View Resource

A Behavioral Intervention to Improve Work Performance in Schizophrenia: Work Behavior Inventory Feedback

Available formats:    Word   |    Text

A Behavioral Intervention to Improve Work Performance in Schizophrenia: Work Behavior Inventory Feedback
Morris Bell, Paul Lysaker, and Gary Bryson
Journal of Vocational Rehabilitation
Volume 18, Number 1, 2003

Article Summary

Most people with schizophrenia and other severe mental illnesses want to work and evidence is mounting that they can gain competitive employment with sufficient accommodations and supports. After two decades of research, supported employment can now be regarded as evidence based practice that is referred in most cases to what Bond has described as gradualistic approaches to rehabilitation.

Supported employment principles include rapid job search with a minimum of evaluation or pre-vocational training. Whereas, traditional vocational programs put most of their effort into the period prior to the person's employment, the bulk of the work in supported employment occurs after the person begins working. Probably the most important principle of supported employment is that supports are on-going. Support takes many forms including integrating vocational and mental health services, job coaching, and brokering accommodations in the work place.

In this paper, Bell and his colleagues developed a very nice study looking at situational assessments of work performance which can be used repeatedly to measure progress in work rehabilitation. These assessments would then be used for feedback and goal setting. The design included 63 people with schizophrenia participating in a 6 month paid work program who were then randomly assigned to receive a behavioral intervention utilizing work performance feedback and goal setting or to receive usual/traditional support services.

The results of this study show that those receiving the behavioral intervention had significantly greater improvement on the work behavior inventory subscales overall, specifically on social skills, personal presentation, and cooperativeness. Those in the behavioral intervention group also worked significantly longer, 36% more hours and 22% more weeks. Additionally, those receiving supported employment showed a trend toward greater improvements on measures of motivation, sense of purpose, and employment in life. These results support the value of including specific work feedback in a workers meeting as a behavioral intervention to improve work performance, increased job retention, and amplify the participant's sense of purpose and motivation. The authors conclude that the essential elements of this behavioral intervention could be adopted by work rehabilitation programs that utilize transitional employment or competitive employment settings. As long as access to the workers was not restricted, job coaches could use the Worker Behavior Inventory to provide systematic feedback to the worker.

This is yet one more excellent study in a long string of studies that have been completed in the areas of supported employment to enhance work outcome for those with mental illness. The quality of this research is excellent and provides compelling data about the efficacy of direct behavioral intervention for persons with very significant mental disorder, schizophrenia. The major impact of this study is significant and needs to be disseminated to the thousands of community mental health centers and transitional rehabilitation programs which do not focus nearly as much on the direct approach to accelerating employment to real work environments.