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

Kirsh, Bonnie

doi:10.1007/s10597-015-9936-7

Cited by 13 publications

(21 citation statements)

References 102 publications

(108 reference statements)

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“…Non significance maybe due to missing data (8%) [ 55 ], resulting from the difficulty rating the variable. Additionally, therapists involved in this present study concurred with other authors [ 34 , 70 , 71 ] that the environmental factors are clinically important. The final multiple logistic regression model included Adapts Routines to Minimize Difficulties and Work-related Goals.…”

Section: Discussionsupporting

confidence: 89%

“…Some studies have found active, positive symptoms are associated with failure to attain employment [ 22 , 23 ] or loss of employment [ 24 ]; while others, including a meta-analysis [ 15 ], have found no association. Psychosocial variables such as a strong work ethic [ 25 – 27 ], expressed desire to work [ 28 – 30 ], maintain habits [ 19 , 31 ] and self-esteem, self-efficacy [ 19 , 32 – 34 ] and work history [ 15 , 35 ] have also been investigated and identified as predictive of success in return to employment or education.…”

Section: Introductionmentioning

confidence: 99%

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An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study

et al. 2020

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Background: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Results: Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R 2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ 2 (7) = 41.38 p < .001. Conclusion: An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment. Trial registration: NCT04083404 Registered 05 September 2019 (retrospectively registered).

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study

et al. 2020

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“…Peer Support/Social Support Peer support may be helpful for dealing with work issues and maintaining employment, although the research is limited (68). Qualitative studies have highlighted the importance of peer and community supports for employees with severe mental illness, including friends, and peers from vocational groups, mental health groups, or spiritual groups (63).…”

Section: Other Supports For Sustaining Employmentmentioning

confidence: 99%

Vocational Service Models and Approaches to Improve Job Tenure of People With Severe and Enduring Mental Illness: A Narrative Review

2021

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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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“…Our concern echoes the statement by Kirsh in an earlier review paper on client factors and contextual factors as predictors of SE program success who stated that "… the literature indicates that SE outcomes are dependent on labour market trends, yet little has been done to adapt SE to difficult economic times." 71 . From our perspective, it is not only the difficult economic times that SE needs to adapt to but more so to a long-term structural change in the labour market.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of supported employment programs: Meta-regression analysis of the global secular trend, 1990 - 2015

Richter¹,

Hoffmann²

2019

Preprint

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Importance: Supported employment programs aim to re-integrate unemployed people with mental illness into the competitive labour market. While it is known that short-term economic developments like the 2008 recession may have negative consequences on the supported employment effectiveness rates, research into long-term secular trends has not yet been conducted. Objective: The primary objective of the regression analysis was to assess the effectiveness of supported employment programs for clients with any mental disorder over a longer time period. Further objectives were a comparison to prevocational training and the identification of moderating variables.Data sources: We retrieved publications on randomized controlled trials and on routine implementation programs that were included in four recent systematic reviews on supported employment for people with mental illness, plus very recent publications that were identified by a new search. This search was conducted in the following databases: Pubmed, PsycInfo, CINAHL (Cumulative Index on Nursing and Allied Health Literature), and Google Scholar. Study selection: We included any publication that was used in the four meta-analyses plus very recently published studies. The included studies were conducted between 1990 and 2015. Data extraction and synthesis: 80 studies with 14,437 participants were included in the analysis. Data was extracted by one author and cross-checked by the second author. We have conducted univariate and multivariate meta-regressions on the basis of a random-effects meta-analysis of proportions. The best-fitting model was computed by utilizing a statistical model selection procedure. Main Outcome and Measures: The outcome was the competitive employment rate over time. The year of study conduction (1990 to 2015) was regressed on the competitive employment rate. Regression coefficient estimates were computed and graphically displayed.

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

Cited by 13 publications

References 102 publications

An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study

An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study

Vocational Service Models and Approaches to Improve Job Tenure of People With Severe and Enduring Mental Illness: A Narrative Review

The effectiveness of supported employment programs: Meta-regression analysis of the global secular trend, 1990 - 2015

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