Generalizability of the Individual Placement and Support (IPS) model of supported employment outside the US. Manage at work: a randomized, controlled trial of a self-management group intervention to overcome workplace challenges associated with chronic physical health conditions Are Work Disability Prevention Interventions Effective for the Management of Neck Pain or Upper Extremity Disorders? A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration Improving employment outcomes for persons with severe mental illnesses. Job Terminations Among Persons with Severe Mental Illness Participating in Supported Employment Client Predictors of Employment Outcomes in High-Fidelity Supported Employment: A Regression Analysis Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial.
While review s of controlled studies of the Individual Placement and Support ( IPS ) model of supported employment for clients with severe mental illness have documented its effectiveness in the US , its generalizability to other countries has not been systematic ally evaluated . This is the first review to compare US to non-US studies . We identified 15 r and omized controlled trials of IPS programs , 9 in the US and 6 outside the US . We examined competitive employment outcomes , including employment rate , days to first job , weeks worked during follow-up , and hours worked . We also considered noncompetitive employment , program retention , and nonvocational outcomes .  IPS programs had significantly better outcomes across a range of competitive employment indicators and higher retention in services than control groups . The overall competitive employment rate for IPS clients in US studies was significantly higher than in non-US studies ( 62 % vs. 47 % ) . The consistently positive competitive employment outcomes strongly favoring IPS over a range of comparison programs in a group of international studies suggest that IPS is an evidence -based practice that may transport well into new setting s as long as programs achieve high fidelity to the IPS model , but further research is needed on international adaptations Background The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries , but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions . While most workers are eligible for job accommodation and disability compensation benefits , other workplace strategies might improve individual-level coping and problem solving to prevent work disability . In this study , we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders . Methods In a r and omized controlled trial ( RCT ) , workers participating in an employer-sponsored self-management group intervention  will be compared with a no-treatment ( wait list ) control condition .  Volunteer employees ( n = 300 ) will be recruited from five participating employers and r and omly assigned to intervention or control . Participants in the intervention arm will attend facilitated group workshop sessions at work ( 10 hours total ) to explore methods for improving comfort , adjusting work habits , communicating needs effectively , applying systematic problem solving , and dealing with negative thoughts and emotions about work . Work engagement and work limitation are the principal outcomes . Secondary outcomes include fatigue , job satisfaction , self-efficacy , turnover intention , sickness absence , and health care utilization . Measurements will be taken at baseline , 6- , and 12-month follow-up . A process evaluation will be performed alongside the r and omized trial . Discussion This study will be most relevant for organizations and occupational setting s where some degree of job flexibility , leeway , and decision-making autonomy can be afforded to affected workers . The study design will provide initial assessment of a novel workplace approach and to underst and factors affecting its feasibility and effectiveness . Trial registration Clinical trials.gov : NCT01978392 ( Issued November 6 , 2013 Abstract Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention ( WDP ) interventions in workers with neck pain , whiplash-associated disorders ( WAD ) , or upper extremity disorders . Methods We search ed electronic data bases from 1990 to 2012 . R and om pairs of independent review ers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria . Scientifically admissible studies were summarized and synthesized following best- evidence synthesis methodology . Results Of the 6,359 articles retrieved , 16 r and omized controlled trials were eligible for critical appraisal and five were admissible . We found that a return-to-work coordination program ( including workplace-based work hardening ) was superior to clinic-based work hardening for persistent rotator cuff tendinitis . Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain . Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints . Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms . Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers ’ recovery from recent work-related neck and upper extremity complaints . Conclusions At present , no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain , WAD , and upper extremity disorders . Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening . Also , adding computer-prompted breaks to ergonomic and workplace interventions benefits workers ’ recovery . The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions BACKGROUND Unemployment remains a major consequence of schizophrenia and other severe mental illnesses . This study assesses the effectiveness of the Individual Placement and Support model of supportive employment relative to usual psychosocial rehabilitation services for improving employment among inner-city patients with these disorders . METHODS Two hundred nineteen out patients with severe mental illnesses , 75 % with chronic psychoses , from an inner-city catchment area were r and omly assigned to either the Individual Placement and Support program or a comparison psychosocial rehabilitation program . Participants completed a battery of assessment s at study enrollment and every 6 months for 2 years . Employment data , including details about each job , were collected weekly . RESULTS Individual Placement and Support program participants were more likely than the comparison patients to work ( 42 % vs 11 % ; P<.001 ; odds ratio , 5.58 ) and to be employed competitively ( 27 % vs 7 % ; P<.001 ; odds ratio , 5.58 ) . Employment effects were associated with significant differences in cumulative hours worked ( t(211 ) = -5.0 , P = .00000003 ) and wages earned ( t = -5.5 , P = .00000003 ) . Among those who achieved employment , however , there were no group differences in time to first job or in number or length of jobs held . Also , both groups experienced difficulties with job retention . CONCLUSIONS As hypothesized , the Individual Placement and Support program was more effective than the psychosocial rehabilitation program in helping patients achieve employment goals . Achieving job retention remains a challenge with both interventions For persons with psychiatric disabilities , maintaining a job is often more difficult than acquiring a job . A large proportion of jobs end unsatisfactorily . This study explored job terminations among 63 persons with severe mental illness who participated in competitive jobs through supported employment programs .  More than half of the job terminations were unsatisfactory , defined as the client quitting without having other job plans or being fired . Baseline ratings of demographic and clinical characteristics , preemployment skills training , and early ratings of job satisfaction and work environment did not predict unsatisfactory terminations . Clients with better work histories were less likely to experience unsatisfactory terminations . In addition , unsatisfactory terminations were associated retrospectively with multiple problems on the job that were related to interpersonal functioning , mental illness , dissatisfaction with jobs , quality of work , medical illnesses , dependability , and substance abuse . These results suggest that supported employment programs need to address job maintenance with interventions that identify and address different types of difficulties as they arise on the job Research on vocational rehabilitation for clients with severe mental illness over the past 2 decades has yielded inconsistent findings regarding client factors statistically related to employment . The present study aim ed to eluci date the relationship between baseline client characteristics and competitive employment outcomes —job acquisition and total weeks worked during an 18-month follow-up — in Individual Placement and Support ( IPS ) . Data from 4 recent r and omized controlled trials of IPS were aggregated for within-group regression analyses . In the IPS sample ( N = 307 ) , work history was the only significant predictor for job acquisition , but receiving Supplemental Security Income — with or without Social Security Disability Insurance — was associated with fewer total weeks worked ( 2.0%–2.8 % of the variance ) . In the comparison sample ( N = 374 ) , clients with a diagnosis of mood disorder or with less severe thought disorder symptoms were more likely to obtain competitive employment . The findings confirm that clients with severe mental illness interested in competitive work best benefit from high-fidelity supported employment regardless of their work history and sociodemographic and clinical background , and highlight the needs for changes in federal policies for disability income support and insurance regulations CONTEXT Although guideline -concordant depression treatment is clearly effective , treatment often falls short of evidence -based recommendations . Organized depression care programs significantly improve treatment quality , but employer purchasers have been slow to adopt these programs based on lack of evidence for cost-effectiveness from their perspective . OBJECTIVE To evaluate the effects of a depression outreach-treatment program on workplace outcomes , a concern to employers . DESIGN , SETTING , AND PARTICIPANTS A r and omized controlled trial involving 604 employees covered by a managed behavioral health plan were identified in a 2-stage screening process as having significant depression . Patient treatment allocation was concealed and assessment of depression severity and work performance at months 6 and 12 was blinded . Employees with lifetime bipolar disorder , substance disorder , recent mental health specialty care , or suicidality were excluded . INTERVENTION A telephonic outreach and care management program encouraged workers to enter outpatient treatment ( psychotherapy and /or antidepressant medication ) , monitored treatment quality continuity , and attempted to improve treatment by giving recommendations to providers . Participants reluctant to enter treatment were offered a structured telephone cognitive behavioral psychotherapy . MAIN OUTCOME MEASURES Depression severity ( Quick Inventory of Depressive Symptomatology , QIDS ) and work performance ( World Health Organization Health and Productivity Question naire [ HPQ ] , a vali date d self-report instrument assessing job retention , time missed from work , work performance , and critical workplace incidents ) . RESULTS Combining data across 6- and 12-month assessment s , the intervention group had significantly lower QIDS self-report scores ( relative odds of recovery , 1.4 ; 95 % confidence interval , 1.1 - 2.0 ; P = .009 ) , significantly higher job retention ( relative odds , 1.7 ; 95 % confidence interval , 1.1 - 3.3 ; P = .02 ) , and significantly more hours worked among the intervention ( beta=2.0 ; P=.02 ; equivalent to an annualized effect of 2 weeks of work ) than the usual care groups that were employed . CONCLUSIONS A systematic program to identify depression and promote effective treatment significantly improves not only clinical outcomes but also workplace outcomes . The financial value of the latter to employers in terms of recovered hiring , training , and salary costs suggests that many employers would experience a positive return on investment from outreach and enhanced treatment of depressed workers . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00057590
The DM program has shown to be effective and efficient .
Nevertheless , some components are emphasized more than others ; job accommodation , facilitation of transitional duty , communication between all stakeholders , health care provider advice , early intervention , and acceptance , goodwill and trust in the stakeholders , in the organization , and in the disability management process
BACKGROUND Disability management ( DM ) is a systematic method to ensure job-retention and job-reintegration in competitive employment for individuals with a disability .
There is evidence that ' returning to work ' has a positive impact on the individual , the company and on the society .
However , a clear overview of the efficacy and efficiency of the DM programs is scarce .
OBJECTIVE To systematic ally review the efficacy and efficiency of the disability management programs .