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Abstract

Objective:

Posttraumatic stress disorder (PTSD) is a potentially disabling mental illness that can cause occupational dysfunction. Although vocational rehabilitation is often prescribed for patients with PTSD, standard vocational services are far from adequate in helping them obtain and maintain competitive employment. This study is the first to examine the outcome of evidence-based supported employment for veterans with PTSD.

Methods:

Unemployed veterans with PTSD were randomly assigned to either individual placement and support (IPS) supported employment (N=42) or a Veterans Health Administration Vocational Rehabilitation Program (VRP) treatment as usual (N=43). Employment rates and occupational outcomes were followed for 12 months.

Results:

During the 12-month study, 76% of the IPS participants gained competitive employment, compared with 28% of the VRP participants (number needed to treat=2.07; χ2=19.84, df=1, p<.001). Veterans assigned to IPS also worked substantially more weeks than those assigned to VRP (42% versus 16% of the eligible weeks, respectively; Mann-Whitney z test p<.001) and earned higher 12-month income (mean±SD income of $9,264±$13,294 for IPS versus $2,601±$6,009 for VRP; Mann-Whitney z test p<.001) during the 12-month period.

Conclusions:

Veterans with PTSD who received IPS were 2.7 times more likely to gain competitive employment than those who received VRP. Because work is central to recovery, these results should assist stakeholders in planning improved services for veterans with PTSD. (Psychiatric Services 63:464–470, 2012; doi:10.1176/appi.ps.201100340)

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Figures and Tables

Figure 1 Time from randomization until first competitive employment among veterans receiving individual placement and support (IPS) supported employment or the Vocational Rehabilitation Program (VRP)
Table 1 Comparison of the Veterans Health Administration Vocational Rehabilitation Program (VRP) and individual placement and support (IPS)
Table 2 Baseline characteristics of veterans with posttraumatic stress disorder (PTSD) randomly assigned to individual placement and support (IPS) supported employment or the Veterans Health Administration Vocational Rehabilitation Program (VRP)
Table 3 Occupational outcomes of veterans with posttraumatic stress disorder who received individual placement and support (IPS) supported employment or the Veterans Health Administration Vocational Rehabilitation Program (VRP)

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 464 - 470
PubMed: 22307881

History

Published online: 1 May 2012
Published in print: May 2012

Authors

Details

Lori L. Davis, M.D. [email protected]
Dr. Davis and Mr. Toscano are affiliated with the Research and Development Service and Dr. Ward is with the Psychology Service, all at the Tuscaloosa Veterans Affairs Medical Center (VAMC), 3701 Loop Road East, Tuscaloosa, AL 35404 (e-mail: [email protected]).
Andrew C. Leon, Ph.D.
The late Dr. Leon was with the Department of Psychiatry, Weill Cornell Medical College, New York.
Richard Toscano, M.Ed. [email protected]
Dr. Davis and Mr. Toscano are affiliated with the Research and Development Service and Dr. Ward is with the Psychology Service, all at the Tuscaloosa Veterans Affairs Medical Center (VAMC), 3701 Loop Road East, Tuscaloosa, AL 35404 (e-mail: [email protected]).
Charles E. Drebing, Ph.D.
Dr. Drebing is with the Department of Psychiatry, Boston University School of Medicine, and with the New England Mental Illness Research, Education and Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts.
L. Charles Ward, Ph.D. [email protected]
Dr. Davis and Mr. Toscano are affiliated with the Research and Development Service and Dr. Ward is with the Psychology Service, all at the Tuscaloosa Veterans Affairs Medical Center (VAMC), 3701 Loop Road East, Tuscaloosa, AL 35404 (e-mail: [email protected]).
Pamela E. Parker, M.D.
Dr. Parker is with the Mental Health Service, VAMC, Birmingham, Alabama.
T. Michael Kashner, Ph.D., J.D.
Dr. Kashner is with the Office of Academic Affiliations, U.S. Department of Veterans Affairs, Washington, D.C., and with Loma Linda University School of Medicine, Loma Linda, California.
Robert E. Drake, M.D., Ph.D.
Dr. Drake is with the Psychiatric Research Center, Dartmouth Medical School, Lebanon, New Hampshire.

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