Effectiveness of Supported Employment for Veterans With Spinal Cord Injury: 2-Year Results
Abstract
Objective To examine if supported employment (SE) remains more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI) at 2-year follow-up.Design Prospective, randomized, controlled, multisite trial of SE versus TAU with 24 months of follow-up.Setting SCI centers.Participants Subjects (N=201) were enrolled and completed baseline interviews. At interventional sites, subjects were randomized to SE (n=81) or TAU (n=76). At observational sites, 44 subjects were enrolled in a nonrandomized TAU condition.Intervention The intervention was a SE program called the SCI Vocational Integration Program, which followed the principles of the individual placement and support model of SE for persons with mental illness.Main outcome measures Competitive employment in the community within 2 years.Results For the entire 2-year follow-up period, SE subjects were significantly more likely to achieve employment (30.8%; 95% confidence interval [CI], 21.8-41.6) than either the TAU subjects at the intervention sites (10.5%; 95% CI, 5.2-19.7; P<.001) or the TAU subjects at the observational sites (2.3%; 95% CI, 0.0-12.9; P<.002). Most subjects who obtained competitive employment did so in year 1, and the average time to first employment was about 17 weeks.Conclusions SE was better than usual practices in improving employment outcomes for veterans with SCI across a 2-year follow-up period. Although SE continued to be superior to traditional practices over the entire study, the first year of participation in SE may represent a critical window for achieving employment after SCI.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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 [24]
Cites
An update on randomized controlled trials of evidence-based supported employment.
Bond, G. R., Drake, R. E., & Becker, D. R. (2008) · Psychiatric Rehabilitation Journal · doi:10.2975/31.4.2008.280.290 · Cited by 696 · see citing works
Implementing Supported Employmentas an Evidence-Based Practice
Bond, G. R., Becker, D. R., Drake, R. E., Rapp, C. A., Meisler, N., Lehman, A. F., Bell, M. D., & Blyler, C. R. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.3.313 · Cited by 681 · see citing works
Supported Employment: Evidence for an Evidence-Based Practice.
Bond, G. R. (2004) · Psychiatric Rehabilitation Journal · doi:10.2975/27.2004.345.359 · Cited by 636 · see citing works
Ottomanelli, L., & Lind, L. M. (2009) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2009.11754553 · Cited by 218 · see citing works
Self-citationIndividual Placement and Support: An Evidence-Based Approach to Supported Employment
Drake, R. E., Bond, G. R., & Becker, D. R. (2012) · Cited by 189 · see citing works
Bond, G. R., Becker, D. R., & Drake, R. E. (2011) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2011.01244.x · Cited by 124 · see citing works
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., et al. (2012) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2012.01.002 · Cited by 103 · see citing works
Self-citationDimensions of supported employment: Factor structure of the IPS fidelity scale
Bond, G. R., Vogler, K. M., Resnick, S. G., Evans, L. J., Drake, R. E., & Becker, D. R. (2001) · Journal of Mental Health · doi:10.1080/09638230124258 · Cited by 50 · see citing works
Ottomanelli, L., Goetz, L. L., McGeough, C., Surís, A., Sippel, J. L., Sinnott, P. L., Wagner, T. H., & Cipher, D. J. (2009) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2008.10.0145 · Cited by 37 · see citing works
Self-citationSupported employment interventions are effective for people with severe mental illness
Becker, D. R., & Drake, R. E. (2006) · Evidence-Based Mental Health · doi:10.1136/ebmh.9.1.22 · Cited by 18 · see citing works
Flagged first, then by citations
1 of the 11 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
A Systematic Review of Interventions on Patients’ Social and Economic Needs
Gottlieb, L. M., Wing, H., & Adler, N. E. (2017) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2017.05.011 · Cited by 455 · see citing works
Frederick, D. E., & VanderWeele, T. J. (2019) · PLOS ONE · doi:10.1371/journal.pone.0212208 · Cited by 219 · see citing works
Economic impact of traumatic spinal cord injuries in the United States
Merritt, C. H., Taylor, M. A., Yelton, C. J., & Ray, S. K. (2019) · Neuroimmunology and Neuroinflammation · doi:10.20517/2347-8659.2019.15 · Cited by 117 · see citing works
Supported employment for persons with serious mental illness: Current status and future directions
Mueser, K. T., & McGurk, S. R. (2014) · L Encéphale · doi:10.1016/j.encep.2014.04.008 · Cited by 94 · see citing works
Bond, G. R., Drake, R. E., & Pogue, J. A. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201800464 · Cited by 74 · see citing works
Individual placement and support: History, current status, and future directions
Drake, R. E., & Bond, G. R. (2023) · Psychiatry and Clinical Neurosciences Reports · doi:10.1002/pcn5.122 · Cited by 72 · see citing works
Hilton, G., Unsworth, C. A., & Murphy, G. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1312566 · Cited by 64 · see citing works
Rose, S. M. S.-F., Eslinger, J. G., Zimmerman, L., Scaccia, J., Lai, B., Lewis, C. E., & Alisic, E. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157726 · Cited by 52 · see citing works
Employment Interventions in Health Settings: A Systematic Review and Synthesis
Pinto, A. D., Hassen, N., & Craig-Neil, A. (2018) · The Annals of Family Medicine · doi:10.1370/afm.2286 · Cited by 50 · see citing works
Roels, E. H., Aertgeerts, B., Ramaekers, D., & Peers, K. (2015) · Spinal Cord · doi:10.1038/sc.2015.133 · Cited by 48 · see citing works
Military and Mental Health Correlates of Unemployment in a National Sample of Women Veterans
Hamilton, A. B., Williams, L. A., & Washington, D. L. (2015) · Medical Care · doi:10.1097/mlr.0000000000000297 · Cited by 41 · see citing works
Hilton, G., Unsworth, C. A., Murphy, G. C., Browne, M., & Olver, J. S. (2017) · Spinal Cord · doi:10.1038/sc.2017.24 · Cited by 48 · see citing works
Ramakrishnan, K., Johnston, D., Garth, B., Murphy, G., Middleton, J. W., & Cameron, I. D. (2016) · Topics in Spinal Cord Injury Rehabilitation · doi:10.1310/sci2203-183 · Cited by 33 · see citing works
Probyn, K., Engedahl, M. S., Rajendran, D., Pincus, T., Naeem, K., Mistry, D., Underwood, M. R., & Froud, R. (2021) · Primary Health Care Research & Development · doi:10.1017/s1463423621000827 · Cited by 32 · see citing works
Ottomanelli, L., Goetz, L. L., Barnett, S. D., Njoh, E. N., Dixon, T. M., Holmes, S. A., LePage, J. P., Ota, D., Sabharwal, S., & White, K. T. (2017) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2016.12.010 · Cited by 32 · see citing works
Self-citationZimmermann, G., Bolter, L., Sluka, R., Höller, Y., Bathke, A. C., Thomschewski, A. C., Leis, S., Lattanzi, S., Brigo, F., & Trinka, E. (2019) · Journal of Evidence-Based Medicine · doi:10.1111/jebm.12356 · Cited by 29 · see citing works
Holmlund, L., Guidetti, S. G. E., Eriksson, G. M., & Asaba, E. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1362597 · Cited by 25 · see citing works
Mueller, L. N., Wolfe, W. R., Neylan, T. C., McCaslin, S. E., Yehuda, R., Flory, J. D., Kyriakides, T. C., Toscano, R., & Davis, L. L. (2019) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000345 · Cited by 25 · see citing works
Labour market outcomes of Veterans
MacLean, M. B., Keough, J., Poirier, A., McKinnon, K., & Sweet, J. (2019) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.2017-0016 · Cited by 19 · see citing works
Evaluation Activities and Influences at the Intersection of Medical and Social Services
Gottlieb, L. M., Ackerman, S., Wing, H. E., & Adler, N. E. (2017) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2017.0089 · Cited by 17 · see citing works
Cost-effectiveness of supported employment for veterans with spinal cord injuries
Sinnott, P. L., Joyce, V., Su, P., Ottomanelli, L., Goetz, L. L., & Wagner, T. H. (2014) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.01.010 · Cited by 19 · see citing works
Self-citationBond, G. R., Al‐Abdulmunem, M., Ressler, D. R., Gade, D. M., & Drake, R. E. (2022) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-022-01208-z · Cited by 16 · see citing works
Wehman, P. (2023) · Journal of Vocational Rehabilitation · doi:10.3233/jvr-230022 · Cited by 16 · see citing works
Craig, A. R., Duff, J., & Middleton, J. W. (2021) · Comprehensive Clinical Psychology · doi:10.1016/b978-0-12-818697-8.00061-3 · Cited by 11 · see citing works
Perspectives on the State of the Art (and Science) of Selected Life-Span Services
Agran, M., Spooner, F., Brown, F., Morningstar, M. E., Singer, G. H. S., & Wehman, P. (2018) · Research and Practice for Persons with Severe Disabilities · doi:10.1177/1540796918769566 · Cited by 11 · see citing works
Evaluation of an Employment Intervention for Veterans Transitioning From the Military
Bond, G. R., Al‐Abdulmunem, M., Ressler, D. R., Drake, R. E., Davis, L. L., Meyer, T. S., Gade, D. M., Frueh, B. C., & Dickman, R. B. (2021) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001472 · Cited by 11 · see citing works
Employers’ perceptions of supports provided to their employees with disabilities
Almalky, H. A., & Alasmari, A. N. (2024) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2024.104750 · Cited by 10 · see citing works
Ponsford, J. L., Downing, M. G., O’Kearney, E., Bedekar, Y., Hilton, G., Mortimer, D., Fossey, E. M., Barclay, L., Olver, J., Castle, W., et al. (2025) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2025.101972 · Cited by 11 · see citing works
Reims, N., & Tisch, A. (2022) · Work · doi:10.3233/wor-205046 · Cited by 10 · see citing works
Cotner, B. A., Ottomanelli, L., Keleher, V., & Dirk, L. (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1443161 · Cited by 10 · see citing works
Self-citationEconomic evaluation of a supported employment program for veterans with spinal cord injury
Sutton, B. S., Ottomanelli, L., Njoh, E. N., Barnett, S. D., & Goetz, L. L. (2019) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1527955 · Cited by 8 · see citing works
Self-citationHolmlund, L., Guidetti, S. G. E., Hultling, C., Seiger, Å., Eriksson, G. M., & Asaba, E. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-036000 · Cited by 8 · see citing works
Back2Work: a new model of early vocational rehabilitation for people with spinal cord injury
McLennan, V., Dorsett, P., Bloom, J., Goossen, T., & Porter, F. (2021) · Australian Health Review · doi:10.1071/ah21069 · Cited by 7 · see citing works
Kendrick, D., Lindley, R., Blackburn, L., Roadevin, C., Thompson, E., Andrews, I. R., Anwar, F., Brooks, A. J., Carlton, E., Crouch, R., et al. (2024) · Trials · doi:10.1186/s13063-024-08183-w · Cited by 5 · see citing works
Update on Individual Placement and Support for New Populations: A Meta-Analytic Review
Bond, G. R., Drake, R. E., & Becker, D. R. (2025) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-025-10347-7 · Cited by 4 · see citing works
Individual Placement and Support Helps People With Spinal Cord Injury Find and Keep Jobs They Want
Ottomanelli, L., Cotner, B. A., Swanson, S. J., Dirk, L., Arriola, N. B., Carlomagno, J., & Toscano, R. (2023) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2022.11.019 · Cited by 4 · see citing works
Self-citationLonger-term employment outcomes of ex-service personnel
Fisher, N. C., Newell, K. A., Barnes, S.-A., Owen, D., & Lyonette, C. (2021) · Warwick Research Archive Portal (University of Warwick) · doi:10.82444/warw.33832150 · Cited by 3 · see citing works
Nizeyimana, E., Louw, Q. A., & Joseph, C. (2025) · Advances in Rehabilitation Science and Practice · doi:10.1177/27536351251326797 · Cited by 2 · see citing works
Employment of persons with disabilities in the open labour market: A scoping review
Ximba, T. M., van Biljon, H., Adams, F., & van Niekerk, L. (2026) · African Journal of Disability · doi:10.4102/ajod.v15i0.1873 · Cited by 2 · see citing works
Ottomanelli, L., Smith, T. J., Cotner, B. A., Toyinbo, P. A., Venkatachalam, H. H., McDonald, S. D., Goetz, L. L., Cessna-Palas, J., Mendelson, S., Dillahunt-Aspillaga, C. J., et al. (2023) · Journal of Vocational Rehabilitation · doi:10.3233/jvr-230016 · Cited by 2 · see citing works
Self-citationMatthews, L. R., McLennan, V., Jessup, G. M., Pebdani, R. N., & Bloom, J. (2025) · Rehabilitation Counseling Bulletin · doi:10.1177/00343552251320949 · Cited by 1 · see citing works
Facilitating Competitive Employment for People with Disabilities
Bond, G. R., Drake, R. E., & Pogue, J. A. (2020) · Springer eBooks · doi:10.1007/978-3-030-24334-0_31 · Cited by 1 · see citing works
Fatehi, F., Hosseini, S. A., Akbarfahimi, N., & Yavari, A. (2024) · Medical Journal of the Islamic Republic of Iran · doi:10.47176/mjiri.38.76 · Cited by 1 · see citing works
Exploring Post-acute Care Challenges and Opportunities in Spinal Cord Injuries
Tamayo, N. C. R., Quinzaños-Fresnedo, J., Sánchez, A. L., Velásquez-Cano, M., Aceves, M. A., Reyes, E. L., & Abramoff, B. A. (2024) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2024.08.003 · Cited by 1 · see citing works
Disability and compensation principles in military-to-civilian transition support
MacLean, M. B., Murray, R., & Lazier, R. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815312-3.00008-5 · Cited by 1 · see citing works
Facilitating Competitive Employment for People with Disabilities
Bond, G. R., Drake, R. E., & Pogue, J. A. (2020) · Springer eBooks · doi:10.1007/978-3-319-75381-2_31-1 · Cited by 1 · see citing works
Holmlund, L. (2019) · Figshare
Employers' Perceptions of Provided Supports to Their Employees with DisabilitiesPreprint
Almalky, H. A., & Alasmari, A. N. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4790965
Bond, G. R., Metcalfe, J. D., & Al‐Abdulmunem, M. (2025) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-025-09934-6
Middleton, J. W. (2025) · Journal of the International Society of Physical and Rehabilitation Medicine · doi:10.1097/ph9.0000000000000072
Implementing employability interventions for workers with health conditions: A systematic review
Daniels, K., Fitzhugh, H., & Nooraya, R. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118597 · Cited by 1 · see citing works
Kendrick, D., Lindley, R., Blackburn, L., Roadevin, C., Thompson, E., Andrews, I. R., Anwar, F., Brooks, A., Carlton, E., Crouch, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26157599
Kendrick, D., Lindley, R., Blackburn, L., Roadevin, C., Thompson, E., Andrews, I. R., Anwar, F., Brooks, A., Carlton, E., Crouch, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26742248
Kendrick, D., Lindley, R., Blackburn, L., Roadevin, C., Thompson, E., Andrews, I. R., Anwar, F., Brooks, A., Carlton, E., Crouch, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26742245
Kendrick, D., Lindley, R., Blackburn, L., Roadevin, C., Thompson, E., Andrews, I. R., Anwar, F., Brooks, A., Carlton, E., Crouch, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26157152
van Velzen, J. M., Mollet, J. M., van Bennekom, C. A. M., & de Boer, A. G. E. M. (2026) · Brain Injury · doi:10.1080/02699052.2026.2654830
Jasionowicz, J. P., Triana, M. D. C., Vogus, T. J., & Delgado, J. (2026) · Journal of Management · doi:10.1177/01492063261456641
Vocational rehabilitation interventions in spinal cord injury: a scoping review
Rodríguez-Gomez, S., Garcia-Otero, B., & Sobrido, M. (2026) · Cadernos Brasileiros de Terapia Ocupacional · doi:10.1590/2526-8910.cto423541862
Intervenciones de rehabilitación vocacional en lesión medular: revisión del alcance
Rodríguez-Gomez, S., Garcia-Otero, B., & Sobrido, M. (2026) · Cadernos Brasileiros de Terapia Ocupacional · doi:10.1590/2526-8910.cto423541863
- Authors
- Ottomanelli, L., Barnett, S. D., & Goetz, L. L.
- Affiliations
- University of South Florida (US)
- James A. Haley Veterans' Hospital (US)
- Virginia Commonwealth University (US)
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 95
- Issue
- 4
- Pages
- 784-790
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2093586685
- Cited by
- 59
- References
- 11
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 9 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 9 · 2018: 3 · 2017: 6 · 2016: 2 · 2015: 2 · 2014: 2
- FWCI
- 5.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Safety Research › Disability Education and Employment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Keywords
- supported employment, spinal cord injury, veterans, competitive employment, Individual Placement and Support, vocational rehabilitation, usual care, employment effects, time to employment
- MeSH terms
- Absenteeism, Employment, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Salaries and Fringe Benefits, Spinal Cord Injuries, Time Factors, United States, United States Department of Veterans Affairs, Veterans, Employment, Supported, Return to Work
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
