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1.
Psychiatr Serv ; : appips20230408, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38835254

RESUMO

OBJECTIVE: People with previous incarceration and a mental disorder, a substance use disorder, or both are less likely to obtain employment than are those without these characteristics. Distance learning and education (DLE) systems are increasingly being integrated into clinical care and provide a pathway to disseminate vocational services. DLE systems can help reach people with barriers to accessing services, including people without transportation, experiencing homelessness, living in rural areas, or who are homebound. This study evaluated the effectiveness of one DLE system, the COMPASS program, in assisting formerly incarcerated veterans with a mental or substance use disorder to obtain employment. METHODS: The authors used a randomized controlled trial to compare employment outcomes of 39 U.S. veterans receiving the COMPASS intervention with those of 43 veterans receiving a paper self-study vocational manual. All participants had previous legal convictions and had a mental disorder, a substance use disorder, or both. The COMPASS system provided vocational services through asynchronous (online practice assignments, reading, and videos) and synchronous (video and telephone practice interviews and live chats) methods. No in-person vocational services were provided in the COMPASS intervention. RESULTS: At 6 months, participants assigned to receive the COMPASS intervention were more likely to have found employment, defined as 1 day of competitive employment, compared with those assigned to receive the self-study manual (64% vs. 35%, respectively)-and to have found employment faster. CONCLUSIONS: This study's findings provide evidence for the effectiveness of the COMPASS system in providing employment services and suggest that these services may benefit other vulnerable populations.

2.
Eval Program Plann ; 97: 102254, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36806008

RESUMO

PURPOSE: We describe the development and pilot evaluation of an online vocational rehabilitation program, the About Face Online System (AFOS), for veterans with a history of felony convictions and either mental illness and/or substance use disorders. METHOD: Phase One was the development and acceptability testing of the online system. Phase Two was a small, randomized trial comparing the likelihood of obtaining employment among people using the AFOS, compared to people receiving a self-directed hardcopy manual, after 6 months. RESULTS: In Phase One, 17 veterans provided feedback as the system was being developed. The final system allows veterans to receive education on vocational reintegration skills, watch short videos describing the techniques, and communicate with a vocational staff member via chat features. Veterans found the AFOS to be as acceptable as a hardcopy manual that covered similar material. In Phase Two, 38 veterans with a history of felony convictions and either mental illness or substance use disorder were randomized to receive the AFOS or a hardcopy manual. After 6 months, people randomized to the AFOS were more likely to obtain employment than people randomized to the hardcopy manual. CONCLUSION: An online vocational program may help veterans who cannot attend traditional in-person vocational services to successfully obtain employment.


Assuntos
Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Veteranos , Humanos , Avaliação de Programas e Projetos de Saúde , Reabilitação Vocacional/métodos , Emprego , Transtornos Relacionados ao Uso de Substâncias/reabilitação
3.
Psychiatr Rehabil J ; 44(2): 142-147, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33939452

RESUMO

Objective : This study evaluates the effects of time incarcerated on employment outcomes between a manualized vocational program, the About Face Vocational Program (AFVP), and a hybrid program of the AFVP and Individualized Placement and Support, Supported Employment (AFVP + IPS-SE). Method : Eighty-four veterans with the histories of felony convictions and a mental illness or a substance use disorder were randomly assigned to the AFVP or AFVP + IPS-SE conditions and followed for 6 months. The associations between time to employment and months incarcerated were evaluated using nonparametric tests. Findings : The number of months incarcerated was positively associated with time to employment in the hybrid AFVP + IPS-SE condition but not the AFVP condition. In addition, significant differences were found between employment rates of the groups at lower number of months incarcerated, with higher rates of employment in the hybrid AFVP + IPS-SE condition, becoming similar as months incarcerated increased. Conclusion and Implications for Practice : Number of months incarcerated may have a deleterious effect on employment rates when using IPS-SE. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Readaptação ao Emprego , Transtornos Mentais , Prisioneiros , Transtornos Relacionados ao Uso de Substâncias , Veteranos , Humanos , Reabilitação Vocacional
4.
Med Care ; 59(Suppl 2): S195-S198, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33710095

RESUMO

BACKGROUND: Homelessness is a significant issue affecting the general US population. Two subsets of the population overrepresented in the US homeless population are justice involved individuals and Veterans. However, relatively little research has addressed alleviating homelessness in justice-involved Veterans (JIV). One direction for addressing homelessness in this population is facilitating employment. OBJECTIVE: This study examined differences in housing and employment outcomes between homeless JIV enrolled in 2 different vocational rehabilitation conditions. METHODS: This study evaluates vocational outcomes of Veterans experiencing homelessness enrolled in a larger US Department of Veterans Affairs-funded study. Participants were randomized into 2 groups: those who participated in a job search group, the About Face Vocational Program (AFVP) and those who received AFVP plus Individualized Placement and Support, Supported Employment (AFVP+IPS-SE). RESULTS: Participants who received supported employment plus group were significantly more likely to secure employment compared with group alone. This significant difference was also found in individuals who identified as chronically homeless. Furthermore, participants who secured employment were significantly more likely to exit homelessness and secure housing, suggesting group membership had an indirect effect on housing status though improved employment outcomes. CONCLUSIONS: Vocational rehabilitation groups combined with supported employment is appropriate and effective for homeless, JIV seeking employment and may also improve downstream housing outcomes.


Assuntos
Readaptação ao Emprego , Pessoas Mal Alojadas , Desemprego , Veteranos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , United States Department of Veterans Affairs
5.
Psychiatr Serv ; 71(8): 816-823, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32393158

RESUMO

OBJECTIVE: This study compared two vocational programs: the About Face Vocational Program (AFVP), a traditional group-based vocational program created for formerly incarcerated veterans, and a hybrid program combining the AFVP with principles of individual placement and support-supported employment. METHODS: The study evaluated 111 veterans with at least one felony conviction who had a mental illness, substance use disorder, or both. Veterans were randomly assigned to either vocational condition. RESULTS: Veterans in the hybrid condition, compared with the AFVP alone, were more likely to find employment, had higher rates of full-time employment, and earned significantly more money over the course of the study. A comparison of only participants who found employment showed higher rates of full-time employment for veterans in the hybrid condition but similarities between the two groups in other measures of employment success. CONCLUSIONS: Blended models of vocational services for veterans with mental illness, substance use disorders, or both are effective at returning formerly incarcerated veterans to competitive employment.


Assuntos
Readaptação ao Emprego , Transtornos Mentais/reabilitação , Prisioneiros , Reabilitação Vocacional , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Veteranos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prisioneiros/psicologia
6.
Psychiatr Rehabil J ; 41(4): 328-335, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30221965

RESUMO

OBJECTIVE: Incarceration and substance use disorders/mental illness can have a significant negative impact on finding employment. However, it is unclear in what phase of the search for employment, that is, applying for jobs, obtaining interviews, being offered employment, does time incarcerated have the most effect. This study will determine how time incarcerated in the past 10 years is associated with negative job search process outcomes. METHOD: This study evaluates 84 (81 men and 3 women) veterans with substance use disorders and histories of felony convictions. Four path analyses were conducted to evaluate models that incorporated time incarcerated at the different phases. RESULTS: The superior model incorporated time incarcerated negatively affecting the number of interviews obtained. Models that assessed the association between time incarcerated with applications submitted and likelihood of being offered employment did not demonstrate adequate goodness-of-fit. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Overall, the findings demonstrate the ex-offenders enrolled exhibited similar effort in searching for employment across time incarcerated. Also, employers are equally likely to hire those with felony histories, regardless of the time incarcerated, once the applicant has been met and interviewed. The results highlight the need for services focusing on breaking down stigma and reducing barriers that screen out ex-offenders from being interviewed by employers. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Criminosos/estatística & dados numéricos , Emprego/estatística & dados numéricos , Candidatura a Emprego , Reabilitação Vocacional/estatística & dados numéricos , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Veteranos/estatística & dados numéricos
7.
Psychol Serv ; 15(1): 56-64, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28541067

RESUMO

Lack of employment is an important barrier to successful reintegration encountered by those released from prison with mental illnesses and/or substance use disorders. This study compares 3 different vocational reintegration modalities for a veteran population: (a) basic services; (b) self-study using the About Face Vocational Manual; and (c) the About Face Vocational Program, a standardized group program focused on the About Face Vocational Manual. One-hundred eleven veterans with a history of at least one felony conviction and a mental illness and/or substance use disorder were recruited from a large urban Veterans Affairs (VA) medical center. Veterans were assigned to 1 of the 3 conditions and followed for 12 months. At the end of the 1-year follow-up period, veterans in the group condition had superior competitive and stable employment rates, as well as faster times to employment compared with both the basic and self-study conditions. The self-study condition was generally indistinguishable from the basic services condition. Overall, new employment during the last 6 months of the follow-up period was relatively low. The findings support the use of standardized group vocational reintegration programs such as the About Face Vocational Program. Limitations and implications are discussed. (PsycINFO Database Record


Assuntos
Criminosos , Transtornos Mentais/reabilitação , Reabilitação Vocacional/métodos , Veteranos , Adulto , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Resultado do Tratamento
8.
Psychiatr Serv ; 67(7): 735-42, 2016 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-27032655

RESUMO

OBJECTIVE: This study evaluated the six-month outcomes of incorporating the principles of supported employment, specifically Individual Placement and Support (IPS), into the About Face program, an existing standardized group-based vocational program for previously incarcerated veterans. METHODS: Participants (N=84) with a history of at least one felony conviction and a substance use disorder (88%) or mental illness or combination (59%) were recruited from a large urban veterans hospital. Veterans were randomly assigned to either the About Face program (AF) or to that program plus a modification of IPS (AF+IPS). Veterans were followed for six months. Employment outcomes, including time to employment, hours worked, and income earned, were evaluated with survival analyses and nonparametric tests. RESULTS: Rates of employment over the follow-up period were significantly higher for those receiving AF+IPS, with 21 of 46 (46%) finding employment, compared with only eight of 38 (21%) who received AF alone. As a group, those receiving AF+IPS worked more hours and earned more wages than those receiving AF alone. CONCLUSIONS: Incorporating many of the principles and techniques of IPS into an existing vocational program was associated with improved employment outcomes over the six-month follow-up period and should be considered a viable rehabilitation option when working with this vulnerable population.


Assuntos
Transtornos Mentais/reabilitação , Avaliação de Resultados em Cuidados de Saúde , Prisioneiros/estatística & dados numéricos , Reabilitação Vocacional/estatística & dados numéricos , Veteranos/estatística & dados numéricos , Adulto , Diagnóstico Duplo (Psiquiatria) , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/reabilitação
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