Effect of Evidence-Based Supported Employment vs Transitional Work on Achieving Steady Work Among Veterans With Posttraumatic Stress Disorder

作者：Lori L. Davis, Tassos C. Kyriakides, Alina Surís, Lisa Ottomanelli, Lisa Mueller, Pamela E. Parker, Sandra G. Resnick, Richard Toscano, Alexandra Scrymgeour, Robert E. Drake, for the VA CSP #589 Veterans Individual Placement and Support Toward Advancing Recovery Investigators · 发表于：JAMA Psychiatry · 年份：2018 · DOI：10.1001/jamapsychiatry.2017.4472 · 被引用次数：85 · 研究领域：Posttraumatic Stress Disorder Research、Healthcare professionals’ stress and burnout、Occupational Therapy Practice and Research

Importance: Posttraumatic stress disorder (PTSD) often interferes with a person's ability to obtain or sustain employment, which leads to premature exit from the labor force and reduced income. Objective: To determine whether individual placement and support (IPS)-supported employment is more effective than stepwise vocational rehabilitation involving transitional work assignments at helping veterans with PTSD attain steady, competitive employment. Design, Setting, and Participants: The Veterans Individual Placement and Support Toward Advancing Recovery (VIP-STAR) study was a prospective, multisite, randomized clinical trial that included 541 unemployed veterans with PTSD at 12 Veterans Affairs medical centers. Data were collected from December 23, 2013, to May 3, 2017. Intent-to-treat analysis was performed. Interventions: Individual placement and support is a supported employment intervention that rapidly engages people with disabilities in community job development to obtain work based on their individual job preferences. Transitional work is a stepwise vocational rehabilitation intervention that assigns people temporarily to noncompetitive jobs as preparation for competitive employment in the community. Main Outcomes and Measures: A priori hypotheses were that, compared with those in transitional work, more participants in the IPS group would become steady workers (primary) and earn more income from competitive jobs (secondary) over 18 months. Steady worker was defined as...