Article Details

Research Database: Article Details

Citation:  Campbell, K., Bond, G., & Drake, R. (2011). Who benefits from supported employment: A meta-analytic study. Schizophrenia Bulletin, 37 (2), 370–380.
Title:  Who benefits from supported employment: A meta-analytic study
Authors:  Campbell, K., Bond, G., & Drake, R.
Year:  2011
Journal/Publication:  Schizophrenia Bulletin
Publisher:  Oxford University Press
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Yes
Research design:  Systematic review / meta-analysis

Structured abstract:

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 (defined 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, Harford CT, Concord and Manchester N.H,, and Chicago IL.
Study 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.
Intervention:  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
Control or comparison condition:  Standardized vocational rehabilitation services such as transitional employment, brokered supported employment (which lacked the integrated services offered by IPS), and paid work adjustment services.
Data collection and analysis:  This meta-analytic study used archival data from 4 independent RCTs to determine the magnitude of effects for IPS within specific client subgroups (defined by 2 work history, 7 sociodemographic, and 8 clinical variables) on 3 competitive employment outcomes (obtaining a job, total weeks worked, and job tenure).
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.

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