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.
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 Emotional disturbance
Populations Male | Female
Outcomes Employment acquisition | Other
NIDILRR Funded No
Research Design Randomized Controlled Trials (RCTs)
Peer Reviewed Yes