Acceptability and Feasibility of Work-Oriented, Veteran-Centric, Social-Cognitive Skills Training

以工作为导向、以退伍军人为中心的社会认知技能培训的可接受性和可行性

• 批准号: 10582392
• 负责人: Tasha Marie Nienow
• 金额: --
• 依托单位: MINNEAPOLIS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10582392
• 关键词: Attitude; Community Integration; Community Participation; Cues; Data; Data Collection; Detection; Development; Education; Educational Curriculum; Educational Intervention; Emotional; Emotions; Employment; Enrollment; Evidence based intervention; Evidence based practice; Feedback; Freedom; Future; Goals; Healthcare Systems; Hour; Individual; Instruction; Interpersonal Relations; Intervention; Intervention Studies; Interview; Job loss; Learning; Life; Logic; Maintenance; Measures; Mental Health; Mental Health Services; Occupations; Outcome; Participant; Performance at work; Persons; Phase; Pilot Projects; Problem Solving; Qualitative Methods; Quality of Care; Quality of life; Randomized, Controlled Trials; Recovery; Rehabilitation therapy; Reporting; Research; Role; Schedule; Secure; Self Efficacy; Services; Severities; Social Functioning; Social Interaction; Social Problems; Specialist; Structure; Suggestion; Supported Employment; Symptoms; Therapeutic; Training; Unemployment; Veterans; Veterans Health Administration; Vocational rehabilitation; Well in self; Work; Workplace; acceptability and feasibility; cognitive skill; cohort; coping; evidence base; follow up assessment; health care service; improved; interest; participant enrollment; participant retention; pilot trial; post intervention; productivity loss; professional atmosphere; programs; promote resilience; psychosocial; satisfaction; severe mental illness; showing emotion; skills; skills training; social; social cognition; social norm; suicidal risk; therapy development; uptake

Supported employment is an evidence-based practice that places individuals with serious mental illness into competitive employment. Employment specialists are embedded into mental health teams and work with individuals to identify employment consistent with their interests and personal goals. Supported employment programs consistently have been found to be effective at job placement. However, maintenance of employment continues to be a significant challenge for individuals living with a serious mental illness. Interpersonal difficulties often contribute to job terminations. Individuals with a serious mental illness often have difficulty with interpreting emotional expressions, perspective taking, and social problem-solving. Thus, in addition to assistance with job placement, individuals living with a serious mental illness are also likely to benefit from intervention focused on developing skills to manage the social demands of work. An existing, evidence-based, psychosocial skills intervention, Social Cognition and Interaction Training (SCIT), will be adapted for use in this study. SCIT targets emotion recognition, perspective taking, and social problem-solving skills. The curriculum will be tailored to work settings and to Veterans with serious mental illness. Then, a pilot study will be conducted to assess the acceptability of integrating this psychosocial skills training with supported employment and the feasibility of conducting a randomized controlled trial in the future. To accomplish the first objective, structured stakeholder interviews will be conducted with Veterans who have participated previously in supported employment (n = 20) and employment specialists at the VA (n = 5) to identify educational topics and work examples to incorporate into SCIT. The curriculum will be piloted to elicit feedback on the session content and flow. Then, to assess acceptability and feasibility, an open trial pilot study will be conducted with 20 Veterans with serious mental illness who are enrolled in the supported employment program at the Minneapolis VA Health Care System. Upon study enrollment, participants will attend one 2-hour skills training session weekly for 13 weeks. Group size will be limited to 4-6 participants. To promote generalization of skills training, assignments will be given weekly to prompt participants to use skills outside of group. After completion of skills training, participants will continue to meet with their employment specialist. Materials will be developed for the employment specialists to use in session to prompt participants to continue to use skills at work. Participants will complete baseline, post-intervention, and 3-month follow-up assessments so that social functioning, relationship quality, work performance, self-efficacy, quality of life, and symptom severity can be measured. In addition, participants and employments specialists will complete an individual, semi-structured, qualitative exit interview that will (1) assess attitudes about the intervention components, structure, and materials; (2) elicit suggestions for intervention improvement; and (3) ask participants for their observations about the impact of the program on intervention targets. Acceptability will be assessed quantitatively as: 1) uptake (percentage of Veterans who participate); 2) engagement (number of sessions attended); and 3) participant ratings of interest, value, and satisfaction. Specifically, we predict: a study uptake rate of 50%; 70% session completion; and positive endorsement on measures of interest, value, and satisfaction. Acceptability also will be measured through qualitative analysis of participant and employment specialist exit interviews. Feasibility will be measured by: participant enrollment; retention in skills training and supported employment at 3- and 6-months post-enrollment; treatment fidelity; and completeness of data collection at baseline, post-intervention, and 3-month follow-up assessments. Main indicators of feasibility will be: enrollment of 3 participants per a month; 75% and 60% participant retention at 3- and 6-months, respectively; 90% consistency with study interventions; and 85% of data points completed.

支持就业是一种基于证据的做法， 有竞争力的就业。就业专家被嵌入到心理健康团队，并与 个人确定符合其兴趣和个人目标的就业。辅助就业 在就业安置方面，方案一直被发现是有效的。然而，维护 对于患有严重精神疾病的人来说，就业仍然是一个重大挑战。 人际关系困难往往会导致工作终止。患有严重精神疾病的人通常 在解释情感表达、观点采择和解决社会问题方面有困难。因此在 除了帮助安置工作外，患有严重精神疾病的人也可能 受益于侧重于发展技能的干预措施，以管理工作的社会需求。一个现有的， 基于证据的社会心理技能干预，社会认知和互动培训（SCIT），将是 适用于本研究。SCIT的目标是情感识别，观点采择和社会问题解决 skills.该课程将根据工作环境和患有严重精神疾病的退伍军人量身定制。然后，一个飞行员 将进行一项研究，以评估将这种心理社会技能培训与支持性培训相结合的可接受性。 就业和未来进行随机对照试验的可行性。 为了实现第一个目标，将与退伍军人进行结构化的利益相关者访谈， 以前曾参加过退伍军人事务部的支持就业（n = 20）和就业专家（n = 5）， 确定纳入SCIT的教育主题和工作实例。该课程将进行试点， 对会议内容和流程的反馈。然后，为了评估可接受性和可行性， 研究将与20名患有严重精神疾病的退伍军人一起进行，他们参加了支持的 明尼阿波利斯VA医疗保健系统的就业计划。研究入组后，受试者将 每周参加一次2小时的技能培训课程，为期13周。团体人数将限制在4-6人。到 促进技能培训的普及，每周将布置作业，以促使参与者使用技能 组外。完成技能培训后，学员将继续与其就业见面 专家。将为就业专家编写材料，供他们在会议上使用， 继续在工作中使用技能。参与者将完成基线、干预后和3个月随访 评估，使社会功能，关系质量，工作表现，自我效能，生活质量， 症状的严重程度可以测量。此外，参与者和就业专家将完成一个 个体、半结构化、定性离职面谈，将（1）评估对干预措施的态度 组件，结构和材料;（2）为干预措施的改进提出建议;（3）询问 参加者就该方案对干预目标的影响发表了意见。 可接受性将被定量评估为：1）吸收率（参与的退伍军人百分比）; 2） 参与度（参加的会议数量）;以及3）参与者对兴趣、价值和满意度的评级。 具体来说，我们预测：50%的研究吸收率; 70%的课程完成率;以及对 兴趣、价值和满意度的衡量标准。可接受性也将通过定性分析来衡量 参与者和就业专家的离职面谈。可行性将通过以下方式衡量： 入学;在入学后3个月和6个月继续接受技能培训和支持就业; 治疗保真度;基线、干预后和3个月随访时数据收集的完整性 评估。可行性的主要指标将是：每月招募3名参与者; 75%和60% 分别在3个月和6个月时的参与者保留率;与研究干预措施的一致性为90%; 数据点已完成。