scholarly journals Web-Based Cognitive Remediation Improves Supported Employment Outcomes in Severe Mental Illness: Randomized Controlled Trial

2017 ◽  
Vol 4 (3) ◽  
pp. e30 ◽  
Author(s):  
Anthony WF Harris ◽  
Tanya Kosic ◽  
Jean Xu ◽  
Chris Walker ◽  
William Gye ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Cognitive Deficits ◽  
Supported Employment ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Cognitive Remediation ◽  
Psychosocial Interventions ◽  
Web Based ◽  
Clinical Trials Registry

Background Finding work is a top priority for most people; however, this goal remains out of reach for the majority of individuals with a severe mental illness (SMI) who remain on benefits or are unemployed. Supported employment (SE) programs aimed at returning people with a severe mental illness to work are successful; however, they still leave a significant number of people with severe mental illness unemployed. Cognitive deficits are commonly found in SMI and are a powerful predictor of poor outcome. Fortunately, these deficits are amenable to treatment with cognitive remediation therapy (CRT) that significantly improves cognition in SMI. CRT combined with SE significantly increases the likelihood of individuals with severe mental illness obtaining and staying in work. However, the availability of CRT is limited in many settings. Objective The aim of this study was to examine whether Web-based CRT combined with a SE program can improve the rate return to work of people with severe mental illness. Methods A total of 86 people with severe mental illness (mean age 39.6 years; male: n=55) who were unemployed and who had joined a SE program were randomized to either a Web-based CRT program (CogRem) or an Internet-based control condition (WebInfo). Primary outcome measured was hours worked over 6 months post treatment. Results At 6 months, those participants randomized to CogRem had worked significantly more hours (P=.01) and had earned significantly more money (P=.03) than those participants randomized to the WebInfo control condition. No change was observed in cognition. Conclusions This study corroborates other work that has found a synergistic effect of combining CRT with a SE program and extends this to the use of Web-based CRT. The lack of any improvement in cognition obscures the mechanism by which an improved wage outcome for participants randomized to the active treatment was achieved. However, the study substantially lowers the barrier to the deployment of CRT with other psychosocial interventions for severe mental illness. Trial Registration Australian and New Zealand Clinical Trials Registry (ANZCTR) 12611000849998; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=12611000849998&isBasic=True (Archived by WebCite at http://www.webcitation.org/6sMKwpeos)

scholarly journals A Controlled Trial of Supported Employment for People With Severe Mental Illness and Justice Involvement

2015 ◽  
Vol 66 (10) ◽  
pp. 1027-1034 ◽  
Author(s):  
Gary R. Bond ◽  
Sunny Jung Kim ◽  
Deborah R. Becker ◽  
Sarah J. Swanson ◽  
Robert E. Drake ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Supported Employment ◽  
Controlled Trial

scholarly journals An Overview of Cognitive Remediation Therapy for People with Severe Mental Illness

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Cherrie Galletly ◽  
Ashlee Rigby
Keyword(s):  
Mental Illness ◽  
Cognitive Function ◽  
Mental Disorders ◽  
Severe Mental Illness ◽  
Cognitive Deficits ◽  
Cognitive Remediation ◽  
Mental Illnesses ◽  
Cognitive Remediation Therapy ◽  
Severe Mental Disorders ◽  
Varying Length

Cognitive remediation refers to nonpharmacological methods of improving cognitive function in people with severe mental disorders. Cognitive remediation therapy (CRT) can be delivered via computerised programs, of varying length and complexity, or can be undertaken one-on-one by a trained clinician. There has been a considerable interest in cognitive remediation, driven by recognition that cognitive deficits are a major determinant of outcome in people with severe, chronic mental illnesses. CRT has been shown to be effective, especially if combined with vocational rehabilitation.

scholarly journals The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial

The Lancet ◽  
2007 ◽  
Vol 370 (9593) ◽  
pp. 1146-1152 ◽  
Author(s):  
Tom Burns ◽  
Jocelyn Catty ◽  
Thomas Becker ◽  
Robert E Drake ◽  
Angelo Fioritti ◽  
...  
Keyword(s):  
Mental Illness ◽  
Randomised Controlled Trial ◽  
Severe Mental Illness ◽  
Supported Employment ◽  
Controlled Trial ◽  
Randomised Controlled

scholarly journals Characteristics of people with severe mental illness who obtain employment

2010 ◽  
Vol 34 (2) ◽  
pp. 47-50 ◽  
Author(s):  
G. Butler ◽  
L. Howard ◽  
S. Choi ◽  
G. Thornicroft
Keyword(s):  
Mental Illness ◽  
Randomised Controlled Trial ◽  
Severe Mental Illness ◽  
Educational Level ◽  
Supported Employment ◽  
Controlled Trial ◽  
Clinical Implications ◽  
Clinical Factors ◽  
Factors Associated ◽  
Randomised Controlled

Aims and methodWe explored sociodemographic and clinical factors associated with obtaining employment for people with severe mental illness. Standardised validated interviews and questionnaires were administered to participants who had been recruited into a randomised controlled trial of supported employment.ResultsOlder age and diagnosis of schizophrenia were found to be independent predictors of unemployment in the previous year. Other factors of unemployment such as ethnicity and educational level were not associated with obtaining employment.Clinical implicationsOlder people and those with a diagnosis of schizophrenia may need additional targeted help in obtaining employment if they are to be helped to meet their vocational aims. Further research is needed to determine how this can be done most effectively.

scholarly journals Supported employment: randomised controlled trial

2010 ◽  
Vol 196 (5) ◽  
pp. 404-411 ◽  
Author(s):  
Louise M. Howard ◽  
Margaret Heslin ◽  
Morven Leese ◽  
Paul McCrone ◽  
Christopher Rice ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Supported Employment ◽  
Controlled Trial ◽  
Intervention Group ◽  
Competitive Employment ◽  
Treatment As Usual ◽  
The Individual ◽  
Randomised Controlled ◽  
The Uk

BackgroundThere is evidence from North American trials that supported employment using the individual placement and support (IPS) model is effective in helping individuals with severe mental illness gain competitive employment. There have been few trials in other parts of the world.AimsTo investigate the effectiveness and cost-effectiveness of IPS in the UK.MethodIndividuals with severe mental illness in South London were randomised to IPS or local traditional vocational services (treatment as usual) (ISRCTN96677673).ResultsTwo hundred and nineteen participants were randomised, and 90% assessed 1 year later. There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment (13% in the intervention group and 7% in controls; risk ratio 1.35, 95% CI 0.95–1.93, P = 0.15), nor in secondary outcomes.ConclusionsThere was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up, which may reflect suboptimal implementation. Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services, and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals.

Videoconferencing in a mental health service in The Netherlands: A randomized controlled trial on patient satisfaction and clinical outcomes for outpatients with severe mental illness

2016 ◽  
Vol 23 (5) ◽  
pp. 513-520 ◽  
Author(s):  
Alexander M Hulsbosch ◽  
M Annet Nugter ◽  
Petra Tamis ◽  
Hans Kroon
Keyword(s):  
Mental Illness ◽  
Patient Satisfaction ◽  
Severe Mental Illness ◽  
Effect Size ◽  
Statistical Power ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Added Value ◽  
Control Group ◽  
Degree Of Satisfaction

Introduction The goal of the study was to determinate if there was added value in the use of videoconferencing (VCF) in outpatient care for people with severe mental illness (SMI). Methods A VCF-group was compared to a control group (care as usual) over a period of 18 months. Block randomization was used to assign patients to one of the two groups. The video communication was available to the patients on a 24/7 basis, so that emergency calls could also be made via VCF. The primary outcome was patient satisfaction, other outcomes were: quality of life, loneliness, daily functioning (psychologically and socially), and the fulfilment of needs of care. Eventually, 93 patients signed their informed consent and participated. Results For the primary outcome a statistically significant time by treatment interaction effect was found, where higher degree of satisfaction was associated with the patients in the VCF-group. The secondary outcomes revealed no differences between the two groups. Despite the participants not using the VCF units extensively during the project, they were reasonably satisfied with VCF; on average, they rated the service with a 7.5 grade (on a scale from 1–10). Discussion Although the study showed a positive result for patient satisfaction, overall the VCF seemed to have limited impact. So VCF might not offer much added value to care as usual. However, statistical power in this study dropped somewhat due to dropout. Furthermore, VCF usage was lower than expected. Assuming that VCF will be most effective if it is actually used, it seems likely that the actual effect-size reached in this study has been significantly lower than the anticipated effect-size. Finally, this study shows that VCF is a tool that can be used in the care for people with severe mental illness.

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