Day treatment versus supported employment for persons with severe mental illness: a replication study

Dartmouth Medical School in Hanover, New Hampshire, USA.
Psychiatric Services (Impact Factor: 1.99). 11/1996; 47(10):1125-7.
Source: PubMed

ABSTRACT Outcomes for 112 clients with severe mental disorders in a community mental health center that converted its rehabilitative day treatment program to a supported employment program were assessed during the year after the program conversion. The study replicated a previous study in showing that the rate of competitive employment improved, especially among clients who had formerly attended the day treatment program, without evidence of adverse effects.

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    • "While a useful point of departure, this descriptive study does not answer the question of cost effectiveness: How expensive is IPS compared to alternatives? Compared to day treatment services, it would appear that IPS is less labor intensive and therefore less expensive, although the cost analyses have not been definitive (Clark, Bush, Becker, & Drake, 1996). "
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    ABSTRACT: Objectives: Recognizing the limitations of conventional frameworks for identifying evidence-based interventions, we sought to develop a comprehensive set of criteria that would have practical and policy relevance. Methods: We identify nine ideal attributes of a mental health practice (well defined, reflecting client goals, consistent with societal goals, effective, minimum side effects, positive long-term outcomes, reasonable costs, easy to implement, and adaptable to diverse communities and client subgroups). Using a case study approach, we applied these criteria to the Individual Placement and Support (IPS) model of supported employment. Findings: IPS generally satisfies all nine criteria, though the evidence is more limited in some areas. Conclusions: This framework provides a template that could be used to evaluate other social work interventions.
    Research on Social Work Practice 11/2009; 4100(5). DOI:10.1177/1049731509358085 · 1.53 Impact Factor
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    • "schizophrenia; supported employment; support intensity; symptom predictors Supported employment (SE) is an evidence-based psychosocial treatment for persons with severe mental illness (Drake et al., 2000;Bond et al., 2001). In particular, the Individual Placement and Support (IPS) model of SE has demonstrated superiority to alternative forms of vocational rehabilitation for SMI clients (Drake et al., 1996;Clark et al., 1998;Drake et al., 1999) and to psychosocial rehabilitation programs incorporating transitional employment services (Mueser 2004). "
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    ABSTRACT: This study examined predictors of intensity of vocational specialist support for clients with schizophrenia or schizoaffective disorder in supported employment. Sixty-nine outpatients with schizophrenia or schizoaffective disorder were recruited from a community mental health center for 12 months of vocational and cognitive rehabilitation. Neuropsychological test scores, symptom ratings, illness severity, and employment history were used to predict vocational support intensity, expressed as hours coached in ratio to total hours worked over 12 months for each client. Weekly work hours were inversely correlated with intensity of vocational support. Half of the sample averaged 10 to 40 h of work per week and received significantly lower proportions of on-site job coaching than the lowest quartile, which averaged 2 to 5 h of work per week. Regressions predicting support intensity from neuropsychological composite scores, educational/vocational, and hospitalization history were not significant. Significant regressions included PANSS, SANS, and SAPS subscales, after which individual symptoms responsible for explained variance were isolated. SANS social inattention and PANSS active avoidance together predicted 23% of the variance in support intensity. A one-way ANOVA comparing work participation quartiles on these symptoms revealed significantly higher levels of active avoidance and social inattention for participants working less than 10 h per week. A profile emerged of the high intensity client as a socially inattentive or avoidant individual requiring a limited work schedule. Results suggest that these clients require more specialist contact because of failure to adequately engage natural supports at work.
    Schizophrenia Research 09/2007; 94(1-3):81-8. DOI:10.1016/j.schres.2007.03.026 · 4.43 Impact Factor
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    • "Given the demonstrated benefits of successful employment, several studies have assessed the outcomes of various kinds of employment programs . These programs range from consumer cooperatives (Clark, 1995) to in-home programs (Kates, Nikolaou, Baillie, & Hess, 1997) to programs following the Individual Placement and Support model (Drake et al., 1996; "
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    ABSTRACT: The work presented here, exploratory in nature, uses a comparative and qualitative approach to understand the factors associated with the ability of individuals with severe and persistent mental illness to successfully gain and maintain employment. Based on open-ended interviews with individuals in an Assertive Community Treatment (ACT) program, we compare the experiences of those who have been successful gaining and maintaining employment, with those who have been successful gaining but not maintaining work, and those who have been unsuccessful gaining employment. The three groups seemed to differ in three significant ways: (1) in the ways the individuals talked about their illness, (2) in the ways the individuals talked about work, and (3) in the strategies they described for coping with bad days. In each of these areas individuals' awareness of and attitude toward their illness was significant. The findings have clear implications for agencies working to help people with severe and persistent mental illness obtain and maintain employment.
    American Journal of Community Psychology 09/2000; 28(4):481-94. DOI:10.1023/A:1005136531079 · 1.74 Impact Factor
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