Improving vocational outcomes of service users in an Early Intervention in Psychosis service.

AIM: People with psychotic symptoms have poor social and occupational functioning. The aim of this research was to improve the engagement in meaningful education, training or employment for young people with psychosis. This was undertaken by introducing a vocational specialist into the early intervention service to implement the individual placement and support (IPS) model. METHODS: Two early intervention services provided information about the vocational status of their service users 6 and 1 months prior to the introduction of the vocational specialist into one of the services. Data were collected again 12 months following the intervention and then 6 months following the end of the intervention. RESULTS: Unemployment was high in both services during the baseline period (approximately 75% in both), but in the service receiving the intervention this reduced to 62% whereas it remained high in the service that did not introduce the vocational specialist. Following the withdrawal of the vocational specialist the improvement was lost. CONCLUSIONS: To enable people in first-episode services to live meaningful and valued lives occupational functioning needs to be considered a key performance indicator. Services can improve outcome by implementing and maintaining the IPS model.

'Jumping to conclusions' in first-episode psychosis: a longitudinal study.

OBJECTIVES: People with psychotic symptoms are reported to have a characteristic reasoning style in which they jump to conclusions. To date, little research has been conducted to investigate if this style changes over time and is associated with improvements or worsening of symptoms. This study considered these questions. METHODS: Thirty-one service users were recruited from a first-episode service and completed measures of reasoning, psychotic, and non-psychotic symptomatology at two time points over 2 years. RESULTS: Over time, people with psychosis generally became less hasty in their decision-making. Those who became less hasty in their reasoning were less symptomatic. For those who remained very hasty in their reasoning, this was associated with a worsening specifically of the delusional beliefs. CONCLUSIONS: This work supports the notion that there is a critical time in the first few years of psychosis during which symptoms and reasoning can change. However, where reasoning style does not change, this may be associated with greater difficulties associated with delusional beliefs.