Abstract

Background: Individuals with severe mental illness have low employment rates, and the job interview presents a critical barrier for obtaining employment. Four randomized controlled trials (RCTs) revealed that virtual reality job interview training (VR-JIT) improved interviewing skills and the odds of obtaining a job offer among trainees with severe mental illness (i.e., schizophrenia and mood disorders) or autism spectrum disorder. This study assessed whether trainees across all four trials had greater odds than controls at receiving a job offer by 6-month follow-up. We also evaluated if interviewing skills mediated the relationship between virtual interview trial completion and receiving job offers by 6-month follow-up. Methods: VR-JIT trainees (n = 79) completed pre- and posttest role-plays and a brief survey approximately 6 months later to assess if trainees received a job offer. VR-JIT trainees completed up to 17 virtual interviews, while controls received services as usual. We used logistic regression to assess the odds of receiving a job offer. We also conducted mediational path model with Mplus 7.2 using a Bayesian estimator (with Sobel Test) to test if post-test interviewing skills mediated the relationship between virtual interviews completed and receiving job offers by 6-month follow-up. Results: The odds of receiving a job offer were higher for VR-JIT trainees across all four cohorts compared to the controls from across all four cohorts (OR = 2.68, 95% CI = 1.14–6.29; P = .03). As hypothesized, the relationship between number of virtual interviews completed and job offer attainment was fully mediated as indicated by the direct effect between completed interviews and job offer changing from significant (B = .09, P < .05; SD = .046, β = .30, 95% PCI:.01–.54) to nonsignificant (B = .07, P < .05; SD = .05, β = .23, 95% PCI:−.06 to −.49) in the mediation model when accounting for posttest job interview performance. In turn, the number of completed virtual interviews predicted posttest interviewing skills, which in turn predicted obtaining a job offer (Product-of-coefficients = .02, SD = .01, P < .05; 95% PCI:.01–.04). Conclusion: Results suggest that VR-JIT trainees have greater odds of receiving a job offer and may provide a mechanism of action that helps trainees across various psychiatric diagnoses obtain job offers in the community. Future research can evaluate the community-based effectiveness of this novel intervention.

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