BACKGROUND: An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes. AIMS: To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes. METHOD: Patient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS. RESULTS:Patients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness. CONCLUSIONS: The IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.
RCT Entities:
BACKGROUND: An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes. AIMS: To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes. METHOD:Patient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS. RESULTS:Patients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness. CONCLUSIONS: The IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.
Authors: K Filia; D Rickwood; J Menssink; C X Gao; S Hetrick; A Parker; M Hamilton; I Hickie; H Herrman; N Telford; S Sharmin; P McGorry; S Cotton Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2021-01-16 Impact factor: 4.328
Authors: Lisa B Dixon; Faith Dickerson; Alan S Bellack; Melanie Bennett; Dwight Dickinson; Richard W Goldberg; Anthony Lehman; Wendy N Tenhula; Christine Calmes; Rebecca M Pasillas; Jason Peer; Julie Kreyenbuhl Journal: Schizophr Bull Date: 2009-12-02 Impact factor: 9.306