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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.

退伍军人健康管理局 (VHA) 提供强大的职业规划，帮助无数退伍军人获得有竞争力的就业；然而，这些服务并不统一有效，因为最近的数据表明，只有 35% 至 43% 的退伍军人在退伍时获得竞争性就业。为了那些成为竞争性就业者，工作任期可能很短，而且往往会因以下因素而减弱：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。退伍军人平均需要四年多的时间才能利用职业服务。这些退伍军人面临多种功能丧失和发展的高风险长期残疾，因为他们的职业需求多年来得不到满足。研究表明，缺乏明确的职业目标、感知到职业障碍等内在因素就业以及对自己工作能力的消极信念会导致敬业度、成果和工作效率低下一些职业康复服务消费者的保有权。因此，VA 或许能够改善通过加强职业参与，患有精神疾病的退伍军人的职业参与、结果和任期针对无益的心理因素进行额外干预的服务。职业咨询和事实证明，发展服务可以有效帮助平民明确职业目标和认同感，增强职业自我效能感，增加面对困难时的主动职业行为障碍。此外，职业咨询和发展服务有助于促进职业之间更好的“匹配” 人与工作，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。该项目的研究人员提出了一项三目标研究，以开发职业咨询和针对患有精神疾病的退伍军人的发展干预（CCD-V）。第一个目标将集中于根据退伍军人和提供者的意见设计和开发 CCD-V 干预措施 (n=16)。第二个目标将在公开试验（n=10）中对干预进行试点测试，以收集退伍军人对初始干预的意见。第三个和最终目标将包括一项可行性试点随机对照试验（n = 50），以检查可接受性和可行性结果并探讨 CCD-V 干预对功能改善的影响和其他职业成果。拟议的 CCD-V 干预措施将由大约八名个人组成将与现有 VHA 职业康复服务同时提供的课程（例如过渡性康复服务）工作经验 [TWE]）。这项研究的最终产品是产生手动 CCD-V 干预，并且相应的保真度监控清单，稍后将在更大规模的功效试验中进行测试。