Article Details

Research Database: Article Details

Citation:  Tsang, H. W., Chan, A., Wong, A., & Liberman, R. P. (2009). Vocational outcomes of an integrated supported employment program for individuals with persistent and severe mental illness. Journal of behavior therapy and experimental psychiatry, 40 (2), 292-305.
Title:  Vocational outcomes of an integrated supported employment program for individuals with persistent and severe mental illness
Authors:  Tsang, H. W., Chan, A., Wong, A., & Liberman, R. P.
Year:  2009
Journal/Publication:  Journal of behavior therapy and experimental psychiatry
Publisher:  Elsevier B.V.
DOI:  https://doi.org/10.1016/j.jbtep.2008.12.007
Full text:  http://proxy.library.vcu.edu/login?url=http://www.sciencedirect.com...   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Randomized controlled trial

Structured abstract:

Background:  The traditional vocational rehabilitation (TVR) services adopt a step-wise approach which offers pre-vocational training at the beginning of the service. In Hong Kong and mainland China, participants usually undergo a prolonged period of preparation before seeking competitive employment. Rates for competitive employment are usually less than 20%. As TVR is the most common form of vocational rehabilitation in Hong Kong, it was important to local service development to benchmark innovative interventions against standard interventions. IPS is an evidence-based rehabilitation service that includes job development and placement, on-going employment supports, coordination of vocational services with multi-disciplinary treatment teams, indefinite services and the opportunity for choice of jobs by participants. PS is less than optimal in clients' maintaining their jobs, with 50% of those employed experiencing job terminations by the six-month follow-up. Over a longer follow-up period, considerably fewer than half of the participants in IPS are working during any single month. In the current study, IPS was amplified by the addition of work-related, social skills training (WSST) together with on-going supports in the community for aiding generalization of social skills in the workplace following the integrated supported employment (ISE) protocol.
Purpose:  The purpose of this study was to examine the effectiveness of an integrated supported employment (ISE) program, which augments Individual Placement & Support (IPS) with social skills training (SST) in helping individuals with SMI achieve and maintain employment.
Setting:  The setting included community mental health programs which offered a range of rehabilitation services.
Study sample:  The study sample was 163 participants from community mental health programs which offered a range of rehabilitation services. The recruitment was based on the following selection criteria: (1) suffering from SMI (operationally defined as schizophrenia, schizo-affective disorder, bipolar disorder, recurrent major depression, or borderline personality disorder); (2) being unemployed; (3) willing and cognitively competent to give informed consent; (4) lacking obvious cognitive, learning and neurological impairments as determined by mental status exam; (5) completed primary education; and (6) expressing a desire to work.
Intervention:  A total of 163 participants were randomly assigned to three vocational rehabilitation programs: ISE, IPS, and traditional vocational rehabilitation (TVR). The ISE participants joined the ISE program which integrated IPS and WSST. The eight principles of IPS also applied to this intervention. The 10-session WSST consisted of a structured program to teach participants job interview skills, basic conversation and social survival skills for effective communication with supervisors, co-workers and customers.
Control or comparison condition:  Individual Placement and Support (IPS) is 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. Traditional Vocational rehabilitation services that clients received included sheltered workshop and supported employment.
Data collection and analysis:  Data collection involved the following: Employment Outcome Checklist (EOC) assessed their employment outcomes such as the number of job interviews attended, the number of jobs obtained, number of hours per week worked, and salary received from each of the jobs that were obtained . The 21-item Chinese Job Stress Coping Scale (CJSC) assessed the coping strategies of participants when faced with job stress, using a five-point response scale ranging from 1 (hardly ever do this) to 5 (almost always do this). The coping dimensions included help seeking, positive self-appraisal, work adjustment, and avoidance. The Chinese Job Termination Checklist (CJTC) is the Chinese version of the Job termination Scale
Findings:  After fifteen months of services, ISE participants had significantly higher employment rates (78.8%) and longer job tenures (23.84 weeks) when compared with IPS and TVR participants. IPS participants demonstrated better vocational outcomes than TVR participants. The findings suggested that ISE enhances the outcomes of supported employment, endorsing the value of SST in vocational rehabilitation.
Conclusions:  The findings suggested that ISE enhances the outcomes of supported employment, endorsing the value of SST in vocational rehabilitation.

Disabilities served:  Chronic mental illness
Depression
Schizophrenia
Populations served:  Gender: Female and Male
Race: Asian
Interventions:  Supported employment
Vocational rehabilitation
Other
Outcomes:  Employment acquisition
Increase in tenure