Mueser K T, McGurk S R
Departments of Occupational Therapy, Psychology, and Psychiatry; Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, United States.
Departments of Occupational Therapy, Psychology, and Psychiatry; Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, United States.
Encephale. 2014 Jun;40 Suppl 2:S45-56. doi: 10.1016/j.encep.2014.04.008. Epub 2014 Jun 11.
The individual placement and supported (IPS) model of supported employment is the most empirically validated model of vocational rehabilitation for persons with schizophrenia or another serious mental illness. Over 18 randomized controlled trials have been conducted throughout the world demonstrating the effectiveness of supported employment at improving competitive work compared to other vocational programs: IPS supported employment is defined by the following principles: 1) inclusion of all clients who want to work; 2) integration of vocational and clinical services; 3) focus on competitive employment; 4) rapid job search and no required prevocational skills training; 5) job development by the employment specialist; 6) attention to client preferences about desired work and disclosure of mental illness to prospective employers; 7) benefits counseling; and 8) follow-along supports after a job is obtained. Supported employment has been successfully implemented in a wide range of cultural and clinical populations, although challenges to implementation are also encountered. Common challenges are related to problems such as the failure to access technical assistance, system issues, negative beliefs and attitudes of providers, funding restrictions, and poor leadership. These challenges can be overcome by tapping expertise in IPS supported employment, including standardized and tested models of training and consultation. Efforts are underway to increase the efficiency of training methods for supported employment and the overall program, and to improve its effectiveness for those clients who do not benefit. Progress in IPS supported employment offers people with a serious mental illness realistic hope for achieving their work goals, and taking greater control over their lives.
个体安置与支持性就业（IPS）模式是针对精神分裂症或其他严重精神疾病患者经实证验证最多的职业康复模式。全球已开展了18项以上随机对照试验，证明与其他职业项目相比，支持性就业在改善竞争性工作方面的有效性：IPS支持性就业由以下原则界定：1）接纳所有想工作的客户；2）整合职业与临床服务；3）专注于竞争性就业；4）快速求职且无需进行职业前技能培训；5）由就业专员开展工作开发；6）关注客户对理想工作的偏好以及向潜在雇主披露精神疾病情况；7）福利咨询；8）就业后持续提供支持。支持性就业已在广泛的文化和临床人群中成功实施，不过实施过程中也遇到了挑战。常见挑战涉及诸如无法获得技术援助、系统问题、提供者的负面信念和态度、资金限制以及领导力不足等问题。通过利用IPS支持性就业方面的专业知识，包括标准化和经过测试的培训及咨询模式，可以克服这些挑战。目前正在努力提高支持性就业培训方法及整个项目的效率，并提高其对未受益客户的有效性。IPS支持性就业方面的进展为患有严重精神疾病的人实现工作目标并更好地掌控自己的生活带来了现实的希望。
