Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study
Abstract
Objective To examine whether supported employment (SE) is more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI).Design Prospective, randomized, controlled, multisite trial of SE versus TAU for vocational issues with 12 months of follow-up data.Setting SCI centers in the Veterans Health Administration.Participants Subjects (N=201) were enrolled and completed baseline interviews. In interventional sites, subjects were randomly assigned to the SE condition (n=81) or the TAU condition (treatment as usual-interventional site [TAU-IS], n=76). In observational sites where the SE program was not available, 44 subjects were enrolled in a nonrandomized TAU condition (treatment as usual-observational site [TAU-OS]).Interventions The intervention consisted of an SE vocational rehabilitation program called the Spinal Cord Injury Vocational Integration Program, which adhered as closely as possible to principles of SE as developed and described in the individual placement and support model of SE for persons with mental illness.Main outcome measures The primary study outcome measurement was competitive employment in the community.Results Subjects in the SE group were 2.5 times more likely than the TAU-IS group and 11.4 times more likely than the TAU-OS group to obtain competitive employment.Conclusions To the best of our knowledge, this is the first and only controlled study of a specific vocational rehabilitation program to report improved employment outcomes for persons with SCI. SE, a well-prescribed method of integrated vocational care, was superior to usual practices in improving employment outcomes for veterans with SCI.
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Research in SE now includes other disabilities such as spinal cord injury and affective disorders.
“Although research in SE first looked at those with severe mental illness, it now includes other disabilities such as spinal cord injury [16, 24] and affective disorders [17].”
From Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support (2019) · cites this paper as [16]
Ottomanelli and colleagues showed that veterans with spinal cord injuries have improved competitive employment outcomes when placed in SE/IPS treatments compared to standard ones.
“Ottomanelli and colleagues show that veterans with SCI have improved CE outcomes when placed in SE/IPS treatments compared to standard ones [16].”
From Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support (2019) · cites this paper as [16]
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- Authors
- Ottomanelli, L., Goetz, L. L., Suris, A., McGeough, C., Sinnott, P. L., Toscano, R., Barnett, S. D., Cipher, D. J., Lind, L. M., Dixon, T. M., Holmes, S. A., Kerrigan, A. J., & Thomas, F. P.
- Affiliations
- James A. Haley Veterans' Hospital (US)
- VA North Texas Health Care System (US)
- United States Department of Veterans Affairs (US)
- The University of Texas at Arlington (US)
- The University of Texas Southwestern Medical Center (US)
- Louis Stokes Cleveland VA Medical Center (US)
- Michael E. DeBakey VA Medical Center (US)
- St. Louis VA Medical Center (US)
- Corresponding author
- Ottomanelli, Lisa
- ORCID
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 93
- Issue
- 5
- Pages
- 740-747
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2145629933
- Cited by
- 103
- References
- 33
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 13 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 10 · 2019: 8 · 2018: 11 · 2017: 10 · 2016: 6 · 2015: 9 · 2014: 9 · 2013: 3 · 2012: 2
- FWCI
- 19.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Lincoln (University of Nebraska) (submittedVersion)
- Topics
- Social Sciences › Safety Research › Disability Education and Employment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- supported employment, spinal cord injury, veterans, vocational rehabilitation, competitive employment, Individual Placement and Support, usual care, employment effects
- MeSH terms
- Adult, Employment, Female, Humans, Male, Middle Aged, Salaries and Fringe Benefits, Spinal Cord Injuries, Time Factors, United States, United States Department of Veterans Affairs, Veterans, Employment, Supported
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