Article

OBJECTIVE: To examine whether supported employment (SE) is more effective than
treatment as usual (TAU) in returning veterans to competitive employment after
spinal cord injury (SCI). DESIGN: Prospective, randomized, controlled, multisite
trial of SE versus TAU for vocational issues with 12 months of follow-up data.
SETTING: SCI centers in the Veterans Health Administration. PARTICIPANTS:
Subjects (N=201) were enrolled and completed baseline interviews. In
interventional sites, subjects were randomly assigned to the SE condition (n=81)
or the TAU condition (treatment as usual-interventional site [TAU-IS], n=76). In
observational sites where the SE program was not available, 44 subjects were
enrolled in a nonrandomized TAU condition (treatment as usual-observational site
[TAU-OS]). INTERVENTIONS: The intervention consisted of an SE vocational
rehabilitation program called the Spinal Cord Injury Vocational Integration
Program, which adhered as closely as possible to principles of SE as developed
and described in the individual placement and support model of SE for persons
with mental illness. MAIN OUTCOME MEASURES: The primary study outcome measurement
was competitive employment in the community. RESULTS: Subjects in the SE group
were 2.5 times more likely than the TAU-IS group and 11.4 times more likely than
the TAU-OS group to obtain competitive employment. CONCLUSIONS: To the best of
our knowledge, this is the first and only controlled study of a specific
vocational rehabilitation program to report improved employment outcomes for
persons with SCI. SE, a well-prescribed method of integrated vocational care, was
superior to usual practices in improving employment outcomes for veterans with SCI.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS