Jiwani Zishan, Xie Qiang, Curtin John J, Riordan Kevin M, Babins-Wagner Robbie, Caperton Derek, Thompson Mindi N, Goldberg Simon B
Department of Counseling Psychology, University of Wisconsin-Madison.
Center for Healthy Minds, University of Wisconsin-Madison.
Psychotherapy (Chic). 2025 Aug 4. doi: 10.1037/pst0000597.
Employment status, an essential socioeconomic factor, may be an important driver of disparities in mental health and access to treatment. However, prior research has been inconclusive and utilized broad employment categories. The present study investigated the associations between various types of employment status and baseline symptomology, psychotherapy engagement, and psychotherapy outcomes. We examined 27,258 patients (age = 32.54; 62.9% female; 75.8% White) who attended 115,936 psychotherapy sessions at a Canadian mental health agency between January 2014 and July 2022. Employment status was categorized into nine distinct groups (e.g., full-time, part-time, unemployed and looking for work, unemployed not looking for work, and retirement). Multilevel models examined the association between employment status and baseline symptoms, psychotherapy engagement (e.g., total sessions, early termination), and outcomes (e.g., symptom change). Patients who were unemployed (both looking for and not looking for work) reported higher baseline symptoms and increased odds of suicide concern compared to patients with full-time employment. Contrary to our preregistered hypotheses, patients who were unemployed attended more sessions and showed no significant differences in symptom change or trajectory of change compared to those employed full-time. Retirement was linked to lower baseline symptomology, and both retirement and full-time student status were associated with slower trajectories of change relative to full-time employment. Findings suggest that unemployment is associated with worse baseline mental health but does not hinder psychotherapy engagement and effectiveness. Ensuring accessibility of psychotherapy for unemployed individuals is crucial, given their heightened risk of psychological distress. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
就业状况作为一个重要的社会经济因素，可能是心理健康及治疗可及性方面差异的一个重要驱动因素。然而，先前的研究尚无定论，且使用的是宽泛的就业类别。本研究调查了各类就业状况与基线症状、心理治疗参与度及心理治疗结果之间的关联。我们考察了2014年1月至2022年7月期间在一家加拿大心理健康机构参加115,936次心理治疗的27,258名患者（年龄 = 32.54岁；62.9%为女性；75.8%为白人）。就业状况被分为九个不同的组（例如，全职、兼职、失业且正在找工作、失业但未找工作以及退休）。多层次模型考察了就业状况与基线症状、心理治疗参与度（例如，总疗程数、提前终止治疗）及治疗结果（例如，症状变化）之间的关联。与全职就业的患者相比，失业（包括正在找工作和未找工作）的患者报告有更高的基线症状以及更高的自杀担忧几率。与我们预先登记的假设相反，失业患者参加的疗程更多，并且与全职就业患者相比，在症状变化或变化轨迹方面没有显著差异。退休与较低的基线症状相关，并且退休和全日制学生身份与相对于全职就业而言更缓慢的变化轨迹有关。研究结果表明，失业与更差的基线心理健康状况相关，但并不妨碍心理治疗的参与度和疗效。鉴于失业个体心理困扰风险更高，确保他们能够获得心理治疗至关重要。（《心理学文摘数据库记录》(c) 2025美国心理学会，保留所有权利）
