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Large trials of psychosocial interventions: examples from individual placement and support.

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Update on Individual Placement and Support for New Populations: A Meta-Analytic Review.

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Individual Placement and Support (IPS) vocational rehabilitation shows positive employment outcomes for individuals with early psychosis, substance use disorders, and common mental disorders. Further research is needed to address implementation challenges and improve study quality for these new populations.

Keywords:
Common mental disordersEarly psychosisEmploymentIndividual placement and supportSubstance use disordersSupported employment

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Area of Science:

  • Vocational Rehabilitation
  • Psychiatric Rehabilitation
  • Evidence-Based Practice

Background:

  • Individual Placement and Support (IPS) is an evidence-based vocational rehabilitation model.
  • IPS has demonstrated effectiveness for individuals with serious mental illness (SMI).
  • Recent efforts have extended IPS to new disability groups.

Purpose of the Study:

  • To review the evidence for IPS effectiveness in five new populations.
  • Populations include early psychosis, common mental disorders, substance use disorders, posttraumatic stress disorders, and severe medical conditions.
  • To update employment outcome findings through meta-analyses of controlled trials.

Main Methods:

  • Systematic review of controlled trials of IPS for new populations.
  • Electronic search to identify recent studies.
  • Meta-analyses to calculate overall odds ratios (OR) and 95% confidence intervals (CI) for employment outcomes.

Main Results:

  • 19 controlled trials were identified, with 9 published since 2019.
  • Significant positive employment outcomes (OR > 1) were found for early psychosis (OR=3.39), substance use disorders (OR=1.88).
  • Common mental disorders showed a non-significant trend towards improved employment (OR=1.42). Evidence for PTSD and severe medical conditions was mixed.

Conclusions:

  • IPS demonstrates generally positive employment outcomes when extended to new populations.
  • The quality of the literature is limited by implementation issues, small sample sizes, and methodological challenges.
  • IPS remains a leading vocational rehabilitation intervention with broad applicability.