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

• 批准号: 10391341
• 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
• 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/10391341
• 关键词: Applications Grants; Attenuated; Award; Behavior; Belief; Career Choice; Chronic; 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; Plant Roots; 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; Vocational Guidance; Vocational rehabilitation; Work; acceptability and feasibility; base; career; career development; design; disability; efficacy testing; efficacy trial; evidence base; experience; functional improvement; functional loss; high risk; improved; improved functioning; innovation; interest; multidisciplinary; pilot test; programs; protocol development; rehabilitation service; therapy development; tool; treatment as usual; trial comparing

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.

退伍军人健康管理局（VHA）提供了强大的职业规划， 无数的退伍军人获得了有竞争力的就业机会;然而，这些服务并不统一有效， 最近的数据表明，只有35%至43%的退伍军人在退伍时有竞争力的就业。为 那些成为有竞争力的就业，工作任期可能很短，这往往是削弱了 就业不足或人与工作不匹配。此外，只有3.5%的退伍军人遇到职业问题， 参与VHA提供的职业服务。平均而言，退伍军人需要四年多的时间来利用 职业服务。这些退伍军人有很高的风险获得多功能损失和发展 长期残疾，因为他们的职业需要多年得不到满足。 研究表明，缺乏明确的职业目标，感知障碍， 就业，以及对一个人的工作能力的负面信念有助于低参与度，结果， 职业康复服务的一些消费者的保有权。因此，VA可能能够改善 职业参与，结果，和任期的退伍军人与精神疾病，通过加强职业 针对无益的心理因素增加干预措施的服务。职业咨询和 发展服务已被证明能有效地帮助平民明确职业目标 和身份，增强职业自我效能感，并增加积极主动的职业行为，面对 障碍.此外，职业咨询和发展服务有助于促进就业者与非就业者之间的更大“匹配”。 人与工作的匹配是个人长期职业生涯的关键决定因素 患有精神疾病 本项目的研究者提出了一个三目标的研究来发展职业咨询， 对患有精神疾病的退伍军人的发展干预（CCD-V）。第一个目标将集中在 CCD-V干预的设计和开发与退伍军人和供应商的输入（n=16）。第二个目标将 在开放试验（n=10）中对干预措施进行初步测试，以收集退伍军人对初始干预措施的意见。第三和 最终目标将包括一项可行性初步随机对照试验（n=50），以检查可接受性， 可行性结果，并探讨CCD-V干预在功能改善方面的影响 和其他职业成果。拟议的CCD-V干预将由大约8名个人组成， 将与现有VHA职业康复服务同时提供的课程，（例如，过渡 本研究的最终产品是制作一个手动的CCD-V干预， 相应的保真度监测清单，稍后将在更大的疗效试验中进行测试。