A randomized controlled trial of supported employment among veterans with post-traumatic stress disorder | Knowledge Translation for Employment Research Center

Authors:	Diclementi, J. D., Ross, M. K., Mallo, C., & Johnson, S.
Year Published	2012
Publication	Psychiatric Services in Advance
Volume	63
Number	5
Pages	464-470
Publisher	American Psychiatric Association
Background	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.
Purpose	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.
Setting	The setting for the study was the Tuscaloosa Veterans Administration Medical Center.
Sample	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.
Data Collection	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.
Control	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.
Findings	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.
Conclusions	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.
URL	http://www.ncbi.nlm.nih.gov/pubmed/22307881
Disabilities	Emotional disturbance
Populations	American Indian or Alaska Native \| Black / African American \| White / Caucasian \| Male & Female \| Veterans
Outcomes	Employment acquisition
NIDILRR Funded	No
Research Design	Randomized Controlled Trials (RCTs)
Peer Reviewed	Yes

Year Published

2012

Publication

Psychiatric Services in Advance

Volume

63

Number

5

Pages

464-470

Publisher

American Psychiatric Association

Background

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.

Purpose

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.

Setting

The setting for the study was the Tuscaloosa Veterans Administration Medical Center.

Sample

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.

Data Collection

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.

Control

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.

Findings

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.

Conclusions

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.

URL

http://www.ncbi.nlm.nih.gov/pubmed/22307881

Disabilities

Emotional disturbance

Populations

American Indian or Alaska Native | Black / African American | White / Caucasian | Male & Female | Veterans

Outcomes

Employment acquisition

NIDILRR Funded

No

Research Design

Randomized Controlled Trials (RCTs)

Peer Reviewed

Yes