Vocational rehabilitation for adults with psychotic disorders in a Scandinavian welfare society

Abstract

BackgroundThis study examined the outcomes of a vocational rehabilitation program (The Job Management Program, JUMP) for persons with psychotic disorders based on close collaboration between health and welfare services.MethodsParticipants (N = 148) with broad schizophrenia spectrum disorders (age 18–65) were recruited from six counties in Norway. Three counties were randomized to vocational rehabilitation augmented with cognitive behaviour therapy (CBT), while the remaining three counties were randomized to vocational rehabilitation augmented with cognitive remediation (CR). This paper compares the vocational activity of the total group of JUMP participants with a treatment as usual group (N = 341), and further examines differences between the two JUMP interventions. Employment status (working/not working) was registered at the time of inclusion and at the end of the intervention period.ResultsThe total number of JUMP participants in any kind of vocational activity increased from 17 to 77% during the intervention. Of these, 8% had competitive employment, 36% had work placements in ordinary workplaces with social security benefits as their income, and 33% had sheltered work. The total number of working participants in the TAU group increased from 15.5 to 18.2%. The JUMP group showed significant improvements of positive (t = −2.33, p = 0.02) and general (t = −2.75, p = 0.007) symptoms of psychosis. Significant differences between the CBT and CR interventions were not demonstrated.ConclusionsThe study supports existing evidence that the majority of persons with broad schizophrenia spectrum disorders can cope with some kind of work, given that internal and external barriers are reduced. Those who wish to work should be offered vocational rehabilitation.Trial registrationClinicalTrials.gov Identifier: NCT01139502. Registered on 6 February 2010.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1183-0) contains supplementary material, which is available to authorized users.

Gambling and family: A two-way relationship

“…Interviews were audio-recorded and subsequently transcribed verbatim. The study has been further described in detail in an earlier article ( Subramaniam et al., 2017 ).…”

“…The four organizing themes – role of family in gambling initiation, maintenance, help-seeking, responsible gambling, and harm – were then arranged into the global theme of family and gambling (Table 2 ). The role of family in the adoption of responsible gambling by the older adult gambler has been described in a previous article ( Subramaniam et al., 2017 ).…”

Job‐ and schoolprescription: A local adaptation to individual placement and support for first episode psychosis

“…However, these services are offered late, when the candidate is deemed “ready” and free of symptoms. Alternatively they are not offered at all, because of the prevailing idea that persons with SMI should be protected from all stress (Falkum et al, ). Students in Norway also have access to support services.…”

Remote Care for Caregivers of People With Psychosis: Mixed Methods Pilot Study

“…Negative symptoms and cognitive deficits required more attention; these symptoms are some of the major reasons for disability in psychotic disorders [ 39 ], and the relatives are the ones facing the problems that the symptoms cause. Treatments such as cognitive remediation, vocational rehabilitation, and cognitive behavior therapy for psychosis [ 40 - 42 ] could have been described in more detail in the program. A wider approach, including a multicultural understanding of psychosis and examples of mixed family patterns in the stories presented in the program may be warranted.…”