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Jäckel D, Willert A, Brose A, Leopold K, Nischk D, Senner S, Pogarell O, Sachenbacher S, Lambert M, Rohenkohl A, Kling-Lourenco P, Rüsch N, Bermpohl F, Schouler-Ocak M, Disselhoff V, Skorupa U, Bechdolf A. Enhancing educational and vocational recovery in adolescents and young adults with early psychosis through Supported Employment and Education (SEEearly): study protocol for a multicenter randomized controlled trial. Trials 2023; 24:440. [PMID: 37400899 PMCID: PMC10316586 DOI: 10.1186/s13063-023-07462-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Psychotic disorders often develop a chronic course with devastating consequences for individuals, families, and societies. Early intervention programs for people in the first 5 years after the initial psychotic episode (early psychosis) can significantly improve the outcome and are therefore strongly recommended in national and international guidelines. However, most early intervention programs still focus on improving symptoms and relapse prevention, rather than targeting educational and vocational recovery. The aim of the present study is to explore the effects of Supported Employment and Education (SEE) following the Individual Placement and Support (IPS) model in people with early psychosis. METHODS The SEEearly trial compares treatment as usual (TAU) plus SEE to TAU alone in outpatient psychiatric settings. The study is a six-site, two-arm, single-blinded, superiority randomized controlled trial (RCT). Participants are randomly assigned (1:1) to the intervention or control group. Aiming to recruit 184 participants, with an assumed drop-out rate of 22%, we will be able to detect a 24% difference in the main outcome of employment/education with 90% power. We make assessments at baseline and at 6- and 12-month follow-ups. Outcome data on employment/education, medication, and current psychiatric treatment is obtained monthly through phone based short assessments. The primary outcome is steady participation for at least 50% of the 12-month follow-up in competitive employment and/or mainstream education. Secondary employment outcomes capture length of employment/education, time to first employment/education, monthly wages/educational attainment, and social return on investment (SROI). Secondary non-employment outcomes include subjective quality of life, psychopathology, substance use, relapse, hospitalization, and functional impairment. To be eligible, participants must be between 16 and 35 years, fulfill diagnostic criteria for early psychosis, and be interested in competitive employment and/or mainstream education. DISCUSSION In SEEearly, we hypothesize that participants with psychosis, who receive TAU plus SEE, present with better primary and secondary outcomes than participants, who receive TAU alone. Positive results of this study will justify SEE as an evidence-based strategy for clinical routine treatment in people with early psychosis. TRIAL REGISTRATION SEEearly was registered nationally and internationally in the German Clinical Trials Register (DRKS; identifier: DRKS00029660) on October 14, 2022.
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Affiliation(s)
- D Jäckel
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - A Willert
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany.
| | - A Brose
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - K Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - D Nischk
- Department of Social Psychiatry, Zentrum für Psychiatrie, Reichenau, Germany
| | - S Senner
- Department of Social Psychiatry, Zentrum für Psychiatrie, Reichenau, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - S Sachenbacher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Rohenkohl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Kling-Lourenco
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - N Rüsch
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - F Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - M Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - V Disselhoff
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - U Skorupa
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - A Bechdolf
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
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A Scoping and Systematic Review of Employment Processes and Outcomes for Young Adults Experiencing Psychosis. Community Ment Health J 2022; 59:728-755. [PMID: 36463531 DOI: 10.1007/s10597-022-01056-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
Young adults who experience psychosis want to work but are less likely to be employed than their peers. Sixty two studies relating to young adults with psychosis and employment were reviewed following a systematic search of five databases: CINAHL, PsycINFO, MEDLINE, SCOPUS and EMBASE. Publication date ranged from 1973 to 2019 with > 70% between 2010 and 2019. Intervention was considered in 29 papers; critical appraisal revealed 90% of these had moderate to good methodological quality with only three RCTs. Of 11 intervention types "Early Intervention" and "Individual Placement and Support" were most common; both demonstrating positive impact on obtaining employment. The review identified minimal participant perspectives and great variability in: terminology used; the reporting of participant attributes; intervention characteristics and ways employment outcomes were measured. Employment processes identified were preparing for, seeking, obtaining, keeping and re-obtaining employment, with current research efforts focused on obtaining work. More focus is required on keeping and re-obtaining employment.
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Thompson JL, Holloway K, Karyczak S, Serody MR, Lane IA, Ellison ML, Gill KJ, Davis M, Mullen MG. Evaluating Educational and Employment Services for Young People With Psychiatric Conditions: A Systematic Review. Psychiatr Serv 2022; 73:787-800. [PMID: 34875848 DOI: 10.1176/appi.ps.202000033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The authors conducted a systematic review of studies evaluating vocational interventions for young people with psychiatric conditions to determine the extent to which services were adapted for young people and whether services promoted gains in postsecondary education and employment. METHODS Five databases (PubMed, PsycINFO, Web of Science, Academic Search Premier, and ERIC) were searched. Sources eligible for inclusion were controlled studies published between 2000 and mid-2020 that evaluated a vocational intervention and examined postsecondary educational or employment outcomes for youths or young adults (ages 14-35 years) with psychiatric conditions. RESULTS Ten studies met the inclusion criteria. Several of the studies evaluated services that were adapted for young people, including through the incorporation of educational supports. The most consistent finding was that services based on the individual placement and support (IPS) model improved employment outcomes more effectively than did comparison approaches and treatment as usual. Fewer studies assessed educational outcomes, and they yielded mixed results; however, recent findings from a controlled trial indicate that an enhanced IPS intervention that included well-specified supported education and skills training led to significantly superior outcomes in both education and employment. CONCLUSIONS These results provide support for the efficacy of IPS-based services to improve employment outcomes among young people with psychiatric conditions and suggest that adapting IPS to include comprehensive educational supports and skills training may be important for efforts to improve postsecondary educational outcomes. Additional well-controlled intervention studies that examine educational and longer-term outcomes should further inform the development and delivery of vocational services for this population.
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Affiliation(s)
- Judy L Thompson
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Katherine Holloway
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Sean Karyczak
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Megan R Serody
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Ian A Lane
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Marsha L Ellison
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Kenneth J Gill
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Maryann Davis
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
| | - Michelle G Mullen
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen)
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Cotton SM, Filia KM, Lambert M, Berk M, Ratheesh A, Schimmelmann BG, Macneil C, Hasty M, McGorry PD, Conus P. Not in education, employment and training status in the early stages of bipolar I disorder with psychotic features. Early Interv Psychiatry 2022; 16:609-617. [PMID: 34313390 DOI: 10.1111/eip.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/30/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There is a lack of existing research regarding young people with bipolar I disorder (BD-I) and psychotic features, who are not in education, employment, and training (NEET). Thus, the aims of the study were to: (a) establish rates of NEET at service entry to a specialist early intervention service; (b) delineate premorbid and current variables associated with NEET status at service entry and (c) examine correlates of NEET status at discharge. METHOD Medical file audit methodology was utilized to collect information on 118 patients with first episode psychotic mania treated at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. NEET status was determined using the modified vocation status index (MVCI). Bivariate and multivariable logistic variables were used to examine relationships between premorbid, service entry and treatment variables, and NEET status at service entry and discharge. RESULTS The NEET rate was 33.9% at service entry, and 39.2% at discharge. Variables associated with NEET status at service entry were premorbid functioning and polysubstance use. NEET status at service entry was the only significant correlate of NEET status at discharge. When service entry NEET was taken out of the model, substance use during treatment was predictive of NEET status at discharge. CONCLUSIONS NEET status at service entry was related to a history of premorbid decline, and risk factors such as substance use and forensic issues. NEET status can decline during treatment, and utility of vocational intervention programs specifically for BD, in addition to specialist early intervention, needs to be examined.
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Affiliation(s)
- Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia
| | - Kate M Filia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia
| | - Martin Lambert
- Psychosis Early Detection and Intervention Centre (PEDIC), Department for Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Berk
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia.,IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Aswin Ratheesh
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany.,University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - Craig Macneil
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia
| | - Melissa Hasty
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen, Parkville, Victoria, Australia
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Departement de Psychiatrie CHUV, Université de Lausanne, Prilly, Switzerland
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Transition to Labor Market among Young Adults with Serious Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084532. [PMID: 35457400 PMCID: PMC9030916 DOI: 10.3390/ijerph19084532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/27/2022] [Accepted: 04/07/2022] [Indexed: 02/05/2023]
Abstract
Background: The research on job attainment and retention among young adults with serious mental illness (SMI) is limited. The objective of this study was to investigate the contributions of emotional, cognitive, motor, demographic, and work-related factors to the transition into supported employment (SE) and retention. Methods: This cross-sectional study included young adults with SMI involved in prevocational (N = 21) services or those who have transferred to SE (N = 21) following prevocational services. Work-related self-efficacy, executive functions, and motor skills were approached with standard and well-established tools. Results: There was a significant difference between groups in most dimensions of work-related self-efficacy, job history and experience, cognitive strategies, and general independence in daily life. The multivariate analysis demonstrates that holding a profession, experiencing self-efficacy in general work skills, cognitive strategies, and independence in living situations explained the between-group differences (χ2(4) = 34.62, p < 0.001; correct classification−90.2%). Conclusions: The study identifies the factors contributing to a sustainable transition to employment among young adults with SMI, suggesting the importance of a comprehensive approach to address a range of personal factors in an integrative way. The augmentation of prevocational training with continued employment support may be beneficial to meet the unique needs of young adults with SMI.
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Stengler K, Bechdolf A, Becker T, Döring A, Höhl W, Jäckel D, Kilian H, Theißing A, Torhorst A, Wirtz G, Zeidler R, Riedel-Heller S. [Implementation of the principle of supported employment in Germany : Position paper of a task force of the DGPPN]. DER NERVENARZT 2021; 92:955-962. [PMID: 33570685 DOI: 10.1007/s00115-020-01038-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
The effects of mental diseases on the employment and working situation can be substantial. They are one of the main reasons for inability to work and reduced earning capacity. Against this background the question arises about suitable occupational reintegration measures for people with severe mental illnesses. In recent years, the principle of supported employment has been internationally shown to be increasingly more successful. In this context mentally ill people are primarily placed at a position of the first employment market and supported on-site by a job coach. This concept is inclusive, individual and evidence based. Despite proven effectiveness, it has so far been insufficiently implemented in German-speaking regions. In the future it will be a matter of considering the individual needs for assistance of mentally ill people more intensively than previously and to respond with functional and in a best-case scenario, multiprofessional and flexible offers.
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Affiliation(s)
- K Stengler
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Helios Park-Klinikum Leipzig, Leipzig, Deutschland
| | - A Bechdolf
- Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Akademische Lehrkrankenhäuser, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - T Becker
- Klinik für Psychiatrie und Psychotherapie II, Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - A Döring
- Fachausschuss Psychiatrie, Deutscher Verband der Ergotherapeuten e. V., Karlsbad, Deutschland.,Referat "Gesundheitsfachberufe", DGPPN, Berlin, Deutschland
| | - W Höhl
- arbeit & integration e. V., Düsseldorf, Deutschland
| | - D Jäckel
- Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Akademische Lehrkrankenhäuser, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - H Kilian
- Bundesarbeitsgemeinschaft Beruflicher Trainingszentren e. V. (BAG BTZ), Berlin, Deutschland
| | - A Theißing
- beta89, Verein für betreuendes Wohnen und Tagesstrukturierung psychisch Gesundender e. V., Hannover, Deutschland
| | - A Torhorst
- RPK Bad Tölz und München, ReAL Holding AG, Bad Tölz, Deutschland
| | - G Wirtz
- SRH Rehabilitationseinrichtung für psychisch Kranke Karlsbad GmbH, Karlsbad, Deutschland
| | - R Zeidler
- DGPPN-Geschäftsstelle, Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V. (DGPPN), Reinhardtstraße 27 B I, 10117, Berlin, Deutschland.
| | - S Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Leipzig, Deutschland
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7
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McDowell C, Ennals P, Fossey E. Vocational Service Models and Approaches to Improve Job Tenure of People With Severe and Enduring Mental Illness: A Narrative Review. Front Psychiatry 2021; 12:668716. [PMID: 34305676 PMCID: PMC8298859 DOI: 10.3389/fpsyt.2021.668716] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Employment is a valued occupation that offers a sense of meaning, identity, and belonging. For people with severe and enduring mental illness, employment has also been associated with personal recovery and decreased use of mental health services. However, this population continues to be underrepresented in the labor market. Sustainable employment is often challenging for people with severe and enduring mental illness, due to a combination of personal, organizational and systemic issues. While Individual Placement and Support is an evidence-based model of employment support known to improve job attainment for people with mental illness, job retention and sustained workforce participation continue to be challenges. This narrative literature review was undertaken to address the question: "What vocational service models and approaches improve job tenure for this population?" CinAHL, Medline, Embase, PsycINFO, and Cochrane Library were searched for the period 2005-2020, using key terms and subject headings, including "severe mental illness," "psychiatric disabilit*," "job tenure," and "job retention." Several adjunct interventions may enhance job retention, including skills training, cognitive interventions, psychological interventions, and supported education, while social firms offer a different approach focused on creating new, sustainable job opportunities. Peer support and support from family and friends also appear to be important, and emerging evidence suggests that employment specialist practices, technology, self-management, and workplace accommodations may each also influence job tenure. Service providers could make more use of these non-clinical vocational approaches to improve employment retention for people with severe and enduring mental illness.
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Affiliation(s)
- Caitlin McDowell
- NorthWestern Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Orygen, Melbourne, VIC, Australia
| | - Priscilla Ennals
- Neami National, Melbourne, VIC, Australia.,Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia.,Living With Disabilities Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia.,Living With Disabilities Research Centre, La Trobe University, Melbourne, VIC, Australia
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Chanen AM, Nicol K, Betts JK, Bond GR, Mihalopoulos C, Jackson HJ, Thompson KN, Jovev M, Yuen HP, Chinnery G, Ring J, Allott K, McCutcheon L, Salmon AP, Killackey E. INdividual Vocational and Educational Support Trial (INVEST) for young people with borderline personality disorder: study protocol for a randomised controlled trial. Trials 2020; 21:583. [PMID: 32591007 PMCID: PMC7320570 DOI: 10.1186/s13063-020-04471-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/30/2020] [Indexed: 12/14/2022] Open
Abstract
Background The clinical onset of borderline personality disorder (BPD) usually occurs in young people (aged 12–25 years) and commonly leads to difficulty achieving and maintaining vocational (education and/or employment) engagement. While current psychosocial interventions lead to improvements in psychopathology, they have little effect upon functioning. Individual Placement and Support (IPS) is a client-driven model that assists individuals with severe mental illness to engage with education and/or employment appropriate to their personal goals, and that provides ongoing support to maintain this engagement. The objective of the INdividual Vocational and Educational Support Trial (INVEST) is to evaluate the effectiveness of adding IPS to an evidence-based early intervention programme for BPD, with the aim of improving vocational outcomes. Methods/design INVEST is a single-blind, parallel-groups, randomised controlled trial (RCT). The randomisation is stratified by gender and age and uses random permuted blocks. The interventions are 39 weeks of either IPS, or ‘usual vocational services’ (UVS). Participants will comprise 108 help-seeking young people (aged 15–25 years) with three or more DSM-5 BPD features and a desire to study or work, recruited from the Helping Young People Early (HYPE) early intervention programme for BPD at Orygen, in Melbourne, Australia. All participants will receive the HYPE intervention. After baseline assessment, staff who are blind to the intervention group allocation will conduct assessments at 13, 26, 39 and 52 weeks. At the 52-week primary endpoint, the primary outcome is the number of days in mainstream education/employment since baseline. Secondary outcomes include the cost-effectiveness of the intervention, quality of life, and BPD severity. Discussion Current treatments for BPD have little impact on vocational outcomes and enduring functional impairment is prevalent among this patient group. IPS is a targeted functional intervention, which has proven effective in improving vocational outcomes for adults and young people with psychotic disorders. This trial will investigate whether IPS is effective for improving vocational (employment and educational) outcomes among young people with subthreshold or full-syndrome BPD. Trial registration Australian New Zealand Clinical Trials Registry, ID: ACTRN12619001220156. 13 September 2019.
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Affiliation(s)
- Andrew M Chanen
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia. .,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.
| | - Katie Nicol
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Jennifer K Betts
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Gary R Bond
- IPS Employment Center, Rockville Institute and Westat Inc., 85 Mechanic Street, Suite C3-1, Box 4A, Lebanon, NH, 03766, USA
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC, 3220, Australia
| | - Henry J Jackson
- Melbourne School of Psychological Sciences, Redmond Barry Building, The University of Melbourne, Parkville, Melbourne, VIC, 3010, Australia
| | - Katherine N Thompson
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Martina Jovev
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Hok Pan Yuen
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Gina Chinnery
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Judith Ring
- Travancore School, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Kelly Allott
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Louise McCutcheon
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Ashleigh P Salmon
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
| | - Eoin Killackey
- Orygen, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Melbourne, VIC, 3052, Australia
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