Research and Development Service, Tuscaloosa VA Medical Center.
VISN 1 Mental Illness Research Education and Clinical Center.
Psychiatr Rehabil J. 2019 Sep;42(3):257-267. doi: 10.1037/prj0000357. Epub 2019 Apr 4.
Transitional work (TW) for veterans with psychiatric disabilities is the predominant model of vocational rehabilitation in the Veterans Health Administration (VA). Although, on average, TW employment outcomes have been demonstrated to be inferior to supported employment, little is known about the potential subgroup of veterans for which TW may be most effective. This study of veterans with posttraumatic stress disorder (PTSD) examines differences in competitive employment outcomes and identifies characteristics of veterans who chose to engage in TW compared with those who did not.
A post hoc comparative subgroup analysis of veterans with PTSD randomly assigned to TW as part of a randomized controlled trial was conducted. Veterans were divided into 2 subgroups: those who engaged in TW (n = 141) and nonengagers (n = 129). Differences in baseline characteristics were examined and 18-month employment outcomes were compared.
There were no differences in 18-month employment outcomes between TW engagers and nonengagers. Compared with TW engagers, those that did not engage in TW were 2.5 times more likely to get a competitive job within the first 6 months and were less likely to obtain lower skilled jobs. Younger age, adequate housing, personal means of transportation, and recent work history factor into the odds of gaining and maintaining competitive work.
Consistent with past research, engagement in TW did not result in improved long-term competitive employment outcomes for veterans with PTSD. Those who did not engage in TW were more likely to gain a competitive job within the first 6 months. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
退伍军人精神残疾的过渡性工作（TW）是退伍军人健康管理局（VA）职业康复的主要模式。尽管 TW 的就业结果平均来说不如支持性就业，但对于 TW 可能最有效的潜在退伍军人亚组知之甚少。这项针对创伤后应激障碍（PTSD）退伍军人的研究考察了竞争性就业结果的差异，并确定了选择从事 TW 的退伍军人与不选择从事 TW 的退伍军人的特征。
对 PTSD 退伍军人进行了一项事后比较亚组分析，这些退伍军人作为一项随机对照试验的一部分被随机分配到 TW 中。退伍军人被分为 2 个亚组：从事 TW（n=141）和非参与者（n=129）。检查了基线特征的差异，并比较了 18 个月的就业结果。
TW 参与者和非参与者在 18 个月的就业结果方面没有差异。与 TW 参与者相比，未参与 TW 的退伍军人在头 6 个月获得竞争性工作的可能性高 2.5 倍，获得低技能工作的可能性低。年轻、充足的住房、个人交通工具和最近的工作经历是获得和维持竞争性工作的因素。
与过去的研究一致，TW 的参与并未改善 PTSD 退伍军人的长期竞争性就业结果。那些不参与 TW 的人更有可能在头 6 个月内获得竞争性工作。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
