The authors review studies of (a) traditional psychiatric rehabilitation (including clubhouse programs and approaches offering an array of employment options) and (b) supported employment approaches for helping people with severe mental illness gain and maintain competitive employment. Based on the results of this review, the authors conclude that the effectiveness of traditional psychiatric rehabilitation in helping people gain competitive employment cannot be conclusively determined at this point. On the other hand, research on the effectiveness of supported employment was consistently positive.The authors recommend that further research be conducted on model definition, intermediate vocational options, interaction between client characteristics and program models, and long-term outcomes.In this report we review the current data regarding the effectiveness of psychiatric rehabilitation approaches for helping people with severe mental illness (SMI) achieve competitive employment. The term psychiatric rehabilitation (also referred to as psychosocial rehabilitation) has been used in many different,