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Published Online: 3 January 2020

Contents and Intensity of Services in Low- and High-Fidelity Programs for Supported Employment: Results of a Longitudinal Survey

Abstract

Objective:

Little is known about the association between service intensity and fidelity scale score in supported employment programs. This study compares service contents and intensity in low- and high-fidelity programs and examines the validity of the Japanese version of the individualized Supported Employment Fidelity Scale.

Methods:

The vocational outcomes and service provision data for 51 individuals with schizophrenia in 13 supported employment programs were collected over a 12-month study period. Outcomes, service contents, and service intensity were compared between the low-fidelity group (seven programs; N=29) and the high-fidelity group (six programs; N=22).

Results:

In both groups, 70% of the total services (hours) were provided in the first 6 months. The high-fidelity group, which was associated with better vocational outcomes than the low-fidelity group (employment rate, 68% versus 38%, respectively), made the greatest effort in job development outside of the agency, whereas the low-fidelity group spent more time on group services. In addition, before the client obtained a job, high-fidelity programs provided outreach services (B=7.2, p=0.043) and agency-based individual services (B=5.7, p<0.001) at greater intensity than did low-fidelity programs. However, no significant between-group difference was found in service intensity once clients were employed.

Conclusions:

Supported employment programs with a high fidelity score focus more intensely on providing individual services in and outside of the agency, particularly before clients obtain a job. However, clarification of the relationships among service quality at the structure level, amount of follow-up services, and individual needs in supported employment programs is a future issue.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 472 - 479
PubMed: 31896342

History

Received: 19 May 2019
Revision received: 17 September 2019
Accepted: 24 October 2019
Published online: 3 January 2020
Published in print: May 01, 2020

Keywords

  1. Fidelity
  2. Longitudinal survey
  3. Service content
  4. Service intensity
  5. Supported employment

Authors

Details

Sosei Yamaguchi, Ph.D. [email protected]
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).
Masashi Mizuno, Ph.D.
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).
Sayaka Sato, Ph.D.
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).
Asami Matsunaga, M.Sc.
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).
Natsuki Sasaki, M.Sc.
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).
Michiyo Shimodaira, Ph.D.
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).
Chiyo Fujii, Ph.D., M.D.
Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo (Yamaguchi, Sato, Matsunaga, Shimodaira, Fujii); Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Tokyo (Mizuno); Brown School, Washington University in Saint Louis, St. Louis (Sasaki).

Notes

Send correspondence to Dr. Yamaguchi ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

JSPS KAKENHI: Grant-in-Aid for Young Scientists [B], 16K21661: D
Ministry of Health, Labour and Welfarehttp://dx.doi.org/10.13039/501100003478: H26-002: A study on facilitating employment for pe
This study was funded by the Ministry of Health, Labor, and Welfare in Japan (H26-002, “A Study on Facilitating Employment for People With Mental Illness”) and JSPS KAKENHI (Grant-in-Aid for Young Scientists [B], 16K21661, “Development of Japanese Version of IPS/Supported Employment Fidelity Scale and Evaluation System”).

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