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同伴主导的团体项目对有心理健康问题的失业人群的疗效:初步随机对照试验。

Efficacy of a peer-led group program for unemployed people with mental health problems: Pilot randomized controlled trial.

机构信息

1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany.

2 Federal Employment Agency, Nürnberg, Germany.

出版信息

Int J Soc Psychiatry. 2019 Jun;65(4):333-337. doi: 10.1177/0020764019846171. Epub 2019 May 6.

Abstract

BACKGROUND

People with long-term unemployment and mental health problems often find it difficult to take active steps toward help-seeking and job search and to navigate the complex system of available services. Likewise, job center staff would welcome interventions to improve the reintegration of long-term unemployed individuals with mental health problems into the labor market.

AIM

To examine the efficacy of a peer-led group program that supports unemployed people with mental health problems in terms of help-seeking, job search and recovery.

METHODS

Based on participatory research, a four-session group program was designed and evaluated in a pilot randomized controlled trial (RCT) with 42 participants, randomized to the program ( n = 23) or treatment as usual ( n = 19). Outcomes were assessed at baseline (T0), 3 weeks (T1), 6 weeks (T2) and 6 months later (T3).

RESULTS

There were no significant intervention effects on primary outcomes (job search self-efficacy and help-seeking). But compared to the control group, intervention participants showed significant improvements in depressive symptoms ( p = .02) and recovery ( p = .04) at T2 with medium effect sizes. There were trend-level positive program effects on self-stigma, hopelessness and secrecy.

CONCLUSION

This pilot RCT provides initial evidence for the efficacy of a peer-led group program to improve symptoms and recovery among unemployed participants with mental health problems.

摘要

背景

长期失业和心理健康问题的人通常发现很难积极寻求帮助和寻找工作,并在可用服务的复杂系统中找到自己的位置。同样,就业中心的工作人员也欢迎采取干预措施,以改善长期失业和有心理健康问题的人的重新融入劳动力市场的情况。

目的

研究一种以同伴为基础的小组方案,该方案支持有心理健康问题的失业者寻求帮助、寻找工作和恢复健康,以评估其疗效。

方法

基于参与式研究,设计了一个四节小组方案,并在一项试点随机对照试验(RCT)中进行了评估,共有 42 名参与者,随机分为方案组(n=23)或常规治疗组(n=19)。在基线(T0)、3 周(T1)、6 周(T2)和 6 个月后(T3)评估结果。

结果

主要结局(求职自我效能感和寻求帮助)没有显示出显著的干预效果。但与对照组相比,干预组在 T2 时的抑郁症状(p=0.02)和恢复情况(p=0.04)有显著改善,具有中等效应量。在自我污名、绝望和保密方面,也有积极的方案趋势效应。

结论

这项初步 RCT 提供了初步证据,证明以同伴为基础的小组方案能够改善有心理健康问题的失业者的症状和恢复情况。

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