Russinova Zlatka, Gidugu Vasudha, Bloch Philippe, Restrepo-Toro Maria, Rogers E Sally
Center for Psychiatric Rehabilitation.
Program for Recovery and Community Health.
Psychiatr Rehabil J. 2018 Sep;41(3):196-207. doi: 10.1037/prj0000303. Epub 2018 Jul 9.
Supported employment has experienced immense growth as an evidence-based intervention targeting the disproportionately high rates of unemployment among individuals with psychiatric disabilities who actively want to work. However, employment services are often not available to individuals who are ambivalent about work or lack work self-efficacy. The purpose of this study was to pilot-test the efficacy of a new peer-run photography-based group intervention (Vocational Empowerment Photovoice [VEP]) designed to empower individuals with psychiatric disabilities to consider employment services and pursue work.
A total of 51 individuals with serious mental illnesses enrolled at a university-based recovery center, who were not employed or enrolled in any vocational services, were randomly assigned to the VEP program or to a wait-list control group. Mixed-effects regression models were used to examine the impact of the VEP program on both extrinsic (enrollment in employment services and employment rates) and intrinsic (work hope, motivation and self-efficacy, vocational identity, overall empowerment and internalized stigma) work-related outcomes.
Participation in the VEP program was associated with a significantly higher rate of engagement in employment services over the course of the intervention and with significantly higher overall empowerment and decrease of internalized stigma sustained through the 3-month follow-up assessment. Stronger engagement in the VEP program was associated with increased work hope, self-efficacy and sense of vocational identity.
The study highlights the malleable nature of defeatist beliefs which prevent many individuals with mental illnesses from pursuing employment services despite their inherent interest in working. (PsycINFO Database Record
支持性就业作为一种循证干预措施，取得了巨大发展，其目标是针对有工作意愿的精神疾病患者中高得不成比例的失业率。然而，对于那些对工作态度矛盾或缺乏工作自我效能感的人来说，就业服务往往无法提供。本研究的目的是对一种新的由同伴主导的基于摄影的团体干预措施（职业赋权摄影发声法[VEP]）的效果进行试点测试，该干预措施旨在使精神疾病患者有能力考虑就业服务并寻求工作。
共有51名在大学康复中心登记的严重精神疾病患者，他们未就业或未参加任何职业服务，被随机分配到VEP项目或等待名单对照组。使用混合效应回归模型来检验VEP项目对外部（就业服务登记和就业率）和内部（工作希望、动机和自我效能感、职业认同、总体赋权和内化耻辱感）与工作相关结果的影响。
在干预过程中，参与VEP项目与就业服务参与率显著更高相关，并且在为期三个月的随访评估中，与总体赋权显著更高和内化耻辱感降低相关。对VEP项目更强的参与度与工作希望、自我效能感和职业认同感的增加相关。
该研究强调了失败主义信念的可塑性本质，这些信念阻止了许多精神疾病患者尽管对工作有内在兴趣却仍寻求就业服务。（PsycINFO数据库记录）
