Client Predictors of Employment Outcomes in High-Fidelity Supported Employment

Abstract

Research on vocational rehabilitation for clients with severe mental illness over the past 2 decades has yielded inconsistent findings regarding client factors statistically related to employment. The present study aimed to elucidate the relationship between baseline client characteristics and competitive employment outcomes-job acquisition and total weeks worked during an 18-month follow-up-in Individual Placement and Support (IPS). Data from 4 recent randomized controlled trials of IPS were aggregated for within-group regression analyses. In the IPS sample (N = 307), work history was the only significant predictor for job acquisition, but receiving Supplemental Security Income-with or without Social Security Disability Insurance-was associated with fewer total weeks worked (2.0%-2.8% of the variance). In the comparison sample (N = 374), clients with a diagnosis of mood disorder or with less severe thought disorder symptoms were more likely to obtain competitive employment. The findings confirm that clients with severe mental illness interested in competitive work best benefit from high-fidelity supported employment regardless of their work history and sociodemographic and clinical background, and highlight the needs for changes in federal policies for disability income support and insurance regulations.

Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities

“…In particular, that problem-focused coping (i.e., efforts to address the stressor itself) was associated with legal income generation suggests this coping style is protective for homeless young people and might facilitate their pursuit of safe and legal economic activity. Prior research with persons experiencing mental illness suggests that higher cognitive functioning and problem-solving are among the characteristics associated with successful formal employment outcomes (Campbell et al, 2010). Clinicians' efforts to strengthen homeless young people's cognitive functioning and problemsolving abilities using cognitive-behavioral techniques such as cognitive restructuring might, in turn, equip these young adults with coping strategies that aid them in formal employment settings (Hope et al, 2010) as well as in navigating and exiting homelessness (Kidd, 2003).…”

“…Clinical interventions drawing on social cognitive theory that strengthen these young people's self-efficacy and belief in their abilities to succeed (Bandura, 1994) might provide them with the skills needed to thrive in formal employment and exit homelessness. Among persons with mental illness, greater self-efficacy is associated with successful employment outcomes (Campbell et al, 2010).…”

Client, Contextual and Program Elements Influencing Supported Employment: A Literature Review

“…A study that combined data from 4 RCTs found that amongst IPS clients, work history was the only significant predictor for job acquisition. Those who had experienced paid work in the community during the previous 5 years were twice as likely as those who had not to obtain competitive employment during the 18-month follow-up, but work history did not predict job retention (Campbell et al 2010).…”

Work Reintegration for Veterans With Mental Disorders: A Systematic Literature Review to Inform Research

“…49 A primary focus on the amelioration of symptoms for people with mental health disorders is unlikely to facilitate their work reintegration. This conclusion is supported by evidence for effective employment programs for people with severe mental illness that do not exclude people on the basis of symptoms, 15 whose symptoms may not improve with work, 52 and whose symptoms are not a barrier to job acquisition, 53,64 and for musculoskeletal disorders, in which interventions that reduce sick leave are not effective in reducing symptoms. 51 Work and health influence each other in complex interactions.…”

“…52 Clients with severe mental illness benefit from IPS regardless of their work history or clinical background; this finding refutes the practice of excluding individuals on the basis of disability income or symptoms. 53 This was among the many barriers described for the implementation of SE. 54 The reluctance to refer people with symptoms for SE has relevance for Canada, where an examination of 23 SE programs found only 13% followed the IPS model.…”