Working with schools: What employment providers need to know for successful collaboration

Authors: 
Grunert, B. K., Smucker, M. R., Weis, J. M., & Rusch, M. D.
Year Published: 
2016
Publication: 
Journal of Vocational Rehabilitation
Volume: 
46
Pages: 
355-359
Publisher: 
IOS Press
Background: 

In 2004, the Individuals with Disabilities Education Act (IDEA) mandated that transition services focus on improving academic and functional achievement of students with disabilities. In 2008 report from the National Council on Disability (NCD) highlighted that outcomes were not being accessed in regards to the benefits being provided to youth with disabilities. Additionally, in 2014 the Workforce Innovation and Opportunity Act, addressed the role of Vocational Rehabilitation Services, that were being provided through the states, in relation to supporting youth with disabilities and transition services.

Purpose: 

This paper examines a collaborative transition model and preliminary results of a 5-year study. The study evaluated the effects of embedded employment resources in schools, the impact on agency connections, employment outcomes, and lessons learned. These results were then used as the basis for the National Association of People Supporting Employment First (APSE) Conference and associated workshop. There were three questions that guided the workshop discussions.

Setting: 

One example that was provided looked at the Indiana School-to-Work Collaborative. IN*SOURCE is a parent training and information center in Indiana that provides information to families.

Sample: 

Students with a disability who had difficulties meeting diploma requirements and were hoping to enter the workforce where the primary target of the Collaborative. There were 208 Experimental Sites and 66 Control Sites. Examples of Agencies involved included Vocational Rehabilitation, Employment Providers, Case Management Providers and several others.

Data Collection: 

Implementation and data collection occurred over three years. Metrics measured included number of internships obtained, employment rate for students, and pay.

Intervention: 

There were 7 aspects of the Collaborative that focused on integrating services for students. Some examples include having a single-point-of-contact, participating in internships through the school, and having Benefits Information Network (BIN) liaisons available for students and families.

Control: 

The control sites included districts that did not have employment resources embedded into schools.

Findings: 

Students were more likely to be connected to vocational services when they are embedded within schools.

Conclusions: 

Schools and employment supports should be integrated to offer students with disabilities the most opportunities for success.

URL: 
https://content.iospress.com/download/journal-of-vocational-rehabilitation/jvr872?id=journal-of-vocational-rehabilitation%2Fjvr872
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Methods of a multisite randomized clinical trial of supported employment amount veterans with spinal cord injury

Authors: 
Ownsworth, T., & McKenna, K.
Year Published: 
2009
Publication: 
Journal of Rehabilitation Research & Development
Volume: 
46
Number: 
7
Pages: 
919-930
Publisher: 
Department of Veterans Affairs
Background: 

Baseline data revealed that 65% of the study sample of veterans with spinal cord injury (SCI) who were seeking employment had never been employed postinjury. Nearly half (41%) of this group had received some type of prior vocational rehabilitation. This rate is consistent with veterans with SCI reported for samples in the community of individuals with SCI.

Purpose: 

This article compares evidence-based supported employment (SE) with conventional vocational rehabilitation for veterans with SCI. The researchers hypothesis was that evidence-based supported employment when compared with conventional vocational rehabilitation will significantly improve competitive employment outcomes. The secondary hypothesis was that evidence-based supported employment for veterans with SCI would be more cost-effective than standard care.

Setting: 

The study took place at multiple competitive employment sites versus standard vocational rehabilitation care at various Department of Veterans Affairs medical SCI centers.

Sample: 

Veterans with spinal cord injury consisting of 95% males with an average age of 48.3 years. More than half of the subjects were white, 35.3% African American, 5% Hispanic.

Data Collection: 

All subjects were followed for 12 months with face-to-face interviews every three months to collect data on primary employment variables and secondary outcomes measured. After this initial 12 months, the follow-up period was extended to 24 months at all sites including telephone interviews every three months. MANCOVAs were used to determine treatment group differences over time on the outcome variables (employment index, perceived barriers to employment, level of disability, quality of life, depression, and sustaining care needs), controlling for specified covariates. This included study site, sex, and age.

Competitive employment was as a primary outcome measure and measured every three months. Competitive employment is "community jobs that pay at least minimum wage (directly by the employer to the employee) that any person can apply for, including full-time and part-time jobs." General rehabilitation outcomes were measured at baseline and 3-month follow-up interviews. Standardized measures used included 1) Alcohol Use Disorders Identification test, 2)The Craig Handicap Assessment and Reporting Technique (CHART), 3) VR-36 that measures health-related quality of life in veterans, and 4) The Quick Inventory of Depressive Symptomatology Self-Report.

Demographic variables were also collected such as age, sec, race/ethnicity, employment history, previous levels of income, educational background, legal history, lifetime employment history, vocational services history, duration of SCI, level of SCE, and type of family structure.

Intervention: 

The Spinal Cord Injury Vocational Integration Program uses the principles of evidence-based supported employment. The program integrates vocational services into the SCI continuum of healthcare. The SE principles include 1) integrated treatment, 2) rapid engagement, 3)competitive employment, 4) belief that success is possible regardless of severity or type of disability, 5) ongoing support, 6) veteran preferences, 7) community-based services, and 8)personalized benefits counseling. The investigators spent 4 to 6 months recruiting and hiring staff to provide the evidence-based SE services. All vocational rehabilitation counselors (VRCs) have master's degrees and are certified rehabilitation counselors. Training consisted of 3-day workshop taught by VA faculty. VRCs received ongoing instruction and coaching by a co-investigator who has more than 30 years experience in vocational rehabilitation (VR).

Control: 

The study design was a randomized clinical trial that consisted of an experimental group and a comparison group. Interventional-site subjects were randomized to either the experimental group or the comparison group. Observational sites were selected based on similarity to the intervention site facilities with regards to subjects, communities, and VAMC culture. The observational sites were included because the researchers were considered that veterans and staff at the four intervention sites might be vicariously influenced by veterans and staff involved with the implementation study.

Findings: 

The findings of this study were preliminary. The final enrollment count for the study was 301 subjects. At the time of this publication, 93 participants had reached study completion. Some of the challenges faced included exhausting the study pool earlier than expected, staff turnover, and slow process of culture change within the centers.

Conclusions: 

This article discussed the methods of an ongoing randomized clinical trial of VR approaches among veterans with SCI. Strengths of the study design include repeated measures to evaluate employment across time, inclusion of benefits-counseling, and ongoing fidelity monitoring of the treatment conditions. Before the study, the researchers concluded that there was a lack of attention to identifying or addressing vocational issues in the treatment setting. A culture change occurred such that providers began to introduce and explore the topic. In this study, the recruitment relied on clinical providers' willingness to broaden their definition of rehabilitation to include vocational issues. The preliminary baseline data from this sample showed that the majority (72%) had never been employed postinjury.

URL: 
http://www.rehab.research.va.gov/jour/09/46/7/Ottomanelli.html
NIDILRR Funded: 
Peer Reviewed: 
Yes

Individual placement and support for individuals with recent-onset schizophrenia: Integrating supported education and supported employment

Authors: 
Nygren, U., Markström, U., Svensson, B., Hansson, L., & Sandlund, M.
Year Published: 
2008
Publication: 
Psychiatric Rehabilitation Journal
Volume: 
38
Number: 
4
Pages: 
340-349
Publisher: 
American Psychological Association
Background: 

In recent years, functional outcome has become a very salient target for intervention for individuals with severe mental illnesses. In particular, supported employment has generated substantial research as a means of facilitating return to competitive jobs for individuals with schizophrenia and other severe mental illnesses. This article summarizes the design of an 18-month longitudinal study of IPS in the early course of schizophrenia. Improving and Predicting Work Outcome in Recent-Onset Schizophrenia and discusses the adaptations of the IPS model that were found important for this phase of the illness.

Purpose: 

The purpose of this study was to describe the adaptation of the Individual Placement and Support model of supported employment to individuals with a recent first episode of schizophrenia or a related psychotic disorder.

Setting: 

All study participants were receiving outpatient psychiatric treatment at the UCLA Aftercare Research Program and were participants in the third phase of the Developmental Processes in Schizophrenic Disorders Project.

Sample: 

The study sample consisted of 69 individuals that were recruited from a variety of local Los Angeles area psychiatric hospitals and psychiatric clinics and through referrals from the UCLA outpatient service at the Resnick Neuropsychiatric Hospital at UCLA.

Data Collection: 

A comparison of individuals who were randomized (n=69) to IPS or the Brokered treatment with those who were not randomized (n=18) reveals no statistically significant demographic differences between the two samples. Similarly the randomized individuals did not differ significantly from those who were not randomized in prior illness indicators or symptom severity at screening.

Intervention: 

Given that the vocational goals of persons with a recent onset of schizophrenia often involve completion of schooling rather than only competitive employment, the principles of Individual Placement and Support were extended to include supported education. This extension involved initial evaluation of the most appropriate goal for individual participants, having the IPS specialist working on placement either with the participant or directly with educational and employment settings (depending on permitted disclosure and individual need), and follow-along support that included work with teachers and aid in study skills and course planning as well as typical supported employment activities. Work with family members also characterized this application of IPS.

Control: 

The condition was Vocational rehabilitation through referral to traditional separate agencies(Brokered Vocational Rehabilitation.

Findings: 

A randomized controlled trial is comparing the combination of Individual Placement and Support and skills training with the Workplace
Fundamentals Module with the combination of brokered vocational rehabilitation and broad-based social skills training. Participants in the IPS condition have returned to school, competitive work, and combined school and work with approximately equal frequency.

Conclusions: 

Individual Placement and Support principles can be successfully extended to integrate supported education and supported employment within one treatment program. The distribution of return to school, work, or their combination in this group of individuals with recent-onset schizophrenia supports the view that an integrated program of supported education and supported employment fits this initial period of illness.

URL: 
http://psycnet.apa.org/journals/prj/31/4/340/
Disabilities: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

The effectiveness of skills training for improving outcomes in supported employment

Authors: 
Mueser, K. T., Becker, D. R., & Wolfe, R.
Year Published: 
2005
Publication: 
Psychiatric Services
Volume: 
56
Number: 
10
Pages: 
1254-1260
Publisher: 
Psychiatryonline.org
Background: 

Supported employment for individuals with mental illness is recognized as an evidenced based practice. Although this approach is more successful at assisting individuals with mental illness with gaining and maintaining work, than other traditional means, better outcomes related to job retention is needed.

Purpose: 

The purpose of this study was to evaluate the impact of a supplementary skills training program on employment outcomes for individuals who were receiving supported employment services.

Setting: 

The study took place at an employment support organization that is funded by State vocational rehabilitation.

Sample: 

Thirty five individuals who were enrolled in a supported employment program and had a diagnosis of severe or persistent mental illness participated in the study. Among these individuals, the majority or 80% were men and 97% were non-Hispanic white. About a third or 30% had graduated from secondary education. The mean age was 38 years.

Data Collection: 

Those who consented to participate, completed a Workplace Fundamentals Knowledge Test. Afterwards they were randomly assigned to receive supported employment services alone or to receive supported employment services and the supplementary skills training about workplace fundamentals. Individuals were assigned to the group on an average of 56 days after obtaining a job. Among the 35 participants, 18 received treatment as usual (supported employment services alone) the rest were assigned to the receive the work fundamentals training too. Chi square test and t test indicated no significant difference in the two groups. Workplace knowledge was measured with the Workplace Fundamental Knowledge Test scores at baseline and at nine month intervals. Rates of employment for each month of the study period for individuals who recently went to work was documented by control group and workplace fundamentals group. These rates were compared using a generalized estimating equations analysis. The researchers also compared cumulative time worked, wages earned and job tenure for the first and subsequent jobs held. Mann-Whitney tests were used because that data was skewed. Vocational services used were also analyzed with Mann-Whitney tests.

Intervention: 

The intervention was the supplementary workplace skills training program in SE

Control: 

The control group was the participants who only received supported employment services and did not attend the workplace skills training.

Findings: 

During the study period, participants held a total of 49 different jobs. Forty three percent of the sample worked in the same job during the study period (18 months), others were laid off, fired or quit their jobs. The majority had disclosed their psychiatric disability to their employers. Individuals who attended the workplace fundamentals program received higher scores on the Workplace Fundamentals Knowledge Test than those who did not. Although more individuals who attended the supplementary training were working during the study period this trend was not significant. Earnings and hours worked was not significant either. Both groups used comparable amounts and intensity of employment services. Job tenures for the first job for participants was 331.6 days for workplace fundamentals group and 288.5 for the control group.

Conclusions: 

The workplace fundamentals program may not be an effective addition to supported employment services, but more research is needed.

URL: 
https://www.ncbi.nlm.nih.gov/pubmed/16215191
Disabilities: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Cognitive training for supported employment: 2-3 year outcomes of a randomized controlled trial

Authors: 
McGurk, S. R., Mueser, K. T., & Pascaris, A.
Year Published: 
2007
Publication: 
American Journal of Psychiatry
Volume: 
164
Number: 
3
Pages: 
437-441
Publisher: 
American Psychiatric Publishing
Background: 

Supported employment has been repeatedly demonstrated to improve competitive work outcomes in people with severe mental illnesses such as schizophrenia and bipolar disorder (1). Although strong research supports the effectiveness of supported employment, and efforts are underway to increase access to these programs (2, 3), not all participants benefit from supported employment. Specifically, across most studies between 20% and 40% of patients do not find jobs (4–8), and of those who do, many have brief job tenures that end unsuccessfully, such as being fired for poor work performance. These findings have stimulated efforts to address illness-related impairments that may limit the effectiveness of supported employment for some individuals with severe mental illness.

Purpose: 

To address cognitive impairments that limit the effectiveness of supported employment services for patients with schizophrenia, a cognitive training program, the Thinking Skills for Work Program, was developed and integrated into supported employment services.

Setting: 

The setting was supported employment programs and various places of employment.

Sample: 

The sample included patients with severe mental illness (N=44) and prior histories of job failures who were enrolled in supported employment programs at two sites in New York City. The eligibility criteria was severe mental illness as by the State of New York Office of Mental Health, current unemployment, desire for employment, enrollment in supported employment, history of at least one unsatisfactory job ending (getting fired from a job held less than 3 months or walking off a job without another job in place), and willingness and capacity to provide informed consent.

Data Collection: 

Employment outcomes were aggregated by computing the total number of jobs, hours worked, and wages earned over the entire follow-up period. Potential interactions between site, treatment group, and work were evaluated by performing an analysis of variance (ANOVA), with site and treatment group (supported employment with cognitive training or supported employment alone) as the independent variables and the total number of jobs worked as the dependent variable. A chi-square analysis was conducted to compare the two treatment groups on percentage of patients who obtained work over the course of the follow-up period. Additional analysis was also done to address a variety of data factors.

Intervention: 

Patients with severe mental illness N=44 and prior histories of job failures who were enrolled in supported employment programs at two sites in New York City were randomly assigned to receive either supported employment alone or supported employment with cognitive training. Measures at baseline and 3 months included a brief cognitive and symptom assessment. Work outcomes were tracked for 2–3 years.

Control: 

The comparison condition was supported employment only.

Findings: 

Patients in the supported employment with cognitive training program demonstrated significantly greater improvements at 3 months in cognitive functioning, depression, and autistic preoccupation. Over 2–3 years, patients in the supported employment with cognitive training program were more likely to work, held more jobs, worked more weeks, worked more hours, and earned more wages than patients in the program offering supported employment alone.

Conclusions: 

The findings support the feasibility of integrating cognitive rehabilitation into supported employment programs and suggest that more research is warranted to evaluate the effects of the Thinking Skills for Work Program.

URL: 
http://www.coalitionny.org/the_center/resources/cognitive_remediation/documents/CogTrainingAmJPsychiatry0307.pdf
Disabilities: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Cognitive training and supported employment for persons with severe mental illness: One-year results from a randomized controlled trial

Authors: 
McGurk, S. R., Mueser, K. T., Harvey, P. D., LaPuglia, R., & Marder, J.
Year Published: 
2005
Publication: 
Schizophrenia Bulletin
Volume: 
31
Number: 
4
Pages: 
898-909
Publisher: 
Oxford University Press
Background: 

Individuals with severe mental illness have poor unemployment rates. Past research indicates supported employment can help improve employment rates among this group. However, not all person with severe mental illness have benefited from that model. For example, poor job tenure rates have been reported. Therefore, it is important to try to improve the effectiveness of these programs. One possible way to enhance outcomes may relate to improving cognitive functioning through an intervention such as cognitive training.

Purpose: 

The purpose of this study was to measure the impact of cognitive rehabilitation on employment outcomes among individuals with severe mental illness who had not been successfully employed and were receiving supported employment services.

Setting: 

The study took place at two mental health centers that provided a wide range of services including supported employment.

Sample: 

Participants included 44 individuals with severe mental illness who were receiving services from 2 mental health centers in New York. The majority were males (62%), from a minority like African American (59%), followed by Hispanic (24%) and had a diagnosis of Schizophrenia. The mean age of participants was 31 years and most had relatively low levels of education. Participants were assigned to either the cognitive training and supported employment program or supported employment.

Data Collection: 

Comprehensive employment data were collected the first year. Cognitive and psychological assessments were administered at baseline and three months later.
Diagnostic and background information were retrieved from the participants charts, interviews, and staff reports. Employment outcomes were measured through contact with the participants and staff. Seven different tests were used to measure cognitive functions (i.e.. attention and concentration, psychomotor speed, information processing speed, verbal learning and memory, executive functioning and overall cognitive functioning) at baseline and 3 month follow up.
Psychiatric symptoms were measured with interviews using the Positive and Negative Syndrome Scale. Efforts were made to get follow up employment data for the one year following randomization. Intent to treat analyses of the employment outcomes were conducted on the entire randomized sample that had some follow up data (n=44). The statistical analysis included: x2, t test and analyses of covariance. Due to skewed data Mann Whitney U tests were also used.

Intervention: 

The intervention was cognitive training titled Thinking Skills for Work and supported employment services.

Control: 

The control was supported employment services without cognitive training.

Findings: 

The rate of retention of the cognitive training program was high. The program was successfully implemented at two sites that predominantly served inner city minorities. Participant who received cognitive training showed improvements in several areas over the first 3 months of the study as well as a better overall cognitive functioning score as compared to those who received only supported employment services. They also had higher rates of employment. Notably, this group showed improvements on the PANSS depression scale.

Conclusions: 

The Thinking Skills for Work program may help individuals with severe mental illness with employment. This program was successfully implemented in a challenging inner city setting. More research is needed.

URL: 
https://academic.oup.com/schizophreniabulletin/article/31/4/898/1877695
Disabilities: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

A comparison of competitive employment outcomes for the clubhouse and PACT models

Authors: 
Secker, J., & Membrey, H.
Year Published: 
2006
Publication: 
Psychiatric services
Volume: 
57
Number: 
10
Pages: 
1416-1420
Publisher: 
Psychiatric Services
Background: 

The unemployment rate among individuals with severe mental illness is high, ranging from 67 to 85 percent. Many studies focus on job placement rates without considering job retention. Supported employment programs vary a lot and no single definition exists. Furthermore, the rapid placement guideline may mean that a lack of job readiness may be impacting an individual's success at work. The clubhouse model to employment may be able to help individuals gain and maintain work at higher rates than other approaches.

Purpose: 

The goal of this study was to determine if a clubhouse model could achieve and maintain employment rates comparable to the Program of Assertive Community Treatment model of supported employment.

Setting: 

The study was conducted in Western Massachusetts Genesis Club.

Sample: 

The study sample included 177 individuals who data was collected over a four year time period. All had a diagnosis of bipolar disorder, depression or schizophrenia and were 18 years of age or older. They were not screened for work readiness and interest in work was not required.

Data Collection: 

After acceptance into the study the Positive and Negative Syndrome Scale was conducted. Interviews were also conducted at baseline and then every 6 months over two and half years. Questions related to symptoms, jobs, hospitalizations and more. Program staff tracked job information. Employment data was also provided by staff or through interviews with participants. Each participant was followed for the study period or until he or she exited services. Time based analyses compared weekly employment and job placement rates for participants in each group. Binary employment outcomes were analyzed with generalized estimating equations of the Genmod procedure in SAS with a logit link function. Another group of job based analyses was also conducted to examine average job duration, hours and wages to compare outcomes from participants in the two groups. Spearman rank-order correlations between job duration, hours and wages were estimated to identify potential covariates in the hours and wages test model.

Intervention: 

The intervention was Supported Employment services delivered through Club Houses.

Control: 

The control was Supported Employment services delivered via Program of Assertive Community Treatment (PACT).

Findings: 

The PACT model had a 14% higher job placement rate than the clubhouse model. Participants in either approach maintained weekly employment levels at or exceeding other published reports. On average participants in more than 2 jobs during the study period and worked 20 hours a week. Clubhouse participants remained employed 2 months longer than individuals in PACT, which resulted in a 66% difference in duration.

Conclusions: 

No difference was found in job placement rates between clubhouse and PACT participants over two and half years. Clubhouse participants remained employed for more weeks and earned slightly higher wages than participants in PACT.

URL: 
http://www.fountainhouse.org/sites/default/files/C.%20Schonebaum%20article.pdf
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Supported employment for middle-aged and older people with schizophrenia.

Authors: 
Twamley, E. W., Padin, D. S., Bayne, K. S., Narvaez, J. M., Williams, R. E., & Jeste, D. V.
Year Published: 
2008
Publication: 
American Journal of Psychiatric Rehabilitation
Volume: 
11
Number: 
1
Pages: 
76-89
Publisher: 
Routledge
Background: 

Older people with severe mental illness are frequently assumed to be incapable of returning to work and are not actively recruited to participate in work rehabilitation programs. However, just as healthy older people are working well past traditional retirement age, many older people with schizophrenia want to work. However, very few vocational rehabilitation programs target older clients with psychiatric illness.

Purpose: 

This study examined employment outcomes among adults with schizophrenia or schizoaffective disorder in a 12-month randomized controlled trial comparing two work rehabilitation programs: Individual Placement and Support (IPS; a supported employment model) and conventional vocational rehabilitation.

Setting: 

The setting was an outpatient clinic in San Diego, California and various places of employment.

Sample: 

The study sample included 50 participants,30 men and 20 women who were 45 years or older, had a DSM-IV (American Psychiatric Association, 1994) diagnosis of schizophrenia or schizoaffective disorder, and were receiving their psychiatric care at an outpatient clinic. Twenty subjects were diagnosed with schizophrenia, and 30 were diagnosed with schizoaffective disorder. They were referred by state vocational rehabilitation.

Data Collection: 

The following techniques were used t-tests, chi-square, logistic regression, and repeated measures ANOVA to analyze the data. Alpha for significance was set at p < .05, and all tests were two-tailed. Cohen's d effect sizes to provide estimates of the magnitude of effects was also calculated.

Intervention: 

The intervention was the Individual Placement and Support (IPS) model of supported employment. This a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice.

Control: 

Conventional vocational rehabilitation programs use a train-then-place approach, emphasizing prevocational training classes and volunteer, transitional, or trial employment before seeking competitive work (i.e., employment in the community at prevailing wages).

Findings: 

Compared with Conventional Vocational Rehabilitation, Individual Placement and Support resulted in statistically better work outcomes, including attainment of competitive employment, number of weeks worked, and wages earned. Cohen's d effect sizes for these variables were medium to large (.66-.81). Treatment group predicted future attainment of competitive work, but demographic and clinical variables (e.g., age, gender, ethnicity, education, illness duration, and medication dose) did not predict employment outcomes. Participants who obtained competitive employment reported improved quality of life over time compared to those who did not.

Conclusions: 

These findings suggest that for middle-aged and older clients with schizophrenia, supported employment results in better work outcomes than does conventional vocational rehabilitation. Furthermore, age was not significantly associated with attainment of competitive work. Finally, the therapeutic value of work is reflected in improved quality of life.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/19212460
Disabilities: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual

Authors: 
Kilsby M. S., & Beyer, S.
Year Published: 
2008
Publication: 
The British Journal of Psychiatry
Volume: 
193
Number: 
2
Pages: 
114-120
Publisher: 
Royal College of Psychiatrists
Background: 

Unemployment has economic, social and health implications for individuals with first episode psychosis and schizophrenia. The Individual Placement and Support model of supported employment shows promise for individuals with chronic mental illness. However, there are no randomized controlled trials on use of this approach to assist individuals with first episode psychosis with employment.

Purpose: 

The aim of this study was to look at the effectiveness of the Individual Placement and Support model of supported employment for young people with first episode psychosis.

Setting: 

The setting included a variety of places of employment.

Sample: 

The study sample was made up of 41 individuals, between the ages of 15 and 25 years, with first-episode psychosis.

Data Collection: 

Both groups were assessed at baseline and 6 months after the conclusion of the intervention. Data about demographics, symptoms, diagnosis and functioning was collected for all participants using a variety of measures. These included the Brief Psychiatric Rating Scale, Structured Clinical Interview for the DSM-IV Axis One Disorders, The Quality of Life Scale and Social and Occupational Functioning Assessment Scale. The Supported Employment Fidelity Scale Implementation questions were used to assess the fidelity of the program. Statistical analysis was conducted using SPSS version 14 for Windows.

Intervention: 

The intervention was six months of the Individual Placement and Support model of supported employment along with typical treatment as usual.

Control: 

The control condition was typical treatment as usual.

Findings: 

Participants in the Individual Placement and Support group had better outcomes. These included level of employment, hours worked per week, jobs acquired, and length of time employed. Twenty three participants in the intervention group went to work as compared to only 3 in the control group. The intervention group also reduced reliance on welfare benefits.

Conclusions: 

The Individual Placement and Support Model has the potential to assist individuals with first episode psychosis with employment. More research is needed.

URL: 
http://bjp.rcpsych.org/content/193/2/114
Disabilities: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Rehab rounds: Supplementing supported employment with workplace skills training.

Authors: 
Wang, P., Simon, G., Avorn, J., Azocar, F., Ludman, E., McCulloch, J., Petukhova, M., & Kessler, R.
Year Published: 
2004
Publication: 
Psychiatric Services
Volume: 
55
Number: 
5
Pages: 
513-515
Publisher: 
American Psychiatric Publishing
Background: 

Supported Employment for persons with serious and persistent mental illness has been termed Individual Placement and Support. In two randomized controlled trials clients who received Individual Placement and Support services were more likely to obtain at least one job in the competitive sector and to work more hours, and to have a higher total income than their counterparts who received more traditional types of vocational rehabilitation. However, individual placement and support did not improve the length of time the employed participants kept their jobs.

Purpose: 

The purpose of this report is to present the preliminary results of a randomized comparison of the workplace fundamental skills module's effects on job retention, symptoms, and community functioning when coupled with individual placement and support.

Setting: 

The setting was a community mental health center and various places of employment.

Sample: 

The study sample included 42 individuals with a diagnosed mental health disorders.

Data Collection: 

Data was collected about job acquisition, hours worked, wage and job retention.

Intervention: 

The intervention was Work skills training and Individual Placement and Support.

Control: 

The control condition was Individual Placement and Support only.

Findings: 

Thirty-four individuals, 17 in each group were employed during the project. There was no significant difference in the hours worked or the earnings for the two groups. The control group held significantly more jobs than the group receiving both modalities indicating there was significantly more job turnover in the group that received individual placement and support only.

Conclusions: 

The most relevant finding from the study was the greater job retention among the participants who received the combination of individual placement and support and the workplace fundamental skills module.

URL: 
https://www.researchgate.net/publication/8576628_Rehab_Rounds_Supplementing_Supported_Employment_With_Workplace_Skills_Training
Disabilities: 
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
No