Career Counseling for Mental Illness
Recruiting in Palo Alto (17 mi)
+1 other location
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Disqualifiers: Acute suicide/homicide risk, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?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 (Purposeful Pathways). The first aim will focus on the design and development of the Purposeful Pathways 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 Purposeful Pathways intervention in terms of functional improvement and other vocational outcomes. Purposeful Pathways consists of up to 12 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 manual of Purposeful Pathways, and corresponding fidelity monitoring checklist, to be tested later in a larger efficacy trial.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It seems focused on career counseling and development, so it's likely you can continue your current treatments, but you should confirm with the trial coordinators.
What data supports the effectiveness of the treatment Career Counseling & Development for Veterans?
Research shows that veterans with mental health conditions have a strong desire for career development services to help them find meaningful employment. Although specific programs like Purposeful Pathways are still being developed, studies highlight the importance of integrating vocational services into mental health care, which can support veterans in achieving their career goals.
12345How is the Career Counseling & Development for Veterans treatment different from other treatments for mental illness?
This treatment is unique because it specifically addresses the career development needs of veterans with mental health conditions, offering tailored support to help them find meaningful employment, which is not typically the focus of standard mental health treatments.
12678Eligibility Criteria
This trial is for Veterans with psychiatric disorders like PTSD, mood or anxiety-related disorders, psychotic disorders, substance use disorders who are unemployed or struggling at work due to their condition. They must plan to work for three years post-study and be eligible for Transitional Work Experience (TWE). Those at acute risk of harm to self/others, currently in supported employment services, or unlikely to complete the study due to deployment/incarceration/hospitalization/relocation are excluded.Inclusion Criteria
Eligibility for, and planning to enroll in TW, or within 16 weeks of having enrolled in TW
I am mentally capable of understanding and signing a consent form.
Self-identification as either unemployed, underemployed, or employed but functioning poorly at work as a result of mental illness or substance use
+3 more
Exclusion Criteria
Not otherwise eligible for TW services
I am not willing to participate in weekly career development sessions.
Your score on the Symptom Checklist-6 is higher than 26.
+4 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Development
Develop a career counseling and development treatment manual for Veterans with psychiatric disorders
Several months
Pilot Testing
Pilot test the manual by treating a small number of Veterans in an open trial
8 weeks
Randomized Controlled Trial
Conduct a randomized controlled pilot study comparing Purposeful Pathways to treatment as usual
3 months
Follow-up
Participants are monitored for safety and effectiveness after treatment
3 months
Participant Groups
The 'Purposeful Pathways' intervention is being tested alongside existing VHA vocational rehabilitation services. It includes up to 12 individual sessions aimed at improving job fit and tenure by addressing psychological barriers. The study will develop this intervention with veteran input and test its feasibility and impact on functional improvement in a small randomized controlled trial.
2Treatment groups
Experimental Treatment
Active Control
Group I: CCD-V GroupExperimental Treatment2 Interventions
Veterans in this arm will receive treatment as usual, which is transitional work experience intervention, as well as the CCD-V intervention
Group II: Treatment as UsualActive Control1 Intervention
Veterans in this arm will receive treatment as usual, which is transitional work experience intervention.
Career Counseling & Development for Veterans is already approved in United States for the following indications:
🇺🇸 Approved in United States as Vocational Rehabilitation and Employment (VR&E) for:
- Psychiatric Disorders
- Vocational Rehabilitation
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MABedford, MA
VA Bedford HealthCare System, Bedford, MABedford, MA
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Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
References
Feasibility of a Career Development Intervention for Veterans in Vocational Rehabilitation: Protocol for a Pilot Randomized Controlled Trial. [2023]Veterans with psychiatric disorders want additional career development services to support their recovery and pursuit of meaningful employment. However, no career counseling programs have been designed for this specific population. We developed the Purposeful Pathways intervention to fill this need.
Career Development in Transitional Work Settings: A Qualitative Investigation Among Veterans and Vocational Counselors. [2023]Veterans living with mental health conditions have ambitious career goals and want support to find employment that meets their interests and preferences. Despite calls from researchers to "invest" and "commit" to career development research and practice for individuals living with psychiatric conditions, we still do not have empirically tested models for facilitating career development among individuals with mental health conditions, especially veterans. This qualitative study investigates the career development needs and recommended intervention strategies of veterans living with mental health conditions. Vocational counselors from the Veterans Health Administration (VHA) and veterans receiving vocational rehabilitation services (N = 13) participated in semi-structured focus groups. Findings illuminate the tasks, barriers, interventions, implementation strategies, and transitional work context that hinder and support career development of veterans with mental health conditions. Findings offer theoretical and applied guidance to researchers and counselors regarding career development of veterans living with mental health conditions.
Project WINS: integrating vocational services on mental health case management teams. [2019]In an effort to expand employment opportunities available to psychiatric consumers, a research demonstration project was developed to incorporate vocational services into case management teams. Following psychiatric rehabilitation principles, Project WINS employs professionals as Vocational Specialists and consumers as Peer Support Specialists to work with clients and their case managers. This report describes the characteristics of clients eligible for WINS services, the implementation of the program, and the impact of WINS on clients and on the mental health and vocational systems. It also describes the challenges and barriers this innovative service is confronting.
The language we use - the effect of writing mental health care plans in the first person. [2019]This study describes the impact of Motivational Aftercare Planning (MAP) - an intervention to increase consumer/clinician collaboration on the content of mental health recovery plans. The intervention focussed on enhancing existing discharge processes in psychiatric inpatient wards and supporting nursing staff in using motivational interviewing techniques to facilitate the completion of these plans.
Successful living: a social skills and problem-solving group for the chronic mentally ill. [2019]The authors describe a skills training group for chronic mental patients called Successful Living that is offered in conjunction with an outpatient medication clinic at a Veterans Administration hospital. The weekly group operates on a drop-in basis and focuses on helping patients select and attain short- and long-term goals. Goal attainment is accomplished primarily through rehearsal of needed behaviors and specific homework assignments for repeating behaviors outside the group. Goals selected by an original group of 22 participants indicate that given the opportunity, chronic patients do want to change their social situation; moreover, 88 percent of completed homework assignments, or 49 percent of the total assignments, had desirable outcomes.
Helping veterans achieve work: A Veterans Health Administration nationwide survey examining effective job development practices in the community. [2018]Veterans Health Administration vocational services assist veterans with mental illness to acquire jobs; one major component of these services is job development. The purpose of this study was to characterize the nature of effective job development practices and to examine perceptions and intensity of job development services.
Exploring the work lives of adults with serious mental illness from a vocational psychology perspective. [2018]Current vocational services for adults with serious mental illness remain largely atheoretical and disconnected from mainstream vocational psychology research and practice. This study explored the perspectives on work of adults with serious mental illness, compared perspectives of young and older adults, and assessed these perspectives for the applicability of a well-established theory of vocational psychology. A national sample of 76 individuals with mental illness engaged in the workforce completed a semistructured questionnaire. We applied the principles of a participatory approach to consensual qualitative research methodology in the study design and data analysis. Results yielded a large number of categories, which clustered under domains representative of the primary constructs of social cognitive career theory (SCCT; Lent, 2013). These domains included the antecedents of self-efficacy, namely, personal accomplishments, vicarious learning, social persuasion, and physical or emotional states as well as additional constructs of outcome expectations, personal goals, and contextual barriers. The SCCT model will likely provide a useful framework to bridge the gap between career development theory and vocational services for individuals with mental illness.
Development of vocational potential assessment tool and counseling module for persons with severe mental disorders. [2020]To develop and validate the vocational potential assessment tool and counselling module for persons with severe mental disorders (SMD).