Predictors of vocational recovery among young people with first-episode psychosis: Findings from a randomized controlled trial | Knowledge Translation for Employment Research Center

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

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