Abstract
PurposeThis paper aims to investigate the feasibility of conducting research on a two-pronged vocational intervention for people with first episode psychosis. The paper also aims to empirically examine the impact of a two-pronged vocational intervention for people with first episode psychosis by determining what effect, if any, introducing a two-pronged vocational intervention to an early intervention for psychosis service (EIPS) has on vocational outcomes using a prospective follow-up design. The approach consisted of supported employment (individual placement and support, IPS) for participants without a productive role and a job retention programme for those employed or studying.Design/methodology/approachBetween 2010 and 2013, a supported employment specialist joined an EIPS where occupational therapy was available to all attenders. The appropriate intervention was determined by the occupational therapist on the team. Participants were interviewed at baseline and one follow-up. Ethical approval was attained. The Individual Placement and Support Fidelity Scale was used to ensure the quality of IPS implementation.FindingsIn total, 39 (20 men, 19 women) consented; 21 (54 per cent) of these participants were unoccupied; 18 (46 per cent) had a productive role; 87 per cent (n= 34) were followed up. The mean length of follow-up was 18 months. At follow-up, 50 per cent (n= 10) of unoccupied participants had attained a productive role, and 17 of the 18 participants had retained their productive role. Overall, participants were found to have spent an average of 62 per cent of the follow-up period in a productive role.Research limitations/implicationsRates of vocational recovery among people affected by psychosis may be enhanced by a two-pronged approach that allows for the persons individual work circumstances to be taken into account.Originality/valueThis study highlights the impact of a two-progroned vocational intervention for people with first episode psychosis in Ireland. It is the first study of its kind to be published in the Republic of Ireland and the first world-wide to include a job retention element in its design.
Highlights
Despite research highlighting the poor extent of vocational recovery among people affected by psychotic conditions, evidence-based interventions for addressing the problem are not widely available (Boardman and Rinaldi, 2013; McGurk and Mueser, 2016)
Research limitations/implications – Rates of vocational recovery among people affected by psychosis may be enhanced by a two-pronged approach that allows for the persons individual work circumstances to be taken into account
This study empirically examines the impact of a two-pronged vocational intervention for people with first episode psychosis (FEP) by determining what effect, if any, its introduction to an early intervention for psychosis service (EIPS) has on vocational outcomes using a prospective follow-up design
Summary
Despite research highlighting the poor extent of vocational recovery among people affected by psychotic conditions, evidence-based interventions for addressing the problem are not widely available (Boardman and Rinaldi, 2013; McGurk and Mueser, 2016). Rates of employment of over 50 per cent are reported among clinical trial populations who receive approaches such as individual placement and support (IPS), whereas without such interventions rates of 25 per cent are typically reported (Becker et al, 2014; Bond et al, 2012; Bond et al, 2015; Burns et al, 2007; Modini et al, 2016a; Marwaha and Johnson, 2004; Marwaha et al, 2007). Prospective studies have highlighted that the level of employment typically declines over time among schizophrenia cohorts (Lindgren et al, 2006; Marwaha and Johnson, 2004; Marwaha et al, 2014). While a number of studies of supported employment have been conducted by occupational therapists in Ireland and elsewhere, the literature remains underdeveloped (Hynes and Harb, 2017; Oka et al, 2004; Noyes et al, 2018)
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