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Vocational rehabilitation in early psychosis : cluster randomised trial
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Craig, Tom, Shepherd, Geoff, Rinaldi, Miles, Smith, Jessica L., Carr, Sarah, Preston, Fay and Singh, Swaran P. (2014) Vocational rehabilitation in early psychosis : cluster randomised trial. British Journal of Psychiatry, 205 (2). pp. 145-150. doi:10.1192/bjp.bp.113.136283 ISSN 0007-1250.
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Official URL: http://dx.doi.org/10.1192/bjp.bp.113.136283
Abstract
BACKGROUND:
Individual placement and support (IPS) is effective in helping patients return to work but is poorly implemented because of clinical ambivalence and fears of relapse.
AIMS:
To assess whether a motivational intervention (motivational interviewing) directed at clinical staff to address ambivalence about employment improved patients' occupational outcomes.
METHOD:
Two of four early intervention teams that already provided IPS were randomised to receive motivational interviewing training for clinicians, focused on attitudinal barriers to employment. The trial was registered with the International Standard Randomised Controlled Trial Register (ISRCTN71943786).
RESULTS:
Of 300 eligible participants, 159 consented to the research. Occupational outcomes were obtained for 134 patients (85%) at 12-month follow-up. More patients in the intervention teams than in the IPS-only teams achieved employment by 12 months (29/68 v. 12/66). A random effects logistic regression accounting for clustering by care coordinator, and adjusted for participants' gender, ethnicity, educational and employment history and clinical status scores, confirmed superiority of the intervention (odds ratio = 4.3, 95% CI 1.5-16.6).
CONCLUSIONS:
Employment outcomes were enhanced by addressing clinicians' ambivalence about their patients returning to work.
| Item Type: | Journal Article | ||||||||
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| Subjects: | H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Psychoses, People with mental disabilities -- Rehabilitation, People with mental disabilities -- Employment, Occupational therapy, Clinical trials | ||||||||
| Journal or Publication Title: | British Journal of Psychiatry | ||||||||
| Publisher: | Royal College of Psychiatrists | ||||||||
| ISSN: | 0007-1250 | ||||||||
| Official Date: | August 2014 | ||||||||
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| Volume: | 205 | ||||||||
| Number: | 2 | ||||||||
| Page Range: | pp. 145-150 | ||||||||
| DOI: | 10.1192/bjp.bp.113.136283 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| RIOXX Funder/Project Grant: |
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