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Client Predictors of Employment Outcomes in High-Fidelity Supported Employment: A Regression Analysis (Campbell et al. 2010)

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Campbell, K., Bond, G. R., Drake, R. E., McHugo, G. J., & Xie, H. X. (2010, August). Client Predictors of Employment Outcomes in High-Fidelity Supported Employment: A Regression Analysis. Journal of Nervous and Mental Disease, 198(8).


  • In 15 rigorous evaluations, Individual Placement and Supprt (IPS) has demonstrated better competitive employment outcomes for people with severe mental illness (SMI) than day treatment or other traditional vocational rehabilitation approaches. Yet many clients do not obtain competitive employment, job tenure is usually short, and studies have provided little evidence for better targeting IPS. This study used in-group analysis of a large sample of IPS recipients to help predict competitive employment outcomes in these types of programs.
  • The study combined data from four recent randomized controlled trials (all of which found IPS more effective than alternative approaches) to estimate the relationship between baseline characteristics and job acquisition and retention. Work history was the only statistically significant predictor of employment—a finding the authors said challenged the practice of labeling clients with certain clinical and background attributes as “high risk,” perhaps because IPS is designed to address such attributes.
  • Among those who obtained employment, only receipt of Supplemental Security Income and Social Security Disability Insurance were associated with fewer total weeks worked. Based on this result and other recent studies, the authors suggest that, although IPS is the current best practice for helping people with SMI return to work, fear of losing disability payments and health care benefits are powerful disincentives to sustaining competitive employment. They conclude that helping people with SMI leave the disability roles would require changes in federal disability income support policies and insurance regulations.

Reviewed by CLEAR

March 2015