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Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support
Open accessAbstract
Supported employment is a treatment whereby those with severe mental illness (or other disabilities) receive aid searching for competitive employment and mental health (or other) treatments concurrently. The most popular implementation of supported employment is individual placement and support (IPS). We conducted meta-analytic analyses of the randomized controlled trials of IPS. We found that subjects in IPS, compared to usual treatment conditions, had better vocational outcomes (obtained any competitive employment: RR = 1.63, 95%CI = [1.46, 1.82]; job tenure: d = 0.55, 95%CI = [0.33, 0.79]; job length: d = 0.46, 95%CI = [0.35, 0.57]; income: d = 0.48, 95%CI = [0.36, 0.59]) Non-vocational outcomes estimates, while favoring IPS, included the null (quality of life: d = 0.30, 95%CI = [-0.07, 0.67]; global functioning: d = 0.09, 95%CI = [-0.09, 0.27]; mental health: d = 0.03, 95%CI = [-0.15, 0.21]). Analysis of the expected proportion of studies with a true effect on non-vocational outcomes with d>0.2 showed some reason to expect a possible improvement for quality of life for at least some settings (Prop = 0.57, 95%CI = [0.30, 0.84]).
Overview
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TL;DR
This meta-analysis of randomized controlled trials found that individual placement and support (IPS) supported employment reliably improves vocational outcomes compared with usual treatment, while non-vocational outcomes were smaller and mostly included the null. A novel proportion-of-settings analysis suggested possible quality-of-life benefits in some settings.
Key findings
- IPS increased any competitive employment (RR = 1.63, 95% CI [1.46, 1.82]) and end-of-study competitive employment (reported as 1.8x more likely; log(RR) = 0.58, 95% CI [0.42, 0.74]), and shortened time to first competitive employment (d = -0.31, 95% CI [-0.46, -0.15]).
- Secondary vocational outcomes favored IPS: job tenure d = 0.55, 95% CI [0.33, 0.79]; job length d = 0.46, 95% CI [0.35, 0.57]; income d = 0.48, 95% CI [0.36, 0.59].
- Non-vocational pooled estimates favored IPS but all confidence intervals included the null: quality of life d = 0.30, 95% CI [-0.07, 0.67]; global functioning d = 0.09, 95% CI [-0.09, 0.27]; mental health d = 0.03, 95% CI [-0.15, 0.21].
- The estimated proportion of settings with a true quality-of-life effect d > 0.2 was 0.57, 95% CI [0.30, 0.84], suggesting possible benefit in some settings.
Methods
- Searched PsycINFO; the primary query “supported employment AND randomized controlled trial” returned 111 results, a broader search returned 313, and after de-duplication 368 unique publications were screened. The final analysis included 30 articles: 25 original RCTs, 2 follow-up studies, and 3 secondary analyses comparing IPS with treatment as usual.
- Random-effects meta-analyses were run in R using the metafor package; binary outcomes used log relative risk and continuous outcomes used standardized mean differences, with intent-to-treat analyses using randomized Ns.
- The authors also estimated the proportion of settings with scientifically meaningful effects (RR > 1.2 or < 0.8; d > 0.2 or < -0.2) using the EValue library for samples with five or more articles.
Limitations
- The paper states that included articles varied greatly in quality, that some non-significant results were reported without estimates and could not be included, and that sample sizes were often powered only for the main outcome, limiting secondary outcomes.
- The paper reports substantial heterogeneity for some outcomes (e.g., quality of life I² = 94.90%; job tenure I² = 68.68%; mental health I² = 64.55%), and some analyses had few studies (job tenure k = 5; global functioning k = 5; mental health k = 6), making estimates imprecise.
- Evident from the text: the search and data extraction were done by the first author alone, and the discussion notes that cost-benefit evidence for SE/IPS is mixed and that SE/IPS is “not a panacea.”
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In the paper
“We estimated that scientific meaningful effects that we expect to be observed with d>0.2 was 0.90 (95%CI = [0.68, 1])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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In the paper
“and the proportion with d<-0.2 to be essentially zero (Prop = <0.001, 95%CI = [0, <0.001]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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In the paper
“Our estimates showed that there was significant heterogeneity in the underlying study populations.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“We estimated that those in IPS conditions would have significantly more income (Fig 5, k = 12; d = 0.48, SE = 0.06, Z = 8.31, p<0.0001, 95%CI = [0.36, 0.59], τ2 (SE) = 0.0004(0.02), I2 = 0.90%, H2 = 1.01, Q(11) = 8.3404, p = 0.6825).”
- Also stated in: § Discussion · plain
“and higher total income (d = 0.48, 95%CI = [0.36, 0.59], Fig 5).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Income from competitive employment
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Length was not a significant moderator (Length = -0.004, 95%CI = [-0.01, 0.005]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Income from competitive employment
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In the paper
“For finding CE during any part of a study, the proportion of studies with true RR>1.2 is estimated to be >0.99 (95%CI = [0.95, 1])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“RR<0.8, Proportion = <0.001, 95%CI = [0, <0.01]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“job length: d = 0.46, 95%CI = [0.35, 0.57]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For total time worked in CE, we estimated that those in the IPS condition worked significantly more than controls (Fig 4B, k = 17, d = 0.46, SE = 0.06, Z = 8.23, p<0.0001, 95%CI = [0.35, 0.57], τ2 (SE) = 0.02(0.02), I2 = 31.03%, H2 = 1.45).”
- Also stated in: § Discussion · plain
“longer durations of work (d = 0.46, 95%CI = [0.35, 0.57], Fig 4B)”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with the proportion of studies with true RR<0.8 expected to be <0.001 (95%CI = [0, <0.01])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“and none to be in the opposite direction with d<-0.2 (Prop = <0.001, 95%CI = [0, <0.001]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Income from competitive employment
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In the paper
“Estimates for length as a moderator for finding CE at any point during the study or having been in CE at the end of the study both were close to zero and included the null (Any: Length = -0.0001, 95%CI = [-0.01, 0.01]; End: Length = 0.0005, 95%CI = [-0.02, 0.02]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“We estimated that we would expect all settings to have an effect size d>0.2 (Prop = 1, 95%CI = [1, 1])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Income from competitive employment
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In the paper
“job tenure: d = 0.55, 95%CI = [0.33, 0.79]”
- Also stated in: § Job tenure & length of competitive employment · hedged
“For job tenure, we estimated that persons in IPS held a CE job longer than those in control conditions (Fig 4A, k = 5, d = 0.56, SE = 0.12, Z = 4.72, p<0.0001, 95%CI = [0.33, 0.79]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Job tenure & length of competitive employment · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Experiment length did not appear to be a significant moderator (Length: d = 0.005, 95%CI = [-0.004, 0.015]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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In the paper
“Looking at CE at the end of follow-up, our estimates were very similar (RR = >1.2, Proportion>0.999, 95%CI = [>0.99, 1]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“quality of life: d = 0.30, 95%CI = [-0.07, 0.67]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
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In the paper
“We estimated that those in IPS would have a shorter time to their first competitive employment job (Fig 3, k = 9; d = -0.31, SE = 0.08, Z = -3.93, p<0.0001, 95%CI = [-0.46, -0.15]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Time to first competitive employment
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In the paper
“We estimated the proportion of effect sizes of d>0.2 as 0.98, (95%CI = [0.86, 1])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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In the paper
“Experiment length was not a significant moderator (Length = 0.02, SE = 0.01, Z = 1.42, p = 0.16, 95%CI = [-0.01, 0.05]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Time to first competitive employment
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In the paper
“obtained any competitive employment: RR = 1.63, 95%CI = [1.46, 1.82]”
- Also stated in: § Competitive employment status · hedged
“We estimated that those in IPS conditions were 1.6x more likely to have found CE at any point in the study compared with those in control conditions (Fig 2A, k = 23, log(RR) = 0.49, SE = 0.06, Z = 8.70, p<0.0001, 95%CI = [0.38, 0.60]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Competitive employment status · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“income: d = 0.48, 95%CI = [0.36, 0.59]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Analysis of the expected proportion of studies with a true effect on non-vocational outcomes with d>0.2 showed some reason to expect a possible improvement for quality of life for at least some settings (Prop = 0.57, 95%CI = [0.30, 0.84]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
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In the paper
“Running the analysis with experiment duration as a moderator was not significant (Length: d = 0.005, 95%CI = [-0.01, 0.02]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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In the paper
“We also estimated that those in IPS conditions, compared to those in control conditions, were 1.8x more likely to have been competitively employed at the end of studies (Fig 2B, k = 13, log(RR) = 0.58, SE = 0.08, Z = 7.23, p<0.0001, 95%CI = [0.42, 0.74]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
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In the paper
“and that the proportion of studies with d<-0.2 to be tiny with a confidence interval that included the null (Prop = 0.003, 95% = [0, 0.02]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Job tenure & length of competitive employment
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In the paper
“and at the end of the study (log(RR) = 0.58, 95%CI = [0.42, 0.74], Fig 2B)”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
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In the paper
“longer job tenure (d = 0.56, 95%CI = [0.33, 0.79], Fig 4A)”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
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In the paper
“but that those that would be expected to be d<-0.2 was relatively small with a confidence interval that included zero (Prop = 0.18, 95%CI = [0, 0.40]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Quality of life
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In the paper
“In the research reviewed here, researchers often reported that a result was not significant, but gave no estimate of the result (e.g., means and standard deviations).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Methodological interpretation and critique
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In the paper
“d<-0.2, Prop = 0.01, 95%CI = [0, 0.15]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Global functioning
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In the paper
“Length of study was not a significant moderator (Length = -0.0005, 95%CI = [-0.03, 0.03]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Quality of life
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In the paper
“d<-0.2, Prop = 0.08, 95%CI = [0, 0.36]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > General mental health
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In the paper
“We estimated that the proportion of settings that we expect the effect size to be d>0.2 was relatively large (Prop = 0.57, 95%CI = [0.30, 0.84])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Quality of life
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In the paper
“For all vocational outcomes, those in IPS treatments had higher rates of competitive employment at any point during the study (log(RR) = 0.49, 95%CI = [0.38, 0.60], Fig 2A)”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
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In the paper
“d>0.2, Prop = 0.15, 95%CI = [0, 0.51]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > General mental health
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In the paper
“shorter time to first competitive employed job (d = -0.31, 95%CI = [-0.46, -0.16], Fig 3)”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
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In the paper
“Experiment length was not a significant moderator (Length = 0.03, SE = 0.02, Z = 1.46, p = 0.14, 95%CI = [-0.01, 0.08]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > General mental health
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In the paper
“d>0.2, Prop = 0.21, 95%CI = [0, 76]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Global functioning
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Beyond narrative accounts, there is evidence that working may be associated with improved aspects of wellbeing such as mental health [3, 4].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Introduction
What the sources say
- Not checked yetcites [3] GR Bond, 2014, Making the Case for IPS Supported Employment. Administration and Policy in Mental Health and Mental Health Services Research, Making the Case for IPS Supported Employment. Administration and Policy in Mental Health and Mental Health Services Research source
- Not checked yetcites [4] M Modini, 2016, The mental health benefits of employment: Results of a systematic meta-review, Australasian psychiatry: bulletin of Royal Australian and New Zealand College of Psychiatrists
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesWhat the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because power was calculated only for the main outcome variable, researchers may have lacked sufficient power to detect secondary outcomes of interest.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Also, vocational rehabilitation closure rates (i.e., success) of SE/IPS compared to TAU has been observed to be the same [70].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Conclusion
What the sources say
- Not checked yetcites [70] VV Fraser, 2008, VR closure rates for two vocational models, Psychiatric rehabilitation journal source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“One RCT investigated the cost-benefit of SE compared to other vocational rehabilitation programs [68]. Depending on the outcome measured, SE/IPS may or may not be more effective.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Conclusion
What the sources say
- Not checked yetcites [68] L Dixon, 2002, Cost-Effectiveness of Two Vocational Rehabilitation Programs for Persons With Severe Mental Illness, Psychiatric Services source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is even good evidence that the IPS treatment can be expanded and remain effective with groups other than those with severe mental illness (who were the original targets of the intervention).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Conclusion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: SE and IPS were originally developed for and used with populations that had severe mental illness.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is some evidence that even though the above is true, the cost-benefit of SE/IPS is not necessarily better than TAU.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Conclusion
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In the paper
“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].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [16] L Ottomanelli, 2012, Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study, Archives of physical medicine and rehabilitation source
- Not checked yetcites [24] L Ottomanelli, 2014, Effectiveness of Supported Employment for Veterans With Spinal Cord Injury: 2-Year Results, Archives of Physical Medicine and Rehabilitation source
- Not checked yetcites [17] U Bejerholm, 2017, Supported employment adapted for people with affective disorders—A randomized controlled trial, Journal of Affective Disorders source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Ottomanelli and colleagues show that veterans with SCI have improved CE outcomes when placed in SE/IPS treatments compared to standard ones [16].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [16] L Ottomanelli, 2012, Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study, Archives of physical medicine and rehabilitation source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“The difference seemed to be most evident in the SE treatment group.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [56] SR McGurk, 2007, Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial, The American journal of psychiatry source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“There is also work done on PTSD and veterans, which also found that SE/IPS was better than TAU [55].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [55] LL Davis, 2014, Impact of social challenges on gaining employment for veterans with posttraumatic stress disorder: An exploratory moderator analysis, Psychiatric Rehabilitation Journal source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is less certain how much better SE is than treatment as usual for other outcomes such as mental health.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Instead of using specialized IPS delivery centers, these researchers were able to show that IPS can be effectively delivered in a ‘multi-server’ program center.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
What the sources say
- Not checked yetcites [67] PJ Barreira, 2010, Adapting Evidence-Based Interventions to Fit Usual Practice: Staff Roles and Consumer Choice in Psychiatric Rehabilitation, Psychiatr Q source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“A fairly recent study looked at the cost-benefit of SE for veterans with spinal cord injuries and found that it was not significantly more cost-effective than TAU [69].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Conclusion
What the sources say
- Not checked yetcites [69] PL Sinnott, 2014, Cost-effectiveness of supported employment for veterans with spinal cord injuries, Archives of physical medicine and rehabilitation source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“They found that the added training significantly increased the outcome of subjects (30% vs. 9%).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
What the sources say
- Not checked yetcites [56] SR McGurk, 2007, Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial, The American journal of psychiatry source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“One study looked at moderating effect of PTSD on outcomes for SE [56] and found that PTSD groups were less likely to be employed in the SE and other conditions.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [56] SR McGurk, 2007, Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial, The American journal of psychiatry source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“From the above results, it is clear that supported employment (SE) as deployed via individual placement and support (IPS) treatments is significantly better than treatment as usual (TAU) on all vocational outcomes.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is little doubt that for the primary outcome, which was competitive employment rates, the supported employment framework and the IPS treatment is more effective than treatment as usual.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Conclusion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“They found that CT+SE outperformed SE alone in percentage of subjects employed.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
What the sources say
- Not checked yetcites [64] SR McGurk, 2005, Cognitive training and supported employment for persons with severe mental illness: one-year results from a randomized controlled trial, Schizophrenia bulletin source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- It may state two separate claims as one. 15
- Probably not a substantial claim. 24
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“global functioning: d = 0.09, 95%CI = [-0.09, 0.27]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“mental health: d = 0.03, 95%CI = [-0.15, 0.21]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Because of this, we were unable to include all outcomes that researchers said that they had measured.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Methodological interpretation and critique
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated that those in IPS had a slightly higher global functioning, but that the confidence intervals of the estimate include the null (Fig 7A, k = 5, d = 0.09, SE = 0.09, Z = 0.9957, p = 0.3194, 95%CI = [-0.0891, 0.2731]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Global functioning
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated that those in IPS conditions had a higher levels of QOL, but that the confidence intervals for the estimate included the null (Fig 6, k = 9, d = 0.30, SE = 0.19, Z = 1.60, p = 0.11, 95%CI = [-0.07 0.67], τ2 (SE) = 0.2955(0.1602), I2 = 94.90%, H2 = 19.59, Q(8) = 62.1751, p<0.0001).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Quality of life
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated a very small effect and that the confidence intervals of the estimate include the null (Fig 7B, k = 6, d = 0.03, SE = 0.09, Z = 0.3320, p = 0.7399, 95%CI-0.15, 0.21], τ2 (SE) = 0.03(0.03), I2 = 64.55%, H2 = 2.82, Q(5) = 15.67, p = 0.0078).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > General mental health
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the heterogeneity and the different scales used, we also tested to see if scale was a significant moderator and we estimated that it may be with the Personal Wellbeing Index having the highest estimate (Table 11).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Quality of life
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“or mental health symptoms (d = -0.20, 95%CI = [-0.62, 0.23]).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
What the sources say
- Not checked yetcites [53] RM van Rijn, 2016, Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis, Occupational and Environmental Medicine source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“and of finding any employment by 3.24-fold (RR = 3.24 95%CI = [2.17, 4.82]) [15].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Introduction
What the sources say
- Not checked yetcites [15] Y Kinoshita, 2013, Supported employment for adults with severe mental illness, The Cochrane database of systematic reviews
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For reproducibility, we saved the relevant data as R data files and have included them as supplemental materials along with the needed R script file (S2 and S3 Files, respectively).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Methods > Statistical methods
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All articles reported the results of randomized controlled trials (RCT) that focused on comparing supported employment (SE) as implemented via individual placement and support (IPS) to a control condition, which was usually the locally available best usual practice.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“but no significant effects on global functioning (d = -0.01, 95%CI = [-0.13, -0.11])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
What the sources say
- Not checked yetcites [53] RM van Rijn, 2016, Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis, Occupational and Environmental Medicine source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The researchers found a significant effect on quality of life with those in IPS having a higher level (d = 0.28, 95%CI = [0.04, 0.52])”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
What the sources say
- Not checked yetcites [53] RM van Rijn, 2016, Work as treatment? The effectiveness of re-employment programmes for unemployed persons with severe mental health problems on health and quality of life: a systematic review and meta-analysis, Occupational and Environmental Medicine source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Articles also varied by whether or not they reported measures of fidelity to the study protocol.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“If a study reported both intent-to-treat and conditional statistics, we selected to use the intent-to-treat values.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Secondary vocational outcomes
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We only performed meta-analysis from papers that only used competitive employment for these statistics. We omit from analysis statistics that combined all types of employment (i.e., competitive and not).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Secondary vocational outcomes
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“In that study, Nordt et al. estimated that one in five suicides might be attributable to unemployment for the period of 2000–2011 within sixty-three countries sampled [8].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Introduction
What the sources say
- Not checked yetcites [8] C Nordt, 2015, Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000–11, The Lancet Psychiatry source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Researchers measured the same outcome variable in a number of ways. For example, competitive employment was often measured as having had any competitive employment during the study period and/or as having been employed at the end of the study.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Past meta-analyses have estimated that supported employment increases the likelihood of achieving competitive employment by 2.4-fold (RR = 2.40 95%CI = [1.99, 2.90]) [14]”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Introduction
What the sources say
- Not checked yetcites [14] M Modini, 2016, Supported employment for people with severe mental illness: Systematic review and meta-analysis of the international evidence, Br J Psychiatry source
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In general, research articles varied greatly in quality, as has been previously reported [15].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Literature search results and data extraction
What the sources say
- Not checked yetcites [15] Y Kinoshita, 2013, Supported employment for adults with severe mental illness, The Cochrane database of systematic reviews
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, given that we had access to the total number of subjects randomized, we performed the analyses following the intent-to-treat paradigm.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Competitive employment status
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Employment may be associated with positive outcomes such as increased physical and mental health [11–13].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Introduction
What the sources say
- Not checked yetcites [11] RE Lucas, 2004, Unemployment Alters the Set Point for Life Satisfaction, Psychological Science source
- Not checked yetcites [12] 2012, Association of Returning to Work With Better Health in Working-Aged Adults: A Systematic Review, Am J Public Health source
- Not checked yetcites [13] 2006, Is Work Good for your Health and Well-being?
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Unemployment may be associated with negative outcomes [9, 10], such as suicide, in the most extreme.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Introduction
What the sources say
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A recent study using mediation analysis suggest improvement in quality of life may be fully mediated via competitive employment [54].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
What the sources say
- Not checked yetcites [54] D Jäckel, 2017, Effects of Sustained Competitive Employment on Psychiatric Hospitalizations and Quality of Life, Psychiatric Services
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, there is some evidence that IPS may also improve quality of life and maybe global functioning, but more research with larger sample sizes are needed to know for sure.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“They found that while the test group increased their knowledge of fundamental concepts of the workplace (e.g., job performance), they did not differ from controls on a host of other outcomes.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
What the sources say
- Not checked yetcites [66] KT Mueser, 2005, The effectiveness of skills training for improving outcomes in supported employment, Psychiatric services (Washington, DC) source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The answer appears to be “yes” that, in the limit, IPS could be provided to everyone.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
Strength:hedged· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If this is a true effect, a possible route of causation for increased quality of life and other non-vocational outcomes could be via the competitive employment.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the effectiveness of IPS, are there additional groups that could benefit. The answer appears to be a ‘yes’ from our above results and past literature.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: SE and IPS were originally developed for and used with populations that had severe mental illness.
In the paper
“They found that while the test group increased their knowledge of fundamental concepts of the workplace (e.g., job performance), they did not differ from controls on a host of other outcomes.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
What the sources say
- Not checked yetcites [66] KT Mueser, 2005, The effectiveness of skills training for improving outcomes in supported employment, Psychiatric services (Washington, DC) source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“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].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [44] EW Twamley, 2012, The efficacy of supported employment for middle-aged and older people with schizophrenia, Schizophrenia research source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For the following analyses, as above, we used only values that were derived from competitive employment (i.e., if the reported statistic was from income of competitive and non-competitive employment sources, we did not use it).”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Income from competitive employment
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“Most recently, they found that for those that didn’t respond to IPS, the individual receiving cognitive enhancement treatments (the “Thinking Skills for Work Program”) had higher employment (60% vs. 36%), worked longer (23.9 vs. 9.2 weeks), and earned more ($3,421 vs. $1,728) than the control group that had an enhanced version of SE [65].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we make supportive employment more effective?
What the sources say
- Not checked yetcites [65] SR McGurk, 2015, Cognitive Enhancement Treatment for People With Mental Illness Who Do Not Respond to Supported Employment: A Randomized Controlled Trial, The American journal of psychiatry source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This latter result is suggestive that there may be a significant effect of IPS on these outcomes, but that the effect is sensitive to the setting.”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“For example, there may be a difference in the structural (white matter) between bipolar and unipolar depression [63].”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Discussion > Can we expand supportive employment to more groups?
What the sources say
- Not checked yetcites [63] G Serafini, 2014, Brain changes in early-onset bipolar and unipolar depressive disorders: a systematic review in children and adolescents, Eur Child Adolesc Psychiatry source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the heterogeneity and the different scales used, we also tested to see if scale was a significant moderator”
§ Supported employment: Meta-analysis and review of randomized controlled trials of individual placement and support > Results > Quality of life
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
Working is better than not working.
“In our society, it is generally thought that working is better than not working.”
The paper relies on this without support.
SE and IPS were originally developed for and used with populations that had severe mental illness.
“SE and IPS were originally developed for and used with populations that had severe mental illness.”
The paper relies on this without support.
Subjects still work below full time and still suffer from their underlying disorder.
“Subjects still work below full time and still suffer from their underlying disorder.”
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?
In the citing paper
“Meta-analytic studies confirm that standard IPS is superior to all non IPS interventions [6–9].”
From An enhanced individual placement and support (iPS) intervention based on the model of human occupation (MOHO); a prospective cohort study (2020) · cites this paper as [7]
Statistics that don’t add up
Each reported p-value recomputed from its test statistic and degrees of freedom.
Inconsistent p-value: Q(22) = 29.64, p = .1277
MinorThe paper reports p = .1277 here; recomputing from the test statistic and its degrees of freedom gives p = .127. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p = .1277 · recomputed p = .127
“Q(22) = 29.64, p = 0.1277”
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Doesn’t add upQ(22) = 29.64reported p = .1277 · recomputed p = .127
“Q(22) = 29.64, p = .1277”
- Consistentz = 8.7reported p < .0001 · recomputed p < .001
“Z = 8.70, p < .0001”
- Consistentz = 7.23reported p < .0001 · recomputed p < .001
“Z = 7.23, p < .0001”
- ConsistentQ(12) = 14.93reported p = .2451 · recomputed p = .245
“Q(12) = 14.93, p = .2451”
- Consistentz = -3.93reported p < .0001 · recomputed p < .001
“Z = -3.93, p < .0001”
- ConsistentQ(8) = 5.8994reported p = .6585 · recomputed p = .658
“Q(8) = 5.8994, p = .6585”
- Consistentz = 1.42reported p = .16 · recomputed p = .156
“Z = 1.42, p = .16”
- Consistentz = 4.72reported p < .0001 · recomputed p < .001
“Z = 4.72, p < .0001”
- ConsistentQ(7) = 21.477reported p = .0031 · recomputed p = .003
“Q(7) = 21.4770, p = .0031”
- Consistentz = 8.23reported p < .0001 · recomputed p < .001
“Z = 8.23, p < .0001”
- Consistentz = 8.31reported p < .0001 · recomputed p < .001
“Z = 8.31, p < .0001”
- ConsistentQ(11) = 8.3404reported p = .6825 · recomputed p = .683
“Q(11) = 8.3404, p = .6825”
- Consistentz = 1.6reported p = .11 · recomputed p = .110
“Z = 1.60, p = .11”
- ConsistentQ(8) = 62.1751reported p < .0001 · recomputed p < .001
“Q(8) = 62.1751, p < .0001”
- Consistentz = 0.9957reported p = .3194 · recomputed p = .319
“Z = 0.9957, p = .3194”
- Consistentz = 0.332reported p = .7399 · recomputed p = .740
“Z = 0.3320, p = .7399”
- ConsistentQ(5) = 15.67reported p = .0078 · recomputed p = .008
“Q(5) = 15.67, p = .0078”
- Consistentz = 1.46reported p = .14 · recomputed p = .144
“Z = 1.46, p = .14”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Drake 1996 employment count exceeds the randomized group
MajorTable 5 reports 526 IPS participants obtaining competitive employment in Drake 1996, but Table 2 says only 74 participants were randomized to IPS in that study.
“| Drake et al. 1996 | 526 | 47 | 347 | 31 | 281 | 25 | 158 | 14 |”
“| Drake et al. 1996 | 18 | Group Skills Training | 74 | 69 |”
Quoted prior-study confidence interval contradicts its significance description
MinorThe text describes the prior global-functioning result as nonsignificant, but the quoted 95% confidence interval lies entirely below zero. The quoted point estimate also falls outside that interval.
“but no significant effects on global functioning”
“(d = -0.01, 95%CI = [-0.13, -0.11])”
Full-text exclusion totals disagree
MinorThe flow-chart description says 24 articles were excluded after full-text review, whereas the accompanying account says 26 were removed at that stage.
“We excluded 24 articles for these reasons.”
“We then read the papers to ensure that they had the needed outcome measures and were in fact RCT studies between IPS and a treatment as usual control group. We removed 26 articles.”
Job-tenure study count disagrees with the heterogeneity degrees of freedom
MinorThe job-tenure analysis reports five studies, but its Q statistic has seven degrees of freedom, corresponding to eight studies in the stated meta-analysis. Table 7 also lists eight studies.
“For job tenure, we estimated that persons in IPS held a CE job longer than those in control conditions (Fig 4A, k = 5, d = 0.56”
“Q(7) = 21.4770, p = 0.0031”
Citations
Cites
Conducting Meta-Analyses in R with the metafor Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464
Unemployment impairs mental health: Meta-analyses
Paul, K. I., & Moser, K. (2009) · Journal of Vocational Behavior · doi:10.1016/j.jvb.2009.01.001 · Cited by 2,706
Psychological and physical well-being during unemployment: a meta-analytic study
McKee-Ryan, F., Song, Z., Wanberg, C. R., & Kinicki, A. J. (2005) · Journal of Applied Psychology · doi:10.1037/0021-9010.90.1.53 · Cited by 2,269
On the promotion of human flourishing
VanderWeele, T. J. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1702996114 · Cited by 1,387
Self-citationAn Evidence-Based Model of Work Engagement
Bakker, A. B. (2011) · Current Directions in Psychological Science · doi:10.1177/0963721411414534 · Cited by 1,381
Unemployment Alters the Set Point for Life Satisfaction
Lucas, R. E., Clark, A. E., Georgellis, Y., & Diener, E. (2004) · Psychological Science · doi:10.1111/j.0963-7214.2004.01501002.x · Cited by 1,327
Job crafting and its relationships with person–job fit and meaningfulness: A three-wave study
Tims, M., Derks, D., & Bakker, A. B. (2015) · Journal of Vocational Behavior · doi:10.1016/j.jvb.2015.11.007 · Cited by 783
Is Work Good for Your Health and Well-being?
Waddell, G., & Burton, K. A. (2006) · University of Huddersfield Repository (University of Huddersfield) · Cited by 780
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
Burns, T., Catty, J., Becker, T., Drake, R. E., Fioritti, A., Knapp, M., Lauber, C., Rössler, W., Tomov, T., van Busschbach, J., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61516-5 · Cited by 613 · cited 1×
“Article IPS TAU Mean SD N Mean SD N Bond 2007 a 27.51 33.11 92 11.06 23.94 95 Burns 2007 b 213.6 159.42 83 108.4 111.95 39 Hoffman 2014a,c 104.8 102.7 46 35.5 68.8 54 Latimer 2006 a 5.8 10.9 75 2.8 8.4 74 Mueser 2004 a 25.54 31.05 68 5.3 14.89 69 Tsang 2009 a 12.34 16.02 56 1.05 4.5 55 Viering 2015…”
Influential
Flagged first, then by citations
1 of the 73 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- GR Bond, 1997, A fidelity scale for the Individual Placement and Support model of supported employment, Rehabilitation Counseling Bulletin, 40, 265
Cited by
Sorted by citations
Hickie, I. B., Scott, E. M., Cross, S. P., Iorfino, F., Davenport, T. A., Guastella, A. J., Naismith, S. L., Carpenter, J. S., Rohleder, C., Crouse, J. J., et al. (2019) · Medical Journal of Australia · doi:10.5694/mja2.50383 · Cited by 208
Employment is a critical mental health intervention
Drake, R. E., & Wallach, M. A. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796020000906 · Cited by 158
Solmi, M., Croatto, G., Piva, G., Rosson, S., Fusar-Poli, P., Rubio, J. M., Carvalho, A. F., Vieta, E., Arango, C., DeTore, N. R., et al. (2023) · Molecular Psychiatry · doi:10.1038/s41380-022-01727-z · Cited by 147
An update on Individual Placement and Support
Bond, G. R., Drake, R. E., & Becker, D. R. (2020) · World Psychiatry · doi:10.1002/wps.20784 · Cited by 129
Recent Advances on Social Determinants of Mental Health: Looking Fast Forward
Alegria, M. M., Álvarez, K., Cheng, M., & Falgas‐Bagué, I. (2023) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20230371 · Cited by 123
Metadata
- Authors
- Frederick, D. E., & VanderWeele, T. J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Frederick, Donald E.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-02-20
- Volume
- 14
- Issue
- 2
- Pages
- e0212208
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6382127
- OpenAlex
- W2915389400
- Semantic Scholar
- f71bf620a9a024e38e5b0ada1aa81d168778204b
- Cited by
- 219
- References
- 73
- Citations by year
- 2026: 26 · 2025: 31 · 2024: 41 · 2023: 32 · 2022: 39 · 2021: 25 · 2020: 18 · 2019: 6
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Education › Disability Education and Employment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
- Keywords
- supported employment, Individual Placement and Support, severe mental illness, competitive employment, career outcomes, job tenure, income, quality of life, global functioning, mental health, randomized controlled trials
- MeSH terms
- Mental Disorders, Female, Humans, Income, Male, Mental Health, Quality of Life, Randomized Controlled Trials as Topic, Employment, Supported
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.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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 ›
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