Article Details

Research Database: Article Details

Citation:  McGurk, S.R., Mueser, K.T., Harvey, P.D., LaPuglia, R., & Marder, J. (2003). Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment. Psychiatric Services, 54 (8), 1129-1135.
Title:  Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment
Authors:  McGurk, S.R., Mueser, K.T., Harvey, P.D., LaPuglia, R., & Marder, J.
Year:  2003
Journal/Publication:  Psychiatric Services
Publisher:  American Psychiatric Association
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Quasi-experimental

Structured abstract:

Background:  Although previous research has indicated that symptoms and cognitive functioning are related to employment outcomes for clients with severe mental illness, few studies have examined the relationship between these client factors and outcomes in supported employment programs.
Purpose:  This study examined the relationships of measures of cognitive functioning and psychiatric symptoms with work outcomes and use of vocational services for clients with schizophrenia in a supported employment program.
Setting:  Study sample received outpatient services at a state hospital. Research team was based at Mount Sinai School of Medicine, New York, New York
Study sample:  The study participants were 30 clients with schizophrenia or schizo affective disorder who ere receiving outpatients services at a state hospital. The clients diagnoses were made by a member of the research team on the basis of clinical interviews with the Comprehensive Assessment of Symptoms and History and information form the clients charts.
Intervention:  The program provided at the hospital's outpatients clinics was based on the individual placement and support employment model. At entry into the program, each client was assigned an employment specialist who provided all components of supported employment, including assessment, assistance with job search, and job support. Each employment specialist functioned as a member of the client's interdisciplinary team. The supported employment program provided follow along as needed for an unlimited time, including both on- and off-site support, depending on the client's needs or preferences.
Control or comparison condition:  There was no control or comparison condition.
Data collection and analysis:  Data for the study included work outcomes, an analysis of demographic and other background predictors of work outcomes, the degree of change in clients' symptom severity and cognitive functioning over the year follow up period, and an analysis of symptom and cognitive predictors of work outcomes. Final analysis was on the relationship of symptoms and cognitive functioning with utilization of supported employment services by the clients who obtained competitive employment.
Findings:  Predictors of clients' work outcomes included previous work history, amount of government entitlement income received, severity of negative symptoms, involvement in sheltered work activity at baseline, and level of cognitive functioning, including scores on measures of executive functioning and verbal learning and memory. The amounts of on-job support and contact with employment specialists were predicted by the cognitive domains of executive functioning, verbal learning, attention, and psycho motor speed as well as by the severity of psychotic symptoms.
Conclusions:  Clients with schizophrenia who have higher levels of cognitive impairment may require greater amounts of vocational support than those with lower levels of impairment. A variety of rehabilitation strategies may be required to improve vocational outcomes and reduce the amount of supported employment services needed by clients with schizophrenia.

Disabilities served:  Schizophrenia
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Ethnicity: Hispanic or Latino
Interventions:  Individual Placement and Support (IPS) model of supported employment
Supported employment
Outcomes:  Employment acquisition