Koletsi Marsha, Niersman Astrid, van Busschbach Jooske T, Catty Jocelyn, Becker Thomas, Burns Tom, Fioritti Angelo, Kalkan Rana, Lauber Christoph, Rössler Wulf, Tomov Toma, Wiersma Durk
Division of Mental Health, St. George's, University of London, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2009 Nov;44(11):961-70. doi: 10.1007/s00127-009-0017-5. Epub 2009 Mar 12.
Although the effectiveness of individual placement and support (IPS) has been well established, little is known about clients' perceptions of the model compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to work with this kind of support. This qualitative study aimed to explore clients' views of the difficulties of obtaining and maintaining employment, their experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients' lives.
Semi-structured interviews were conducted with 48 people with psychotic disorders participating in a six-centre international randomised controlled trial of IPS compared to usual vocational rehabilitation. To assess their experiences of the services and the perceived effects of working, two IPS and two Vocational Service clients at each centre who had found work during the study period were interviewed, along with two IPS and two Vocational Service clients at each centre who had not.
IPS clients reported having received more help seeking and maintaining employment, whereas Vocational Service clients reported having received more help in finding sheltered employment or placements. Clients who had worked associated this with financial stability, improved social lives, increased self-esteem, integration into society and amelioration of their symptoms, as well as reduced feelings of boredom and isolation, but also reported increased levels of stress. IPS clients as well as Vocational Service ones reported not receiving enough follow-up support, despite this being proposed as a key feature of the model.
Findings from the in-depth interviews reflect differences in service models that have also been tested quantitatively but further work in disaggregating the IPS model and assessing the impact of each component would be valuable.
尽管个别安置与支持（IPS）模式的有效性已得到充分证实，但与常规职业康复相比，客户对该模式的看法以及他们在这种支持下寻找和重返工作岗位的经历却鲜为人知。这项定性研究旨在探讨客户对获得和维持就业困难的看法、他们从IPS或职业服务工作者那里获得支持的经历以及工作对客户生活的感知影响。
对参与一项六中心国际随机对照试验的48名患有精神疾病的人进行了半结构式访谈，该试验将IPS与常规职业康复进行了比较。为了评估他们对服务的体验以及工作的感知效果，对每个中心在研究期间找到工作的两名IPS客户和两名职业服务客户，以及每个中心未找到工作的两名IPS客户和两名职业服务客户进行了访谈。
IPS客户报告在寻找和维持就业方面得到了更多帮助，而职业服务客户报告在寻找庇护性就业或安置方面得到了更多帮助。有工作的客户将此与经济稳定、社交生活改善、自尊增强融入社会、症状改善以及无聊和孤立感减少联系起来，但也报告压力水平有所增加。IPS客户和职业服务客户都报告没有得到足够的后续支持，尽管这被认为是该模式的一个关键特征。
深入访谈的结果反映了服务模式的差异，这些差异也已通过定量方法进行了测试，但进一步分解IPS模式并评估每个组成部分的影响将是有价值的。
