Fidelity of supported employment: Lessons learned from the National Evidence-Based Practice Project | Knowledge Translation for Employment Research Center

Authors:	Bond, G. R., Peterson, A., Becker, D., & Drake, R.
Year Published	2008
Publication	Psychiatric Rehabilitation Journal
Volume	31
Number	4
Pages	300-305
Publisher	American Psychological Association
Background	As the movement to disseminate evidence-based practices (EBPs) for people with severe mental illness gatherers momentum, providers need guidance about implementing and sustaining high-quality services. The National Evidence Based Practices Project evaluated the implementation of five EBPs across 53 sites in eight states over a two-year period.
Purpose	The purpose of the study was to describe the implementation of supported employment in the National Evidence-Based Practices Project, examining and interpreting fidelity changes over two years of program implementation.
Setting	Nine sites that initially provided vocational services for persons with severe mental illness. Services departed from high fidelity supported employment. All nine sites took prompt action to transform existing vocational services that were contrary to evidence-based supported employment.
Sample	Nine sites, three from each state, implemented supported employment. Eight sites provided mental health treatment, while one was a psychiatric rehabilitation agency that did not offer clinical services. Five sites with in urban areas; four in rural.
Data Collection	Nine new supported employment programs were evaluated by examining supported employment fidelity ratings at baseline and every 6 months thereafter. Site reports based on the nine case studies were used to interpret the fidelity findings.
Control	Comparison conditions varied across the studies. Conditions included Group skills training, enhanced vocational rehabilitation, psychosocial rehabilitation, diversified placement, train-place, sheltered workshop, brokered vocational rehabilitation, and traditional vocational services.
Findings	At two years, eight of nine sites achieved high fidelity. Most changes occurred within the first year. Twelve of the 15 supported employment fidelity items showed rapid improvement.
Conclusions	A review of the site reports suggested four factors that facilitated movement toward high fidelity: (1) Discontinuing non-evidence-based vocational services, (2) Making rapid structural changes through administrative action, (3) Measuring key process indicators to move toward desired changes, and (4) Gradually improving integration of the employment specialists with clinical services, primarily through supervisor leadership.
URL	http://www.worksupport.com/kter/details.cfm
Disabilities	Emotional disturbance
Populations	Hispanic or Latino \| Black / African American \| White / Caucasian \| Male & Female \| Rural \| Urban
Outcomes	Employment acquisition
NIDILRR Funded	No
Research Design	Observational
Peer Reviewed	Yes

Year Published

2008

Publication

Psychiatric Rehabilitation Journal

Volume

31

Number

4

Pages

300-305

Publisher

American Psychological Association

Background

As the movement to disseminate evidence-based practices (EBPs) for people with severe mental illness gatherers momentum, providers need guidance about implementing and sustaining high-quality services. The National Evidence Based Practices Project evaluated the implementation of five EBPs across 53 sites in eight states over a two-year period.

Purpose

The purpose of the study was to describe the implementation of supported employment in the National Evidence-Based Practices Project, examining and interpreting fidelity changes over two years of program implementation.

Setting

Nine sites that initially provided vocational services for persons with severe mental illness. Services departed from high fidelity supported employment. All nine sites took prompt action to transform existing vocational services that were contrary to evidence-based supported employment.

Sample

Nine sites, three from each state, implemented supported employment. Eight sites provided mental health treatment, while one was a psychiatric rehabilitation agency that did not offer clinical services. Five sites with in urban areas; four in rural.

Data Collection

Nine new supported employment programs were evaluated by examining supported employment fidelity ratings at baseline and every 6 months thereafter. Site reports based on the nine case studies were used to interpret the fidelity findings.

Control

Comparison conditions varied across the studies. Conditions included Group skills training, enhanced vocational rehabilitation, psychosocial rehabilitation, diversified placement, train-place, sheltered workshop, brokered vocational rehabilitation, and traditional vocational services.

Findings

At two years, eight of nine sites achieved high fidelity. Most changes occurred within the first year. Twelve of the 15 supported employment fidelity items showed rapid improvement.

Conclusions

A review of the site reports suggested four factors that facilitated movement toward high fidelity: (1) Discontinuing non-evidence-based vocational services, (2) Making rapid structural changes through administrative action, (3) Measuring key process indicators to move toward desired changes, and (4) Gradually improving integration of the employment specialists with clinical services, primarily through supervisor leadership.

URL

http://www.worksupport.com/kter/details.cfm

Disabilities

Emotional disturbance

Populations

Outcomes

Employment acquisition

NIDILRR Funded

No

Research Design

Observational

Peer Reviewed

Yes