supported employment services) and efficiency (percentage of people receiving supported employment services who are working). The purpose of this study was to determine the extent of differences in access and efficiency and the factors that predict access and efficiency.

Setting: 

The setting included 26 mental health agencies that partner with federal-state vocational rehabilitation programs.

Sample: 

Cross sectional survey of 26 sites that participated in the Johnson & Johnson Dartmouth Community Mental Health Program during January to June 2004.

Data Collection: 

Supported employment supervisors submitted data on: the number of adults served in the mental health agency, case mix, number of full time equivalent staff positions in vocational services, staff turnover, referral rate from VR, timing of eligibility determination, number of clients served.

Intervention: 

The intervention was Supported Employment.

Control: 

There was no control or comparison condition.

Findings: 

Access varied from 2 to 100% and was related to the percentage of supported employment specialists per consumers with serious mental illness served by the mental health agency (funding). Efficiency varied from 7 to 75% and was related to implementation of the critical components of evidence-based supported employment and to the local unemployment rate.

Conclusions: 

To help mental health clients achieve their employment goals, state systems and local programs should address consolidation of resources in supported employment and the quality of implementation of supported employment.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/16532378
Disabilities: 
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Predictors of vocational recovery among young people with first-episode psychosis: Findings from a randomized controlled trial

Authors: 
Baksheev, G. N., Allott, K., Jackson, H. J., McGorry, P. D., & Killackey, E.
Year Published: 
2012
Publication: 
Psychiatric Rehabilitation Journal
Volume: 
35
Number: 
6
Pages: 
421-427
Publisher: 
American Psychological Association
Background: 

A substantial body of knowledge has demonstrated the benefits of the Individual Placement and Support (IPS) model among persons diagnosed with schizophrenia. The IPS model is a form of supported employment that is based on seven key principles, including a focus on securing competitive employment positions, attending to consumers' preferences, and integration with mental health treatment teams (Becker & Drake, 2003). Limited work, however, has examined whether vocational intervention in the early phase of psychosis might also lead to improved vocational outcomes. This is important to consider more fully as the first 5 years following psychosis onset is thought to be a critical period during which the peak levels of disability associated with psychosis emerge (Birchwood & Fiorillo, 2000).

Purpose: 

The purpose of this study was to examine demographic and clinical predictors of vocational recovery among young people with first-episode psychosis who participated in a randomized controlled trial (RCT) investigating the effectiveness of the supported employment model among this population.

Setting: 

The setting was a public mental health clinic in Melbourne Australia.

Sample: 

The study sample included 41 individuals aged 17-25 with mental illness.

Data Collection: 

The study compared Individual Placement and Support and treatment as usual with treatment as usual alone. A series of logistic regression analyses were conducted to assess the predictive power of demographic and clinical factors on vocational recovery.

Intervention: 

The intervention was individual placement and support with regular treatment.

Control: 

The comparison was treatment as usual.

Findings: 

The main finding was that demographic and clinical factors did not significantly predict vocational recovery in the final multivariate analysis. Vocational recovery was solely predicted by participant group. That is, participants who were randomized to receive IPS were over 16 times more likely to secure a competitive employment position or participate in an educational activity during the follow-up period when compared with participants who were randomized to treatment as usual.

Conclusions: 

It is critical that vocational services are introduced as part of an evidence-based, multidisciplinary approach in routine clinical care at early psychosis services. Further replication of these findings is indicated with a larger sample, particularly with the addition of cognitive training interventions to further improve vocational outcomes for young people with first-episode psychosis.

URL: 
http://psycnet.apa.org/journals/prj/35/6/421/
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Work resumption after vocational rehabilitation: A follow-up two years after completed rehabilitation

Authors: 
Ahlgren A, Bergroth A, Ekholm J, Schüldt K
Year Published: 
2007
Publication: 
Work: A Journal of Prevention, Assessment and Rehabilitation
Volume: 
23
Number: 
4
Pages: 
343-354
Publisher: 
IOS Press
Background: 

Sick leave absence and disability have become burdensome both socially and financially. The causes of sickness absence are numerous and so are the factors that, positively and negatively, are associated with successful rehabilitation defined as work resumption after vocational rehabilitation (VR) One of the key factors important for the outcome of VR services is early rehabilitation intervention.

Purpose: 

The primary objective of this study was to evaluate work resumption among individuals that were on sick leave and then participated in VR services. The aim of the follow-up was to assess the stability of the outcome of VR over time and to analyze factors of importance for clients that remained at work.

Setting: 

The setting was various vocational rehabilitation programs.

Sample: 

A review of 815 cases where the clients had taken part in vocational rehabilitation.

Data Collection: 

The data was case outcome reviews.

Intervention: 

The intervention was vocational rehabilitation services.

Control: 

There was no control or comparison condition.

Findings: 

Of the clients studied, 52.4% had attained full working capacity directly after completed VR. The proportion had decreased to 37.4% two years later. One factor that differed between those who resumed work and those who returned to sick leave was the duration of the previous sick-leave period. Those who returned to work had had shorter sick leave, had jobs to return to and had received job training as a vocational rehabilitation measure.

Conclusions: 

The clients with the best chances of being in work two years after completing vocational rehabilitation were those with short sick leave absence, had job training through vocational rehabilitation, between the ages of 16-29 and were employed in industry

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/17522455
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: