A randomized controlled trial of supported employment among veterans with post-traumatic stress disorder
|Authors:||Diclementi, J. D., Ross, M. K., Mallo, C., & Johnson, S.|
|Publication||Psychiatric Services in Advance|
|Publisher||American Psychiatric Association|
Post traumatic stress disorder (PTSD) is a potentially disabling mental illness that can cause occupational dysfunction. Although vocational rehabilitation is often prescribed for patients with PTSD, standard vocational services are far from adequate in helping them obtain and maintain competitive employment.
This study is the first to examine the outcome of evidence-based supported employment for veterans with PTSD. Study addressed this gap in the field of rehabilitation research.
The setting for the study was the Tuscaloosa Veterans Administration Medical Center.
Veterans were eligible for the study if they had a diagnosis of PTSD, wee aged 19-60, were eligible for the VAMC Vocational Rehabilitation Program, were currently unemployed, were interested in competitive employment, and were planning to remain in a 100 mile radius of the Tuscaloosa VAMC for the 12-month duration.
Using intent to treat analyses and two tailed tests with significance set at p less than or equal to .05, researchers compared rates of competitive employment, as well as number of weeks , day and hours worked; gross wages earned from all sources; and gross wages earned from competitive jobs.
The VRP followed the standard care in place at the VMC, which included one or more of these components: routine prevocational testing and evaluation for all patients on referral to VRP, vocational rehabilitation therapy and provided a work regimen with monetary incentives, and a transitional work program that included a temporary work experience.
During the 12-month study, 76% of the IPS participants gained competitive employment, compared with 28% of the VRP participants (number needed to treat = 2.07; ?(2) = 19.84, df = 1, p<.001). Veterans assigned to IPS also worked substantially more weeks than those assigned to VRP (42% versus 16% of the eligible weeks, respectively; Mann-Whitney z test p<.001) and earned higher 12-month income (mean ¬± SD income of $9,264 ¬± $13,294 for IPS versus $2,601 ¬± $6,009 for VRP; Mann-Whitney z test p<.001) during the 12-month period.
Veterans with PTSD who received IPS were 2.7 times more likely to gain competitive employment than those who received VRP. Because work is central to recovery, these results should assist stakeholders in planning improved services for veterans with PTSD.
|Populations||American Indian or Alaska Native | Black / African American | White / Caucasian | Male & Female | Veterans|
|Research Design||Randomized Controlled Trials (RCTs)|