Improving Vocational Outcomes of Veterans with Psychiatric Disorders: Career Counseling & Development

改善患有精神疾病的退伍军人的职业成果：职业咨询

基本信息

批准号：
10604333
负责人：
Brian Stevenson
金额：
--
依托单位：
EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10604333
关键词：
Applications Grants Attenuated Award Behavior Belief Chronic Compensation Complex Data Dissemination and Implementation Employment Evaluation Evidence based practice Future Goals Health Individual Intervention Intrinsic factor Manuals Mental disorders Mentors Monitor Needs Assessment Occupations Outcome Personal Satisfaction Persons Population Provider Psychological Factors Randomized, Controlled Trials Research Research Personnel Research Proposals Resources Secure Self Efficacy Services Strategic Planning Suicide prevention System Testing Time Training Treatment Efficacy Underemployment Unemployment Veterans Veterans Health Administration Vocation Vocational Guidance Vocational rehabilitation Work acceptability and feasibility career career development design disability efficacy testing efficacy trial evidence base experience functional improvement functional loss high risk improved innovation interest multidisciplinary pilot test programs protocol development rehabilitation service therapy development tool treatment as usual trial comparing

项目摘要

The Veterans Health Administration (VHA) offers robust vocational programming that have helped countless Veterans obtain competitive employment; however, these services are not uniformly effective as recent data suggests that only 35 to 43% of Veterans are competitively employed at time of discharge. For those who become competitively employed, job tenure may be brief, which is often attenuated by underemployment or poor person-job fit. Moreover, only 3.5% of Veterans experiencing vocational problems engage in vocational services offered by the VHA. On average, it takes Veterans more than four years to utilize vocational services. These Veterans are at high risk of acquiring multiple functional losses and developing chronic disabilities as their vocational needs go unmet for years. Research suggests that intrinsic factors like lacking clear vocational goals, perceiving barriers to employment, and negative beliefs about one’s ability to work contribute to low engagement, outcomes, and tenure of some consumers of vocational rehabilitation services. Thus, the VA may be able to improve vocational engagement, outcomes, and tenure of Veterans with psychiatric disorders by enhancing vocational services with added interventions targeting unhelpful psychological factors. Career counseling and development services have been shown to be effective in helping civilian populations clarify vocational goals and identity, enhance vocational self-efficacy, and increase proactive vocational behaviors in the face of obstacles. Additionally, career counseling and development services help facilitate greater “match” between a person and their job, and person-job match is a key determinant of long-term career tenure among individual with psychiatric disorders. The researchers of this project propose a three-aim study to develop a career counseling and development intervention for Veterans with psychiatric disorders (CCD-V). The first aim will focus on the design and development of the CCD-V intervention with veteran and provider input (n=16). The second aim will pilot test the intervention in an open trial (n=10) to gather Veteran input on the initial intervention. The third and final aim will consist of a feasibility pilot randomized controlled trial (n=50) to examine acceptability and feasibility outcomes and to explore the impact of the CCD-V intervention in terms of functional improvement and other vocational outcomes. The proposed CCD-V intervention will consist of approximately eight individual sessions that will be offered concurrently with existing VHA vocational rehabilitation services, (e.g., transitional work experience [TWE]).The final product of this study is to produce a manualized CCD-V intervention, and corresponding fidelity monitoring checklist, to be tested later in a larger efficacy trial.

退伍军人卫生管理局（VHA）提供了强大的出版节目无数的退伍军人获得竞争性就业；但是，这些服务并不统一，因为最近的数据表明，在出院时，只有35％至43％的退伍军人受到竞争性雇用。为了那些竞争性地工作的人，工作任期可能是简短的，这通常会受到就业不足或贫穷的人工作。而且，只有3.5％的退伍军人遇到职业问题参与VHA提供的投票服务。平均而言，退伍军人需要四年以上的时间才能使用职业服务。这些退伍军人有获得多重功能损失和发展的高风险慢性疾病随着他们的职业需求多年就无法满足。研究表明，诸如缺乏明确的职业目标，感知障碍之类的内在因素就业和对工作能力的负面信念有助于低参与，结果和一些投票康复服务消费者的任期。那，VA可能能够改善通过增强职业的职业参与，成果和担任精神疾病的退伍军人针对无助的心理因素的增加干预措施的服务。职业咨询和发展服务已被证明有效地帮助平民澄清选民目标以及身份，提高选民的自我效能感，并在面对面前提高主动选民行为障碍。此外，职业咨询和发展服务有助于促进更大的“匹配” 人及其工作以及人job比赛是个人长期职业任期的关键决定者患有精神疾病。该项目建议的研究人员进行了三aim研究，以开发职业咨询和患有精神疾病的退伍军人的发展干预措施（CCD-V）。第一个目标将集中于使用资深人士和提供商输入的CCD-V干预的设计和开发（n = 16）。第二个目标试点在开放试验（n = 10）中测试干预措施，以收集初始干预的老兵意见。第三和最终目标将包括可行性试验随机对照试验（n = 50），以检查可接受性和可行性结果并探索CCD-V干预的影响和其他投票结果。拟议的CCD-V干预将由大约八个单独组成将与现有的VHA康复服务同时提供的会议（例如过渡性工作经验[twe]）。这项研究的最终产品是生产手动的CCD-V干预措施，并相应的保真度监视清单，将在更大的效率试验中进行测试。