Table 4 Work and education outcomes for gaining and retaining paid employment, and education enrolment

Finding paid employment

CMD

Transitional employment + psychiatric care

Occupational training integrated into psychodynamic treatment vs TAU

At 12 months post baseline, there was no significant difference between the intervention and control groups in the likelihood of being employed (OR = 1.11, 95% CI: 0.63, 1.96), however, at 24 months, the occupational training and psychodynamic treatment intervention group were significantly more likely to be unemployed than the treatment as usual group (OR = 2.71, 95% CI: 1.51, 4.84)

Prevocational training (Job related skills training)

Adjuvant occupational therapy + TAU vs TAU

While after 6 months, there was no difference between the intervention and control group in terms of the proportion of participants engaged in part time work (16 + hours), OR of part time work = 0.80, 95% CI: 0.32, 2.02, the adjuvant occupational therapy intervention group resulted in significantly more participants being employed part time at both 12 months (OR = 3.62, 95% CI: 1.83, 7.15) and 24 months post baseline (OR = 1.84, 95% CI: 1.05, 3.24)

Supported employment (Low fidelity/not IPS)

IPS modified for people with mood and anxiety disorders vs TAU

There was no significant difference between the IPS and TAU groups in the number of participants returning to competitive work at either 12 months (OR = 1.18, 95% CI: 0.73, 1.90) or 24 months (OR = 1.32, 95% CI: 0.85, 2.05)

Supported employment (High fidelity IPS)

IPS vs TAU

IPS participants were significantly more likely to gain competitive employment by 12 months than the TAU control group (OR = 8.27, 95% CI: 3.12, 21.89)

IPS vs transitional work

IPS participants were significantly more likely to be competitively employed at 6 months (OR = 2.4, 95% CI: 1.74, 3.49), 12 months (OR = 2.19, 95% CI: 1.55, 3.10) and 18 months (OR = 1.65, 95% CI: 1.16, 2.34)

SMI

Transitional employment

Paid work vs unpaid work

Significantly more participants in the pay condition accepted work (35% vs 5%, OR of accepting work = 10.23, 95% CI: 3.81, 27.50)

Transitional employment + Cognitive skills training

Work therapy + neurocognitive enhancement vs work therapy

The NET + WT condition had a higher percentage of patients having competitive-wage employment at 12 months post baseline, however, this difference was not significant (OR of competitive employment = 1.51, 95% CI: 0.73, 3.14, 0.275)

Vocational rehabilitation + cognition remediation vs vocational rehabilitation + cognitive games

Rate of competitive employment at 12 months did not differ between the cognitive remediation and cognitive games control group (OR = 1.11, 95% CI: 0.38, 3.21)

Enhanced vocational services + cognitive remediation (thinking skills for work) vs enhanced vocational services only

Although more participants in the thinking skills for work intervention obtained competitive work at 36 month follow up (57% vs. 48%), these differences were not statistically significant (OR = 1,56, 95% CI: 0.53, 4.56)

Indianapolis vocational rehabilitation programme vs supportive therapy

Nearly half of the intervention group went on to secure supported employment by the 12-month follow-up (14 out of 29; 48%), compared to 17% of those in the SG condition (6 out of 35, 17%) (OR of supported employment = 4.51, 95% CI: 1.44, 14.13)

Computer assisted cognitive strategy training + Vocational rehabilitation vs vocational rehabilitation

The rate of successful job placement (more than 3 months of half- or full-time employment, or at least sheltered workshop jobs) was higher in the computer assisted cognitive strategy training intervention group than the vocational rehabilitation only control at 12 months (OR of successful job placement = 2.96, 95% CI: 1.24, 7.07)

Prevocational training with cognitive therapy

Social recovery CBT + TAU vs TAU

In the combined sample of individuals with affective and non-affective psychosis, more individuals in the social recovery + TAU group had engaged in paid work over the 15 months since the end of the intervention period compared to the TAU alone group (31.0% vs. 16%), however this difference was not significant (OR of paid work = 2.33, 95% CI: 0.72, 7.54)

Prevocational training (cognitive skills training)

Cognitive remediation vs computerized control

Among the 37 unemployed patients at baseline in the cognitive remediation group, 51% obtained a job during the 12-month follow-up, compared with 35% of 31 initially unemployed patients in the control group, which was not a statistically significant difference (OR = 1,92, 95% CI: 0.72, 5.10)

Vocational empowerment photovoice vs wait-list

The VEP intervention group did not have significantly different rates of engagement in employment services at the post 10-week core VEP curriculum assessment (OR of engagement in employment services = 2.8, 95% CI: 0.71, 11.03), the posttreatment assessment following the last booster session (OR = 2.4, 95% CI: 0.65, 8.86) or the 3-month follow-up assessment point (OR = 0.59, 95% CI: 0.18, 1.96)

Prevocational training (job related skills training)

BRDGE supported education programme vs TAU

Only 1 intervention group participant obtained paid employment, while no control group participants obtained paid employment (non-significant difference)

Psychiatric vocational rehabilitation vs enhanced state vocational rehabilitation

There was no significant difference between the intervention and control group at either 9 months (OR = 2.42, 95% CI: 0.40, 2.60), or 24 months (OR = 1.03, 95% CI: 0.40, 2.60) in the number of participants with competitive work

Supported employment (Low fidelity/not IPS)

Supported employment vs TAU

Participants in the supported employment group had significantly higher rates of competitive employment than the control group at 24 months (OR = 3.79, b = 1.33 (SE: 0.12), P < 0.001), controlling for gender, race, education, drug/alcohol use, intellectual disability, disability beneficiary status, prior work history, age, months worked in prior 5 years, physical health, work motivation, age at first hospitalization, lifetime months hospitalised, psychotic symptoms, study site and attrition

Supported employment (High fidelity IPS)

IPS + TAU vs TAU

There was no significant difference in the proportion of participants employed in the past 6 months at either 6 months (OR = 0.88, 95% CI:0.42, 1.88) or 12 months (OR = 1.73, 95% CI: 0.81, 3.70)

IPS vs TAU

At the end of the intervention (6 months), the IPS group had a significantly higher rate of having been employed (71.2%, 47/66) than the TAU group (48%, 29/60), OR = 3.40 (95% CI 1.17, 9.91, P = 0.025, controlling for employment at baseline).; however, no significant between-group differences in odds of employment were seen at 6–12 and 12–18 months (P = 0.288 and P = 0.594, respectively)

Augmented supported employment (SE + cognitive skills training)

Neurocognitive enhancement + vocational rehabilitation vs vocational rehabilitation only

no significant difference in odds of being employed at 12 months (end of intervention) or 24 months post baseline (12 months OR = 1.08, 95% CI:0.60, 1.95, 24 months OR = 1.57, 95% CI: 0.82, 3.00)

Supported employment + cognitive training vs supported employment

Over the first year, significantly more clients in supported employment with cognitive training worked (69.6%) than those in the supported employment only programme (4.8%). Similarly, at 24 months, significantly more patients worked in the supported employment with cognitive training programme than the supported employment alone programme (OR = 13.71, 95% CI: 3.03, 62.14)

Enhanced supported employment + cognitive remediation (thinking skills for work) vs enhanced supported employment only

Significantly more participants in Thinking skills for work group obtained competitive employment at 24 months (60% vs 36%, OR = 2.63, 95% CI: 1.20, 5.75)

IPS plus cognitive remediation vs IPS

The IPS plus cognitive remediation group had higher odds of being employed in the past 6 months at both 12 months (OR = 2.65, 95% CI: 1.48, 4.74) and 16 months from baseline (OR = 2.60, 95% CI: 1.47, 4.59)

Compensatory cognitive training vs enhanced supported employment

Compensatory cognitive training did not result in significantly more participants attaining competitive employment compared to supported employment at 24 months (OR = 0.58, 95% CI: 0.33, 1.01)

Augmented supported employment (SE + cognitive therapy)

CBT for supported employment vs supported employment

Those who received CBT-SE were significantly more likely to obtain at least one job (OR = 3.36, 95% CI: 1.75, 6.46) after 1 year than the supported employment only control group

Augmented supported employment (SE + job related skills training)

IPS plus work skills training vs IPS only

Over 24 month follow up, there was no difference between the IPS plus work skills training group and the IPS only group in the time to first job (Hedges g = 0.22, 95% CI: -0.27, 0.70)

IPS + errorless learning vs IPS

at 12 months, 40.7% of the errorless learning plus supported employment group (11/27) were still continuously working compared to 13.8% of the supported employment alone group (4/29) which was statistically significant (OR = 4.29, 95% CI: 2.14, 8.58)

IPS + Workplace fundamentals module vs brokered vocational rehabilitation + social skills training

The IPS + workplace fundamentals intervention group did not show significant differences in the number in competitive employment at 6 months (OR = 0.87, 95% CI: 0.48, 1.59), however, over the following 12 months, this group were significantly more likely to competitively employed than the comparison group (OR = 4.52, 95% CI: 2.49, 8.19)

Mixed mental health conditions

Prevocational training (Job related skills training)

Use of a decision aid + TAU vs TAU

[Feasibility trial]

More of the intervention group than controls were in full-time employment at follow-up (P = 0.03)

Supported employment (Low fidelity/not IPS)

Employment-orientated case management vs TAU

37 of the 73 participants (51%) in the intervention group got a job of any type by the end of the study (between 3 and 18 months from baseline), while 28 of the 79 control group participants (35%) got a job. This difference was not significant (OR = 1.87, 95% CI = 0.98, 3.59)

Supported employment (High fidelity IPS)

IPS vs TAU

Significantly more IPS participants were employed at 12 months compared to the control group (OR = 1.55, 95% CI: 1.02, 2.37), as well as at 18 months (OR = 1.61, 95% CI: 1.06, 2.46)

IPS with 55 h placement budget vs IPS with 25 h placement budget

According to the cox regression analysis, participants in the 25 h group (control) were more successful at getting their first employment relative to the 55 h group (Hazard ratio = 1.75, 95% CI: 0.86, 3.49). The cumulative proportion of participants who obtained a competitive employment was 33.3% in the intervention (55 h) group and 51.3% in the control (25 h) group

Augmented supported employment (SE + cognitive skills training)

Individual enabling and support vs TAU

At 6-month follow-up, 12.1% of participants in the individual enabling and support condition were competitively employed, while 14.8% of control participants reached their working goal, a non-significant difference (3% difference in favour of control, OR of employment = 0.79, 95% CI: 0.18, 3.52)

At 12-month follow-up, 42.4% of participants in the individual enabling and support condition were competitively employed, while 4% of control participants reached their working goal (38% difference in favour of the intervention group; OR of employment = 17.68, 95% CI: 2.13, 146.77)

IPS with cognitive training vs TAU

At 18 months, the IPS intervention group was significantly more likely to be employed or enrolled in education compared to the TAU group (OR = 1.49, 95% CI: 1.03, 2.17)

Cognitive remediation + supported employment vs usual employment services

The employment rate during the 12 month follow up [number of people working (n) = 28, 62.2%] was significantly higher in the CR + SE group than in the TVS group (n = 9, 19.1%, OR = 11.06, 95% CI = 3.53, 34.62, P < 0.001 after controlling for site and baseline GAF score)

Retaining paid employment

CMD

Prevocational training (Job related skills training)

Adjuvant occupational therapy + TAU vs TAU

Patients in the TAU + occupational therapy group worked significantly more median hours in the last 6 months at 6 months (Hedges g = 0.60, 95% CI: 0.08, 1.12, P = 0.024)) and 12 months (Hedges g = 0.53, 95% CI: 0.01, 1.04, P = 0.044). However, the groups did not differ in the last 6 months at 24 months (Hedges g = 0.30, 95% CI: -0.20, 0.81)

Supported employment (Low fidelity/not IPS)

IPS modified for people with mood and anxiety disorders vs TAU

There was no significant difference between groups in the mean number of weeks worked at both 12 months post baseline (Hedges g = 0.10, 95% CI: -0.12, 0.32) and 24 months (Hedges g = 0.16, 95% CI:-0.10, 0.38)

Supported employment (High fidelity IPS)

IPS vs TAU

IPS participants worked significantly more weeks in competitive employment 21.6 vs 6.8 during the 12 months from baseline (Hedges g = -093, 95% CI: 0.48, 1.37)

IPS vs transitional work

IPS participants spent significantly longer employed in a competitive job, on average, than the transitional work control group (Hedges g = 0.32, 95% CI: 0.15, 0.49) at 18 months follow up

Augmented supported employment (SE + cognitive therapy)

Work directed CBT and job support programme (At work and Coping) vs TAU

In the full sample, the average (median) number of months with work (and receiving no benefits) were 18.5 (15) for the control group and 20.3 (21) for the intervention group. For the subgroup on long-term benefits, the corresponding numbers were 6.0 (0) and 8.8 (0), respectively

SMI

Transitional employment

Paid work vs unpaid work

The paid work group were significantly more likely to still be in employment at the 6 month follow up (OR = 14.81, 95% CI: 4.11, 53.46)

Transitional employment + Cognitive skills training

Vocational rehabilitation + cognition remediation vs vocational rehabilitation + cognitive games

There was no significant difference between the cognitive remediation intervention group and the control group in the number of hours of competitive work at 12 months from baseline (Hedges g = -0.24, 95% CI: -0.73, 0.24)

Enhanced vocational services cognitive remediation (thinking skills for work) vs enhanced vocational services only

There was no significant difference between groups in the mean number of weeks worked after 3 years (Hedges g = -0.04, 95% CI: -0.57, 0.50)

Transitional employment + cognitive therapy

CBT + cognitive remediation vs vocational support

At 6 months post baseline, the CBT + cognitive remediation group did not work significantly more hours across the 6-month intervention phase than the vocational support control (Hedges g = 0.18, 95% CI: -0.38, 0.73)

Vocational CBT programme vs TAU

Participants in the vocational CBT group worked significantly more weeks than those in the standard support group after 12 months. Hedges g = 0.70, 95% CI: 0.11, 1.29)

Transitional employment + Social Skills training

Boston University approach to psychiatric rehabilitation vs active control condition

During the study period, total hours of participation in employment increased significantly (t-ratio = 2.84, df = 241, p = 0.005), with no difference between the conditions (t-ratio = 0.649, df = 97, P = 0.518). There were significant effects for fewer baseline psychiatric symptoms (t ratio =  − 3.55, df = 97, P < 0.001); previous paid employment (t-ratio = 3.54, df = 97, P < 0.001); and having received additional support (t-ratio = 2.77, df = 97, P = 0.007)

Prevocational training (Job related skills training)

Paid work plus behavioural intervention vs paid work only

Participants in the behavioural intervention condition worked significantly more weeks at 6 months from baseline than participants who received usual services (Hedges g = 0.53, 95% CI: 0.03, 1.03)

Prevocational training (Symptom related, Mindfulness)

Mindfulness based stress reduction (Mirrors) vs Intensive support control

[feasibility trial]

The number of weeks worked at the 24 months (end of intervention) were similar in the mindfulness based stress reduction and intensive support control

Prevocational training (cognitive skills training)

Cognitive remediation vs computerized control

Patients who received cognitive remediation worked significantly more weeks after 12 months than patients in the control group (mean 9.2 vs 3.7, Hedges g = 0.49, 95% CI: 0.00, 0.97)

Supported employment (High fidelity IPS)

IPS + TAU vs TAU

There were no significant differences between groups at either 6 months (Hedges g = 0.02, 95% CI: -0.36, 0.39) or 12 months (Hedges g = 0.21, 95% CI: -0.16, 0.59) post baseline in the number of days worked

IPS vs TAU

At 18 months post baseline, the interaction between treatment group and time was not significant, F(2, 148.4) = 0.95, P = 0.390. Furthermore, the main effects for time, F(2, 148.4) = 0.50, P = 0.608 and for group, F(1,112.9) = 0.20, P = 0.652, were not significant, suggesting that IPS did not improve the number of hours worked

Augmented supported employment (SE + job related skills training)

IPS plus work skills training vs IPS only

Over the 24 months of follow up, the IPS + work skills training group did not work significantly more weeks than the IPS only group (Hedges g = -0.30, 95% CI: -0.78, 0.19)

IPS + errorless learning vs IPS

Though the IPS + errorless learning group worked more weeks on average, the difference was not significant at 12 months (Hedges g = 0.37, 95% CI: -0.16, 0.89)

Supported employment skills training programme vs TAU

There was no significant difference in the number of days worked in the first job obtained by the participants in the intervention vs the control group (Hedges g = 0.15, 95% CI: -0.51, 0.82)

IPS + Workplace fundamentals module vs brokered vocational rehabilitation + social skills training

At 18 months post baseline, the mean number of weeks in competitive employment did not differ significantly between the two groups (Hedges g = 0.30, 95% CI: -0.22, 0.82)

Augmented supported employment (SE + symptom related skills training)

Cognitive remediation and supported employment vs internet information

At 6-months, those participants randomized to CogRem had worked significantly more hours (P = .01) than those participants randomized to the WebInfo control condition. (no additional data)

Supported employment + cognitive training vs supported employment

Significantly more hours over the past 12 months were worked by the cognitive training group compared to the supported employment only group at both 12 months (Hedges g = 1.08, 95% CI: 0.44, 1.71) and 24 months (Hedges g = 0.72, 95% CI: 0.11, 1.33)

Enhanced supported employment + cognitive remediation (thinking skills for work) vs enhanced supported employment only

Participants in the thinking skills for work programme worked significantly more hours over the past 12 months after 24 months follow up (Hedges g = 0.55, 95% CI: 0.16, 0.94)

IPS plus cognitive remediation vs IPS

There was no significant difference in the average number of weekly hours worked at 12 months post baseline (Hedges g = 0.10, 95% CI: -0.48, 0.67) however at 16 months post baseline, the cognitive remediation group worked significantly more weekly hours (Hedges g = 1.26, 95% CI: 0.63, 1.89)

Compensatory cognitive training vs enhanced supported employment

There was no significant difference between the groups in the weeks worked over the two year follow up period (Hedges g = -0.22, 95% CI: -0.54, 0.10)

Neurocognitive enhancement + vocational rehabilitation vs vocational rehabilitation only

There was no significant difference between the neurocognitive enhancement intervention and control vocational rehabilitation only group in the number of hours of competitive work at 12 months from baseline (Hedges g = -0.06, 95% CI: -0.52, 0.40)

Augmented supported employment (SE + cognitive therapy)

CBT for supported employment vs supported employment

There were no significant differences in the number of weeks worked at 13 months from baseline (Hedges g = 0.05, 95% CI: -0.26, 0.36)

Mixed mental health conditions

Prevocational training (Cognitive training)

Work-related CBT + vocational services vs vocational services only

[pilot trial]

The CBT group worked more hours at both end of treatment (1 month) and 4 months post baseline

Augmented supported employment (SE + cognitive skills training)

Individual enabling and support vs TAU

The individual enabling and support group worked significantly more weeks than the TAU control group by the 12 month follow up (Hedges g = 0.68, 95% CI: 0.15, 1.22)

IPS with cognitive training vs TAU

Participants in the IPS group spent significantly more hours in competitive employment or education compared to the TAU control group at 18 months post baseline (Hedges g = 0.22, 95% CI: 0.04, 0.40)

Cognitive remediation + supported employment vs usual employment services

The cognitive remediation + supported employment intervention group worked significantly more average total days at 12 months compared to the control group (Hedges g = 0.68, 95% CI: 0.26, 1.10)

Engagement in education

SMI

Prevocational training (with cognitive therapy)

Social recovery CBT + TAU vs TAU

Only 38% of the CBT group vs 51% of the TAU group engaged in education. This difference was not significant (OR = 0.58, 95% CI 0.22, 1.56)

Prevocational training (job related skills training)

BRDGE supported education programme vs TAU

The Bridge participants were significantly more likely to successfully enrol in education at 6 months from baseline compared to the TAU group- 43% vs 6%, OR = 12, 95% CI: 1.33, 108.02)

Psychiatric vocational rehabilitation vs enhanced state vocational rehabilitation

The psychiatric vocational rehabilitation group did not show significantly higher odds of partaking in education at either 9 months (OR = 0.45, 95% CI: 0.08, 2.54) nor 24 months (OR = 1.45, 95% CI: 0.49, 4.33)

Supported employment (High fidelity IPS)

IPS vs TAU

There was a significant interaction between group and time with respect to studying status, (OR = 0.87, 95% CI 0.77–0.97), after controlling for baseline study status. The odds ratio comparing studying status between the IPS and TAU groups at the 0–6-month time interval was significant, (OR = 3.04, 95% CI 1.01–9.17). No between-group differences were observed at 6–12 and 12–18 months

Augmented supported employment (SE + job related skills training)

IPS + Workplace fundamentals module vs brokered vocational rehabilitation + social skills training

IPS–WFM patients had a substantially greater likelihood of returning to school during the initial 6 months than brokered vocational rehabilitation patients (OR = 4.62, 95% CI: 1.52, 14.04), However, at 18 months there was no significant difference in the mean number of total weeks in education (Hedges g = 0.49, 95% CI: -0.04, 1.01)

Mixed mental health conditions

Augmented supported employment (SE + cognitive skills training)

Individual enabling and support vs TAU

At 12-month follow-up, 15.2% of individual enabling and support participants were taking part in education, while 4% of TAU participants were (19% difference; non-significant- OR = 4.29, 95% CI:0.47, 39.27)