Department of Experimental Psychology, University of Oxford, Oxford, UK.
NHS Oxfordshire Talking Therapies, Oxford Health NHS Foundation Trust, Oxford, UK.
Behav Cogn Psychother. 2024 Jan;52(1):93-99. doi: 10.1017/S1352465823000474. Epub 2023 Oct 23.
Many people achieve positive outcomes from psychological therapies for anxiety and depression. However, not everyone benefits and some may require additional support. Previous studies have examined the demographic and clinical characteristics of people starting treatment and identified a patient profile that is associated with poor clinical outcomes.
To examine whether the addition of employment-related support alongside psychological therapy was associated with a greater chance of recovery for clients belonging to this patient profile.
We analysed 302 clients across three services, who were offered employment-related support alongside psychological therapy. The rate of clinical recovery (falling below clinical thresholds on measures of both anxiety and depression) was compared between individuals who accepted the offer and those who declined, while adjusting for potential confounders.
Logistic regression showed that receiving employment support was significantly associated with clinical recovery after controlling for baseline anxiety and depression scores, the number of psychological treatment sessions, and other clinical and demographic variables. The odds of recovery were 2.54 times greater if clients received employment support; 47% of clients who received employment support alongside psychological therapy were classified as recovered, compared with 27% of those receiving psychological therapy only.
Providing employment support alongside therapy may be particularly helpful for clients belonging to this patient profile, who represent approximately 10% of referrals to NHS Talking Therapies for Anxiety and Depression services. Services could consider how to increase the provision and uptake of employment-focused support to enhance clients' clinical outcomes.
许多人通过心理治疗在焦虑和抑郁方面取得了积极的效果。然而，并非每个人都受益，有些人可能需要额外的支持。先前的研究已经检查了开始治疗的人群的人口统计学和临床特征，并确定了与不良临床结果相关的患者特征。
研究在心理治疗之外提供与就业相关的支持是否与属于这种患者特征的客户的康复机会增加有关。
我们分析了来自三个服务的 302 名客户，他们在接受心理治疗的同时也获得了与就业相关的支持。在调整潜在混杂因素后，比较了接受和拒绝该提议的个体之间的临床康复率（在焦虑和抑郁两个方面的测量指标上均低于临床阈值）。
逻辑回归显示，在控制基线焦虑和抑郁评分、心理治疗次数以及其他临床和人口统计学变量后，接受就业支持与临床康复显著相关。如果客户接受就业支持，康复的可能性会增加 2.54 倍；在接受心理治疗和就业支持的客户中，有 47%被归类为康复，而仅接受心理治疗的客户中只有 27%。
在治疗之外提供就业支持可能对属于这种患者特征的客户特别有帮助，这些客户约占 NHS 焦虑和抑郁治疗服务转介的 10%。服务可以考虑如何增加以就业为重点的支持的提供和利用，以提高客户的临床结果。
