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: 2.41). 11/1996; 47(10):1125-7.
Source: PubMed


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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    • "The IPS model demonstrated significant increases in employment rates, between 40% and 60% for individuals with psychiatric disabilities (Crowther et al., 2001; Lehman et al., 2002; Bond et al., 2001; Cook & Razzano, 2000; Rogers, Anthony, Toole, & Brown, 1991; Becker & Drake, 1993, 2003; Bond, 1998, 2004; Bond, Drake & Becker, 1999; Drake, Becker, Biesanz, Wyzik, & Torrey, 1996a; Honey, 2000; Lehman, 1995; Schneider, Heyman, & Turton, 2002). Five randomized controlled trials specifically on IPS indicated three-to fivefold increases in employment rates and income (Drake et al., 1996a, 1996b; Cook et al., 2005a, 2005b; Meisler & Williams, 1998). On the other hand, 40–60% of individuals do not obtain employment through the IPS intervention. "
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    ABSTRACT: Objective: This study examined the impact of an Individual Placement and Support (IPS) program enhanced with Motivational Interviewing (MI) on process and outcome variables. This combined program assisted individuals with psychiatric disabilities in weighing the pros and cons of work, locating employment based on personal choice, and maintaining competitive jobs through unlimited support. Methods: 125 individuals completed employment process and outcome measures at baseline and six-month follow-up. McNemar, paired samples t-test, correlation, and simultaneous regression were utilized to analyze the data set. Results: From baseline to six-month follow-up, program participants significantly increased the number of obtained jobs, hours worked per week, hourly wage, and monthly job income. Job interviews and offers were found to be positively correlated with the combination of job leads from employment specialists (ES) and clients telephoning employers. Participants' stage of change was found to be positively correlated with jobs offered, jobs obtained, and hourly wage. Conclusions: Results indicated that this supported employment program had a positive impact on employment variables and individuals' stages of change were related to these outcomes.
    American Journal of Psychiatric Rehabilitation 10/2007; 10(4-4):339-353. DOI:10.1080/15487760701680604
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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 · 3.92 Impact Factor
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