The efficacy of supported employment for middle-aged and older people with schizophrenia
Open accessAbstract
Objective Supported employment is the evidence-based treatment of choice for assisting individuals with severe mental illness to achieve competitive employment, but few supported employment programs specifically target older clients with psychiatric illness. The purpose of this study was to evaluate the efficacy of supported employment for middle-aged or older people with schizophrenia.Method Participants included 58 outpatients with schizophrenia or schizoaffective disorder aged 45 or older who were recruited from a community mental health clinic. Participants were randomly assigned to receive Individual Placement and Support (IPS; the manualized version of supported employment) or conventional vocational rehabilitation (CVR) for one year, and completed assessments at baseline, six months, and twelve months.Results IPS was superior to CVR on nearly all work outcome measures, including attainment of competitive employment, weeks worked, and wages earned. Fifty-seven percent of IPS participants worked competitively, compared with 29% of CVR participants; 70% of IPS participants obtained any paid work, compared with 36% of CVR participants. Within the IPS group, better baseline functional capacity (as measured by the UCSD Performance Based Skills Assessment) and more recent employment were modestly associated with better work outcomes.Conclusions Middle-aged and older adults with schizophrenia are good candidates for supported employment services.
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RCTs have shown significant improvement with other manualized psychosocial interventions in older patients with schizophrenia, such as supported employment with or without compensatory cognitive training, to help them obtain and retain paid jobs.
“Randomized controlled trials have also shown significant improvement with other manualized psychosocial interventions in older patients with schizophrenia, such as supported employment without and with compensatory cognitive training to help them obtain and retain paid jobs282, 283.”
From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [282]
Previous research reported that for populations with schizophrenia or schizoaffective disorder, IPS proved more effective than treatment as usual as measured by subjects finding competitive employment (57% vs. 29%).
“Previous research reported that for populations with schizophrenia or schizoaffective disorder, IPS proved more effective than TAU as measured by subjects finding competitive employment (57% vs. 29%)[44].”
From Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support (2019) · cites this paper as [44]
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- Authors
- Twamley, E. W., Vella, L., Burton, C. Z., Becker, D. R., Bell, M. D., & Jeste, D. V.
- Affiliations
- University of California San Diego (US)
- San Diego State University (US)
- Dartmouth Psychiatric Research Center (US)
- Yale University (US)
- Corresponding author
- Twamley, Elizabeth W.
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 135
- Issue
- 1-3
- Pages
- 100-104
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC3288765
- OpenAlex
- W2049294452
- Cited by
- 75
- References
- 34
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 18 · 2018: 3 · 2017: 8 · 2016: 6 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 1
- FWCI
- 7.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- University of California, San Diego
- National Institute of Mental Health (K23MH066011, R01MH080150, MH066011)
- Topics
- Social Sciences › Safety Research › Disability Education and Employment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Keywords
- supported employment, Individual Placement and Support
- MeSH terms
- Aged, Aging, Employment, Female, Humans, Male, Middle Aged, Psychotic Disorders, Rehabilitation, Vocational, Schizophrenia, Schizophrenic Psychology, Severity of Illness Index, Employment, Supported, Outcome Assessment, Health Care, Evidence-Based Medicine, Area Under Curve
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