Supported Employment: Motivational Enhancement for Entry and Outcome

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT01041976
First received: December 31, 2009
Last updated: May 12, 2014
Last verified: May 2014
  Purpose

The purpose of this study is to compare 6 monthly counseling sessions to 6 monthly information sessions on veterans' decisions to (a) participate in vocational rehabilitation services and (b) become employed.


Condition Intervention Phase
Psychotic Disorders
Bipolar Disorder
Unemployment
Behavioral: Adapted Motivational Interviewing for Supported Employment (AMI-SE)
Behavioral: Support and Education for Recovery (SER)
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Supported Employment: Motivational Enhancement for Entry and Outcome

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Participation in Vocational Rehabilitation Services [ Time Frame: 18 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Employment [ Time Frame: 18 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 150
Study Start Date: January 2011
Estimated Study Completion Date: September 2014
Estimated Primary Completion Date: May 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1

Adapted Motivational Interviewing for Supported Employment (AMI-SE) Intervention.

Veterans assigned to the AMI-SE condition will be scheduled for 6 sessions, approximately one month apart, starting with month 1 of the study, with the last session at month 6. Sessions at months 1, 3, and 5 will be individual sessions with the veteran, and sessions at month 2, 4, and 6 will be joint sessions conducted with the veteran and their significant other. Sessions will utilize a variety of motivational enhancement strategies including evocative questions, importance and confidence scales, collaborative problem solving, and planning. Consistent with the three phases of MET, sessions are organized around (a) building motivation for change, (b) strengthening commitment to change, and (c) follow-through strategies.

Behavioral: Adapted Motivational Interviewing for Supported Employment (AMI-SE)
Veterans assigned to the AMI-SE condition will be scheduled for 6 sessions, approximately one month apart, starting with month 1 of the study, with the last session at month 6. Sessions at months 1, 3, and 5 will be individual sessions with the veteran, and sessions at month 2, 4, and 6 will be joint sessions conducted with the veteran and their SO. Sessions will utilize a variety of motivational enhancement strategies including evocative questions, importance and confidence scales, collaborative problem solving, and planning (36). Consistent with the three phases of MET, sessions are organized around (a) building motivation for change, (b) strengthening commitment to change, and (c) follow-through strategies (40).
Placebo Comparator: Arm 2
Control Condition: Support and Education for Recovery (SER). Veterans assigned to the control condition will be seen for 6 monthly sessions of basic support and education about VA and non-VA psychiatric rehabilitation and recovery services. The session topics will be (1) Bedford VA Psychiatric Rehab Services (2) Boston VA Psychiatric Rehab Services (3) The Boston University Center for Psychiatric Rehabilitation, (4) Local Recovery Centers (funded by state of MA), (5) National non-profit organizations related to recovery and rehabilitation, who have MA chapters, including National Alliance on Mental Illness (NAMI), United States Psychiatric Rehabilitation Association (USPRA), and Depression/Bipolar Support Alliance (DBSA), (6) Mental Illness Research Education and Clinical Center (MIRECC) Peer Education Center. In addition, the veteran's significant other will be asked to attend sessions 2, 4, and 6 with the veteran.
Behavioral: Support and Education for Recovery (SER)
Veterans assigned to this control condition will be seen for 6 monthly sessions of basic support and education about VA and non-VA psychiatric rehabilitation and recovery services. The session topics will be (1) Bedford VA Psychiatric Rehab Services (2) Boston VA Psychiatric Rehab Services (3) The Boston University Center for Psychiatric Rehabilitation, (4) Local Recovery Centers (funded by state of MA), (5) National non-profit organizations related to recovery and rehabilitation, who have MA chapters, including National Alliance on Mental Illness (NAMI), United States Psychiatric Rehabilitation Association (USPRA), and Depression/Bipolar Support Alliance (DBSA), (6) Mental Illness Research Education and Clinical Center (MIRECC) Peer Education Center. In addition, the SOs will be asked to attend sessions 2, 4, and 6 with the veteran.

Detailed Description:

Approximately 85-90% of those with serious mental illness are unemployed (9, 10). This level of unemployment exists despite the finding that, among people who have a psychiatric disability and are unemployed, 55-61% desire employment, with the total reaching 75% when concern about losing benefits was taken into account (1, 2). The rewards of employment for adults with SMI are greater than simply an increase in financial resources. Studies have found that people with serious mental illness who worked competitively scored higher on measures of self-esteem, satisfaction with finances, leisure, and overall life satisfaction compared to those worked little or not at all (11). Supported employment (SE) has been more effective than any other vocational rehabilitation approach for this population (3, 4) and the VA has mandated that SE be integrated into all current VHA Compensated Work Therapy (CWT) programs (VHA Directive 2007-005). Two areas of concern include (a) national utilization of SE services is low (13), and (b) the percentage of SE participants who obtain at least one job during the studies averages 56% even though everyone who enters the program expressed an interest in working (13).

Motivational interviewing (MI) is an evidence-based practice that has been effective in enhancing a range of clinical services (6), but has just recently been applied to employment and vocational services by Drebing et al. (7) and Glynn et al (8).

The proposed project is a randomized trial of Adapted Motivational Interviewing for Supported Employment (AMI-SE) provided to veterans and their significant others (family members or key friends) in order to address the internal and external barriers to the veteran enrolling in supported employment and returning to work.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Eligible to receive VA services
  • Diagnosis of serious mental illness: schizophrenia, schizoaffective, psychosis NOS, bipolar disorder, or depression with psychotic features
  • Currently unemployed
  • Not currently enrolled in Supported Employment services
  • Expects to stay within 100 miles of Bedford, MA for the next 18 months
  • Has a key person (friend or family member) who is also willing to participate

Exclusion Criteria:

  • Currently in prison
  • Not able to provide informed consent
  • Not able to speak and understand English
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01041976

Locations
United States, Massachusetts
Edith Nourse Rogers Memorial Veterans Hospital, Bedford
Bedford, Massachusetts, United States, 01730
Sponsors and Collaborators
Investigators
Principal Investigator: Lisa Mueller, PhD MSEd Edith Nourse Rogers Memorial Veterans Hospital, Bedford
  More Information

No publications provided

Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT01041976     History of Changes
Other Study ID Numbers: D7306-R
Study First Received: December 31, 2009
Last Updated: May 12, 2014
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Veterans
Vocational Rehabilitation

Additional relevant MeSH terms:
Bipolar Disorder
Psychotic Disorders
Mental Disorders
Affective Disorders, Psychotic
Mood Disorders
Schizophrenia and Disorders with Psychotic Features

ClinicalTrials.gov processed this record on July 26, 2014