Who benefits from supported employment: A meta-analytic study
Authors: | Carolina, H., Ellice, S., Strobel Gower, W. |
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Year Published | 2011 |
Publication | Schizophrenia Bulletin |
Volume | 37 |
Number | 2 |
Pages | 370-380 |
Publisher | Oxford University Press |
Background |
Individual Randomized Controlled Trials (RCTs) of supported employment often have not had sufficient power to examine individual client subgroups. Research is needed that examines the question: Among various subgroups of clients with SMI ( by work history, demographic, and clinical variables), which subgroups benefit from evidence-based supported employment? Alternatively, which subgroups benefit more from brokered stepwise vocational models? |
Purpose |
Meta-analysis sought to identify which subgroups of clients with severe mental illness (SMI) benefited from evidence-based supported employment. |
Setting |
This study is a systematic review. The included studies were undertaken in various locations and settings. This included mental health programs in Washington DC, Hartford CT, Concord and Manchester N.H,, and Chicago IL. |
Sample |
The sample consisted of study participants from 4 RCTs of IPS vs usual services.31–34 All 4 studies compared a newly established IPS program with one or more well-established vocational programs. In all 4 studies, participants were recruited from mental health centers (or a psychiatric rehabilitation agency in the Chicago Study). Participants were adults who met each state's criteria for SMI, typically a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) Axis I or II diagnosis plus severe and persistent impairment in psychosocial functioning. All participants were unemployed at the time of study admission. |
Data Collection |
This meta-analytic study used archival data from 4 independent RCTs to determine the magnitude of effects for IPS within specific client subgroups ( by 2 work history, 7 sociodemographic, and 8 clinical variables) on 3 competitive employment outcomes (obtaining a job, total weeks worked, and job tenure). |
Control |
Standardized vocational rehabilitation services such as transitional employment, brokered supported employment (which lacked the integrated services offered by IPS), and paid work adjustment services. |
Findings |
The findings strongly favored IPS, with large effect sizes across all outcomes: 0.96 for job acquisition, 0.79 for total weeks worked, and 0.74 for job tenure. Overall, 90 (77%) of the 117 effect sizes calculated for the 39 subgroups exceeded 0.70, and all 117 favored IPS. |
Conclusions |
IPS produces better competitive employment outcomes for persons with SMI than alternative vocational programs regardless of background demographic, clinical, and employment characteristics. |
URL | http://www.ncbi.nlm.nih.gov/pubmed/19661196 |
Disabilities | Emotional disturbance |
Populations | Male & Female |
Outcomes | Employment acquisition | Full-time employment | Part-time employment |
NIDILRR Funded | Yes |
Research Design | Systematic reviews and meta-analysis |
Peer Reviewed | Yes |