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1.
J Ment Health Policy Econ ; 22(3): 95-108, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31811753

RESUMO

BACKGROUND: Psychosis onset commonly occurs at ages 16-30 when individuals are typically developing their education, employment and career trajectories. Coordinated specialty care (CSC) programs provide access to team-based early invention services for psychosis, including supported education and employment (SEE) services. AIMS OF STUDY: We examine factors associated with the use of SEE services and whether use of SEE services (for supported education, supported employment, or both) is associated with education and employment participation within New York's CSC program, OnTrackNY. METHODS: Participants (n=779) enrolled in OnTrackNY from October 2013-September 2017. Assessments were collected by clinical staff at admission, quarterly, and at discharge. Logistic regression models were specified to identify factors associated with the probability of use of SEE specialist services during the first year of program participation, using generalized estimating equations with an autoregressive covariance structure to account for within-subject correlations over time. Logistic models were also used to predict whether use of SEE services in the prior quarter predict the probability of work and school participation in the subsequent quarter, respectively; these were analyzed cross-sectionally for each time period. Models controlled for other factors associated with work/school outcomes for young people with early psychosis. RESULTS: Participants who were younger, and who had lower rates of work/school participation had greater odds of SEE service use. Use of SEE services for education support in the first quarter among clients under age 23 is significantly associated with school enrollment in the second quarter and this continued through the first year. Use of SEE services for employment support in the first quarter is significantly associated with employment in the second quarter, but significant associations for employment were not found at later periods of participation. Use of SEE services for both education and employment support was inconsistently associated with subsequent school enrollment or employment in the subsequent quarter. Results were upheld when limiting the sample to those not receiving other SEE services. DISCUSSION: Rates of school and work participation increased over the duration of OnTrackNY participation. Clients with lower work/school participation were more likely to use SEE services. Supported education services are associated with greater school participation during the first year for clients under age 23. However, this association is only significant in the first quarter for supported employment services, and is inconsistent when examining those who used both simultaneously. It is possible that we may find significant associations for employment as the program continues. It is also possible that clients may end supported employment services after obtaining employment, while those in school may require ongoing services (e.g. to renew educational accommodations). Additionally, it is possible that OnTrackNY's supported education model, designed to adhere to Individual Placenment and Support (IPS) principles, may be helping clients stay in school. However, as this is an observational study with no control condition, we cannot say that OnTrackNY, or SEE services participation, caused the observed outcomes. IMPLICATIONS FOR FURTHER RESEARCH: Future research should continue to develop the evidence base for supported education services.


Assuntos
Pessoas com Deficiência/psicologia , Intervenção Médica Precoce/métodos , Educação Especial/métodos , Readaptação ao Emprego/métodos , Transtornos Psicóticos/reabilitação , Adolescente , Adulto , Serviços Comunitários de Saúde Mental , Readaptação ao Emprego/estatística & dados numéricos , Hospitalização , Humanos , New York , Desenvolvimento de Programas , Transtornos Psicóticos/complicações , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/terapia , Adulto Jovem
2.
NeuroRehabilitation ; 44(3): 333-339, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31177239

RESUMO

BACKGROUND: The effects of traumatic brain injury (TBI) on return to work have been the focus of many clinical studies in recent years. Veterans with a history of TBI may be at increased risk of unemployment. OBJECTIVE: We sought to understand predictors of work outcomes for Veterans with a history of TBI who received evidence-based supported employment. METHODS: Fifty unemployed Veterans with a history of mild-to-moderate TBI and current neuropsychological impairment participated in a 12-month supported employment intervention. Demographic data and baseline assessments of neuropsychological impairment, functional capacity, and psychiatric and post-concussive symptom severity were investigated as predictors of work outcomes (job attainment, weeks worked, and wages earned). RESULTS: Bivariate analyses showed that lower disability ratings, more recent work history, more months worked in the past 5 years, lower PTSD symptom severity, worse verbal memory, and better cognitive flexibility were all associated with better work outcomes. In multivariate regression analyses, better cognitive flexibility and worse verbal memory performance predicted better work outcomes. CONCLUSIONS: Further research is needed to determine how treatment of cognitive impairments and psychiatric symptoms is related to return to work in Veterans with a history of TBI.


Assuntos
Lesões Encefálicas Traumáticas/psicologia , Lesões Encefálicas Traumáticas/reabilitação , Readaptação ao Emprego/psicologia , Readaptação ao Emprego/tendências , Veteranos/psicologia , Adulto , Lesões Encefálicas Traumáticas/diagnóstico , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/reabilitação , Feminino , Previsões , Humanos , Masculino , Síndrome Pós-Concussão/diagnóstico , Síndrome Pós-Concussão/psicologia , Síndrome Pós-Concussão/reabilitação , Distribuição Aleatória , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/reabilitação
3.
Psychiatr Prax ; 46(6): 338-341, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31137040

RESUMO

OBJECTIVE: This study reports on the evaluation of the Bern Job Coach Placement program, a supported employment intervention, in the routine operation. METHODS: Administrative data of participants from the years 2005 to 2016 were analysed in terms of integration into the general labour market and in terms of achieving a regular job. RESULTS: 46 percent of all participants (N = 420) were able to achieve the primary outcome of being integrated into the general labour market and 33 percent achieved a regular job. DISCUSSION: The Bern Job Coach Placement program has achieved a high rate of job integration even in routine implementation.


Assuntos
Readaptação ao Emprego , Avaliação de Programas e Projetos de Saúde , Alemanha , Humanos
4.
Psychiatr Rehabil J ; 42(3): 246-256, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30932508

RESUMO

OBJECTIVE: Posttraumatic stress disorder (PTSD) has significant negative effects on occupational, interpersonal, and social functioning. Supported employment is highly effective in helping people with a diagnosis of PTSD obtain and maintain competitive employment. However, less is known about the impact of supported employment on functioning in work or school, social, and interpersonal areas as specifically related to the symptoms of PTSD. METHOD: The Veterans Individual Placement and Support Toward Advancing Recovery study was a prospective, multisite, randomized, controlled trial that compared Individual Placement and Support (IPS) supported employment with a stepwise vocational rehabilitation involving transitional work (TW) assignments with unemployed veterans with PTSD diagnoses (n = 541) at 12 Veterans Administration (VA) medical centers. This analysis focuses on the PTSD-related functional outcomes over the 18-month follow-up period. RESULTS: Compared with those randomized to TW, the PTSD Related Functioning Inventory (PRFI) total score significantly improved for participants randomized to IPS (LSMeans difference = -3.92, 95% CI [-7.49, -.36]; p = .03) over 18 months. When the Work/School subscale of the PRFI was removed from the analysis, the IPS group continued to show significant improvements compared with the TW group on the PRFI relationship and lifestyle domains (LSMeans difference = -2.37, 95% CI [-4.74, .00]; p = .05), suggesting a positive impact of IPS beyond work/school functioning. CONCLUSION: Compared with the usual-care VA vocational services for veterans with PTSD, IPS supported employment is associated with greater improvement in overall PTSD-related functioning, including occupational, interpersonal, and lifestyle domains. In addition to superior employment outcomes, IPS has a positive impact on occupational-psychosocial functioning outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Readaptação ao Emprego , Transtornos de Estresse Pós-Traumáticos/reabilitação , United States Department of Veterans Affairs , Veteranos , Adulto , Readaptação ao Emprego/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
5.
Work ; 62(3): 427-434, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30856141

RESUMO

This case study will focus on the "evolution" of finding meaningful occupation for a young man, Patrick, 27, in spite of his multiple disabilities within his rural home environment in Stowe, Vermont. The purpose of this case study is to show others (family members, therapists, support service individuals and adult agencies) that it is possible to be self-employed despite life's challenges, and that with some creativity (and funding), there is a niche of meaningful occupation available for all!


Assuntos
Paralisia Cerebral/complicações , Readaptação ao Emprego/métodos , Reabilitação Vocacional/métodos , Adulto , Paralisia Cerebral/reabilitação , Readaptação ao Emprego/tendências , Humanos , Masculino , Reabilitação Vocacional/tendências , Vermont
6.
PLoS One ; 14(2): e0212208, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785954

RESUMO

Supported employment is a treatment whereby those with severe mental illness (or other disabilities) receive aid searching for competitive employment and mental health (or other) treatments concurrently. The most popular implementation of supported employment is individual placement and support (IPS). We conducted meta-analytic analyses of the randomized controlled trials of IPS. We found that subjects in IPS, compared to usual treatment conditions, had better vocational outcomes (obtained any competitive employment: RR = 1.63, 95%CI = [1.46, 1.82]; job tenure: d = 0.55, 95%CI = [0.33, 0.79]; job length: d = 0.46, 95%CI = [0.35, 0.57]; income: d = 0.48, 95%CI = [0.36, 0.59]) Non-vocational outcomes estimates, while favoring IPS, included the null (quality of life: d = 0.30, 95%CI = [-0.07, 0.67]; global functioning: d = 0.09, 95%CI = [-0.09, 0.27]; mental health: d = 0.03, 95%CI = [-0.15, 0.21]). Analysis of the expected proportion of studies with a true effect on non-vocational outcomes with d>0.2 showed some reason to expect a possible improvement for quality of life for at least some settings (Prop = 0.57, 95%CI = [0.30, 0.84]).


Assuntos
Readaptação ao Emprego/economia , Renda , Transtornos Mentais , Saúde Mental/economia , Qualidade de Vida , Feminino , Humanos , Masculino , Transtornos Mentais/economia , Transtornos Mentais/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Psychiatry Res ; 273: 312-317, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30677720

RESUMO

Deciding whether to disclose one's psychiatric disorder to a prospective employer is a complex decision for people with severe mental illness seeking to return to work, with potential advantages and disadvantages. The present study examined the rates, patterns, and correlates of disclosure in 51 participants (74.5% schizophrenia or schizoaffective disorder) receiving high fidelity Individual Placement Support (IPS) who obtained competitive work over a two-year study period. Most participants (64.7%) disclosed their psychiatric disorder in their first job, and there was a tendency for those with multiple jobs who did not disclose initially to shift to disclosure in subsequent jobs. Participants who disclosed for their first job had worse baseline cognitive scores on the Positive and Negative Syndrome Scale (PANSS), lower self-esteem, and poorer psychosocial functioning than those who did not disclose. However, participants who disclosed to their first employer were more likely to obtain jobs that matched their interests, and worked significantly longer than those who did not disclose (32.55 vs. 12.50 weeks, respectively). The findings suggest that individuals receiving supported employment who disclose their mental illness to prospective employers may have better work outcomes.


Assuntos
Readaptação ao Emprego/psicologia , Transtornos Mentais/psicologia , Revelação da Verdade , Adulto , Tomada de Decisões , Feminino , Humanos , Masculino , Comportamento Social , Trabalho/psicologia
8.
Early Interv Psychiatry ; 13(4): 859-866, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-29888528

RESUMO

AIM: Individual placement and support (IPS) for first episode psychosis (FEP) has proven effective for employment and education, but yields differing results across geographical regions. Local adaptations may be necessary for various reasons, such as regional differences in employment- and welfare services; in educational opportunities and job markets. The aim of this study was to investigate the efficacy of an adapted Norwegian intervention offering early IPS for education and employment to persons with FEP. METHOD: Matched control (N = 66) study with a 1-year early IPS intervention and a 2-year follow up. A rating of fidelity to the IPS model was conducted. RESULTS: Fidelity was "good." Adaptations to the model included the use of internships and flexible combinations of education and employment. Thirty out of 33 participants completed the intervention. Fourteen were in competitive employment >20 h/wk post intervention, compared to 2 in the control group. Fifteen participants were enrolled in education >20 h/wk, 10 of whom also had employment >20 h/wk and 3 < 20 h/wk, compared to 5 in the control group, with 2 having employment <20 h/wk on the side. Symptom levels did not predict outcome. CONCLUSION: The School- and JobPrescription adaptation of IPS, allowing for temporary internships as a step towards obtaining the goal of paid competitive employment and facilitating flexible combinations of employment and education, showed encouraging results. These were however not sustained after closure of the intervention. At the 2-year follow up, Job- and SchoolPrescription advantages had waned, underscoring the point in IPS that support should be time-unlimited.


Assuntos
Educação não Profissionalizante/métodos , Readaptação ao Emprego/métodos , Transtornos Psicóticos/reabilitação , Reabilitação Vocacional/métodos , Apoio ao Desenvolvimento de Recursos Humanos/métodos , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Educação não Profissionalizante/estatística & dados numéricos , Readaptação ao Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Apoio ao Desenvolvimento de Recursos Humanos/estatística & dados numéricos , Adulto Jovem
9.
Disabil Rehabil ; 41(7): 786-795, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29182029

RESUMO

PURPOSE: Most people with common mental disorders (CMDs) are employed and working, but few studies have looked into how they manage their jobs while ill. This study explores workers' experiences of strategies to keep working while suffering from CMDs. METHODS: In this grounded theory study, we interviewed 19 women and eight men with depression or anxiety disorders. They were 19-65 years old and had different occupations. Constant comparison method was used in the analysis. RESULTS: We identified a core pattern in the depressed and anxious workers' attempts to sustain their capacities, defined as Managing work space. The core pattern comprised four categories describing different cognitive, behavioral, and social strategies. The categories relate to a process of sustainability. Two categories reflected more reactive and temporary strategies, occurring mainly in the onset phase of illness: Forcing the work role and Warding off work strain. The third category, Recuperating from work, reflected strategies during both onset and recovery phases. The fourth category, Reflexive adaptation, was present mainly in the recovery phase and involved reflective strategies interpreted as more sustainable over time. CONCLUSIONS: The results can deepen understanding among rehabilitation professionals about different work-related strategies in depressed and anxious workers. Increased awareness of the meaning and characteristics of strategies can inform a person-oriented approach in rehabilitation. The knowledge can be used in clinical encounters to reflect together with the patient, exploring present options and introducing modifications to their particular work and life context. Implications for rehabilitation Self-managed work functioning in common mental disorders involves diverse strategies. Strategies interpreted as sustainable over time, seem to be reflective in the sense that the worker consciously applies and adapts the strategies. However, at the onset of illness, such reflection is difficult to develop as the worker might not want to realize their reduced functioning. Rehabilitation professionals' awareness of different strategies can facilitate a person-centered approach and understanding of the vocational rehabilitation process.


Assuntos
Ansiedade , Depressão , Transtornos Mentais/reabilitação , Reabilitação Vocacional , Adulto , Ansiedade/psicologia , Ansiedade/reabilitação , Depressão/psicologia , Depressão/reabilitação , Readaptação ao Emprego/métodos , Feminino , Teoria Fundamentada , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Vocacional/métodos , Reabilitação Vocacional/psicologia , Apoio Social , Desempenho Profissional
10.
Epidemiol Psychiatr Sci ; 28(1): 4-8, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30012237

RESUMO

This study is aimed at the importance of social care in rehabilitation. A brief overview of the social care theme is used as the methodology. There is a tension in mental health care between biological and psychological treatments that focus on deficits at the individual level (symptoms, disabilities) and social interventions that try to address local inequalities and barriers in order to improve access for service users to ordinary housing, employment and leisure opportunities. The history of mental health care tells us that social care is often underfunded and too easily dismissed as not the business of health care. But too much emphasis on a health model of individual deficits is a slippery slope to institutionalisation by way of therapeutic nihilism. Rehabilitation services follow the biopsychosocial model but with a shift in emphasis, recognising the vital role played by social interventions in improving the functional outcomes that matter to service users including access to housing, occupation, leisure facilities and the support of family and friends. In conclusion, rehabilitation is framed within a model of personal recovery in which the target of intervention is to boost hope and help the individual find a meaning to life, living well regardless of enduring symptoms.


Assuntos
Readaptação ao Emprego , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/organização & administração , Reabilitação Psiquiátrica , Habitação Popular , Apoio Social , Assistência à Saúde , Humanos , Transtornos Mentais/psicologia , Fatores Socioeconômicos
11.
Scand J Work Environ Health ; 45(1): 33-41, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30074050

RESUMO

Objectives The aim of this study was to evaluate the effectiveness of individual placement and support (IPS) for people struggling with work participation due to moderate-to-severe mental illness. The study was conducted in Norway, a setting characterized by a comprehensive welfare system and strong employment protection legislation. Methods A randomized controlled multicenter trial including 410 participants was conducted. The intervention group received IPS according to the IPS manual. The control group received high-quality usual care. The main outcome was competitive employment at 12- and 18-months follow-up, based on objective registry data. Changes in mental health and health-related quality of life were secondary outcomes. Results At 12-months follow-up, 36.6% of participants in the IPS group and 27.1% of participants in the control group were in competitive employment, while the difference was slightly higher (37.4% versus 27.1%) at 18-months follow-up. Furthermore, IPS yielded positive effects on all the secondary outcomes compared to the control group (all P<0.05). Conclusions The IPS model of supported employment was superior to high-quality usual care on both vocational and non-vocational outcomes for people with moderate-to-severe mental illness, even in a policy context characterized by high job security and a comprehensive welfare system.


Assuntos
Readaptação ao Emprego , Transtornos Mentais/reabilitação , Reabilitação Vocacional , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Noruega , Qualidade de Vida
12.
Soc Psychiatry Psychiatr Epidemiol ; 54(5): 525-531, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30078035

RESUMO

PURPOSE: While supported employment (SE) programs for people with mental illness have demonstrated their superiority in randomized controlled trials (RCTs) and meta-analyses, little is known about the effectiveness of non-trial routine programs. The primary objective of this study was to estimate a pooled competitive employment rate of non-trial SE programs by means of a meta-analysis. A secondary objective was to compare this result to competitive employment rates of SE programs in RCTs, prevocational training programs in RCTs and in routine implementation. METHODS: A systematic review and a random-effects meta-analysis of proportions were conducted. Quality assessment was provided. Moderator analyses by subgroup comparisons were conducted. RESULTS: Results from 28 samples were included in the meta-analysis. The pooled competitive employment rate for SE routine programs was 0.43 (95% CI 0.37-0.50). The pooled competitive employment rates for comparison conditions were: SE programs in RCTs: 0.50 (95% CI 0.43-0.56); prevocational programs in RCTs: 0.22 (95% CI 0.16-0.28); prevocational programs in routine programs: 0.17 (95% CI 0.11-0.23). SE routine studies conducted prior to 2008 showed a significantly higher competitive employment rate. CONCLUSION: SE routine programs lose only little effectiveness compared to SE programs from RCTs but are much more successful in reintegrating participants into the competitive labor market than prevocational programs. Labor market conditions have to be taken into account when evaluating SE programs.


Assuntos
Readaptação ao Emprego/estatística & dados numéricos , Emprego/estatística & dados numéricos , Implementação de Plano de Saúde/métodos , Pessoas Mentalmente Doentes/estatística & dados numéricos , /estatística & dados numéricos , Feminino , Humanos , Masculino
13.
Br J Psychiatry ; 214(2): 76-82, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30251616

RESUMO

BACKGROUND: High unemployment is a hallmark of psychotic illness. Individual placement and support (IPS) may be effective at assisting the vocational recoveries of young people with first-episode psychosis (FEP).AimsTo examine the effectiveness of IPS at assisting young people with FEP to gain employment (Australian and Clinical Trials Registry ACTRN12608000094370). METHOD: Young people with FEP (n = 146) who were interested in vocational recovery were randomised using computer-generated random permuted blocks on a 1:1 ratio to: (a) 6 months of IPS in addition to treatment as usual (TAU) or (b) TAU alone. Assessments were conducted at baseline, 6 months (end of intervention), 12 months and 18 months post-baseline by research assistants who were masked to the treatment allocations. RESULTS: At the end of the intervention the IPS group had a significantly higher rate of having been employed (71.2%) than the TAU group (48.0%), odds ratio 3.40 (95% CI 1.17-9.91, z = 2.25, P = 0.025). However, this difference was not seen at 12- and 18-month follow-up points. There was no difference at any time point on educational outcomes. CONCLUSIONS: This is the largest trial to our knowledge on the effectiveness of IPS in FEP. The IPS group achieved a very high employment rate during the 6 months of the intervention. However, the advantage of IPS was not maintained in the long term. This seems to be related more to an unusually high rate of employment being achieved in the control group rather than a gross reduction in employment among the IPS group.Declaration of interestNone.


Assuntos
Readaptação ao Emprego , Transtornos Psicóticos/reabilitação , Reabilitação Vocacional , Feminino , Humanos , Masculino , Método Simples-Cego , Fatores de Tempo , Adulto Jovem
14.
Scand J Occup Ther ; 26(7): 535-545, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30301392

RESUMO

BACKGROUND: Individuals experiencing severe and persistent mental illness report a desire to gain and sustain work. Individual Placement and Support (IPS) is an evidence-based approach to vocational rehabilitation to support competitive employment outcomes. AIM/OBJECTIVE: This study aimed to evaluate whether a joint-governance management partnership, between a clinical adult mental health and an employment service, could deliver a sustained IPS program in Australia. MATERIALS AND METHOD: The methodology entailed a Clinical Data Mining approach, to examine records from seven years of implementation of IPS in one setting within an Australian public mental health service context. RESULTS/FINDINGS: Despite the prevalence of schizophrenia spectrum diagnoses and an older mean age (39 years), indicating that a large proportion of the cohort had experienced serious mental illness for over twenty years, findings were that 46.3% of participants achieved employment. CONCLUSIONS: This is an excellent result and is comparable to the only randomised control trial, with adult services, in the Australian context, which found a 42.5% employment rate possible under IPS compared with just 23.5% with referral to external employment services. SIGNIFICANCE: More extensive trialling of IPS across clinical services is required, in Australia and internationally, including fidelity protocols, for knowledge translation to be achieved.


Assuntos
Readaptação ao Emprego/organização & administração , Transtornos Mentais/reabilitação , Serviços de Saúde Mental/organização & administração , Reabilitação Vocacional/métodos , Adulto , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Scand J Occup Ther ; 26(3): 205-218, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29078724

RESUMO

BACKGROUND: The Individual Enabling and Support (IES) model is an adapted, supported employment program developed to meet motivational, cognitive and time-use needs of people with affective disorders. Vocational programs for this target group have been developed but more knowledge is needed about the important characteristics and perceived usefulness of the programs. The aim of this study was to illustrate the IES model and process from multiple perspectives. METHODS: Five participants were included in this multiple-case study. The material comprised interviews with participants, intervention documents, memos and interviews with employment specialists. Within and cross-case analyzes and an analytical generalization were performed. RESULTS: The cases illustrated different IES processes, and the theme; Enabling engagement in return to work (RTW) was formulated. Continuous support from the employment specialist and a focus on personal resources and motivation were essential to overcome low self-confidence regarding RTW. Motivational, cognitive and time-use strategies gave an opportunity to learn new behavior and coping strategies for job seeking, getting employed and working. CONCLUSION: Providing a combination of these strategies integrated with supported employment could promote self-efficacy and engagement in the RTW process among people on sick leave due to an affective disorder.


Assuntos
Adaptação Psicológica , Readaptação ao Emprego/psicologia , Transtornos do Humor/reabilitação , Retorno ao Trabalho/psicologia , Autoeficácia , Licença Médica/estatística & dados numéricos , Adulto , Readaptação ao Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retorno ao Trabalho/estatística & dados numéricos
16.
Schizophr Res ; 203: 41-48, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-28823720

RESUMO

Treatments for cognitive and functional impairments associated with severe mental illnesses are urgently needed. We tested a 12-week, manualized, Compensatory Cognitive Training (CCT) intervention targeting prospective memory, attention, learning/memory, and executive functioning in the context of supported employment for people with severe mental illnesses who were seeking work. 153 unemployed, work-seeking outpatients with schizophrenia/schizoaffective disorder (n=58), bipolar disorder (n=37), or major depression (n=58) were randomized to receive supported employment plus CCT or enhanced supported employment, a robust control group. Assessments of neuropsychological performance, functional capacity, psychiatric symptom severity, and self-reported functioning and quality of life were administered at baseline and multiple follow-up assessments over two years; work outcomes were collected for two years. Forty-seven percent of the participants obtained competitive work, but there were no differences in work attainment, weeks worked, or wages earned between the CCT and the enhanced supported employment group. ANCOVAs assessing immediate post-treatment effects demonstrated significant, medium to large, CCT-associated improvements on measures of working memory (p=0.038), depressive symptom severity (p=0.023), and quality of life (p=0.003). Longer-term results revealed no statistically significant CCT-associated improvements, but a trend (p=0.058) toward a small to medium CCT-associated improvement in learning. Diagnostic group (schizophrenia-spectrum vs. mood disorder) did not affect outcomes. We conclude that CCT has the potential to improve cognitive performance, psychiatric symptom severity, and quality of life in people with severe mental illnesses. Receiving CCT did not result in better work outcomes, suggesting that supported employment can result in competitive work regardless of cognitive status.


Assuntos
Transtorno Bipolar/reabilitação , Disfunção Cognitiva/reabilitação , Remediação Cognitiva/métodos , Transtorno Depressivo Maior/reabilitação , Readaptação ao Emprego , Reabilitação Psiquiátrica/métodos , Transtornos Psicóticos/reabilitação , Esquizofrenia/reabilitação , Adulto , Transtorno Bipolar/complicações , Disfunção Cognitiva/etiologia , Transtorno Depressivo Maior/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/complicações , Esquizofrenia/complicações
17.
Psychiatry Clin Neurosci ; 73(2): 47-49, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30370626

RESUMO

Individual Placement and Support is a standardized model of supported employment, developed initially for people with serious mental disorders and now applied to people with a range of disabilities. More than two dozen randomized controlled trials around the world show that the approach helps a majority of participants to succeed in competitive employment. Individual Placement and Support is spreading rapidly across the USA and in many other high-income countries, with facilitation by an international learning community.


Assuntos
Readaptação ao Emprego , Transtornos Mentais/reabilitação , Humanos , Japão
18.
Scand J Occup Ther ; 26(3): 219-225, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30421626

RESUMO

BACKGROUND: The clubhouses are part of a growing international movement concerned with providing work-oriented psychosocial rehabilitation for people with a history of mental illness. Instruments used for measuring outcomes from clubhouse participation is in a developing phase. AIMS: This study aimed to assess psychometric properties of an outcome survey tool used at a Norwegian clubhouse, and to explore factors associated with members' perceived outcomes from participation at the clubhouse. METHODS: A cross-sectional design was used. The instrument's factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach's α. Associations with the derived outcome scale score were examined with linear regression analysis. RESULTS: All scale items belonged to the same latent factor, and internal consistency of the items was α = 0.81. Members, who used the clubhouse more frequently perceived the outcomes from participating to be better, compared to their counterparts. CONCLUSION: The outcome scale was unidimensional and the items fit well together. Active members were likely to evaluate outcomes of clubhouse participation as more positive, compared to less active members. SIGNIFICANCE: The scale can be useful for exploring clubhouse members' perceptions of the outcomes they relate to their participation at the clubhouse.


Assuntos
Readaptação ao Emprego/psicologia , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Reabilitação Psiquiátrica/métodos , Psicometria/métodos , Retorno ao Trabalho/psicologia , Grupos de Autoajuda/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Inquéritos e Questionários
19.
J Appl Res Intellect Disabil ; 32(3): 648-656, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30585384

RESUMO

BACKGROUND: Research on supported employment for individuals with intellectual disabilities has focused mainly on its effect on employees. Scant research has assessed the influence on employers and on the work setting. This study focused on a unique program to foster the employment of individuals with intellectual disabilities in the Israeli military and examined the effect of the program on the employers (military commanders) and on the military units. METHOD: Semi-structured interviews were conducted with 28 military commanders. RESULTS: Four themes illustrate the influence of people with intellectual disabilities on the military units in which they work: (a) functioning of the military unit, (b) effect on other soldiers, (c) effect on commanders, and (d) effect on attitudes toward people with intellectual disabilities. CONCLUSIONS: Results suggest that employing soldiers with intellectual disabilities has beneficial effects on both commanders and the military units, although some negative attitudes remain and merit interventions.


Assuntos
Readaptação ao Emprego , Deficiência Intelectual/reabilitação , Militares , Adulto , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
20.
BMJ Open ; 8(12): e024487, 2018 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-30567825

RESUMO

OBJECTIVES: The issue of gaining employment for those with mental illness is a growing global concern. For many in the young adult population, who are at a transitional age, employment is a central goal. In response, we conducted a scoping review to answer the question, 'What are the barriers and facilitators to employment for young adults with mental illness?' DESIGN: We conducted a scoping review in accordance to the Arksey and O'Malley framework. We performed a thorough search of Medline, EMBASE, CINAHL, ABI/INFORM, PsycINFO and Cochrane. We included studies that considered young adults aged 15-29 years of age with a mental health diagnosis, who were seeking employment or were included in an employment intervention. RESULTS: Our search resulted in 24 research articles that focused on employment for young adults with mental illness. Four main themes were extracted from the literature: (1) integrated health and social services, (2) age-exposure to employment supports, (3) self-awareness and autonomy and (4) sustained support over the career trajectory. CONCLUSIONS: Our review suggests that consistent youth-centred employment interventions, in addition to usual mental health treatment, can facilitate young adults with mental illness to achieve their employment goals. Aligning the mental health and employment priorities of young adults may result in improved health and social outcomes for this population while promoting greater engagement of young adults in care.


Assuntos
Readaptação ao Emprego , Transtornos Mentais , Saúde Mental , Readaptação ao Emprego/métodos , Readaptação ao Emprego/psicologia , Humanos , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Adulto Jovem
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