McFarlane 2000.
| Methods | Allocation: randomised Design: multi centre Duration: 18 months Country: New York City, New York, USA |
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| Participants | N = 69 Diagnosis: a diagnosis in either the schizophrenia or the mood disorder spectrum. Included: 73% schizophrenia spectrum, 27% mood spectrum Setting: 2 New York state CMH centres , 1 of the 2 service sites was located in an increasingly urbanised suburb of New York City (New Rochelle, Westchester County) and the other in rural New York state (Kingston, Ulster County) Age: 18‐55 years, mean 33.0 years Gender: 70% male Ethnicity: 87% white Substance abuse: 91% none/rare alcohol use, 94% non/rare other substance use Living situation: 36% lived with family member, 64% non family Marital status: 74% never married, 13% separated/divorced Employment status: not employed competitively for the past 6 months Working history: mean months since last job 15, mean number of prior jobs: 6 Motivation: explicit wish to work Education: 34% high school graduate, 21% not high school graduate, 35% some college, 10% college grad Disability benefit: 64% SSI, 49% SSD, 4% SSA Excluded:‐ |
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| Interventions |
FACT (N = 37) Family‐aided Assertive Community Treatment consisted of ACT, family intervention and vocational specialists. The vocational specialists were trained by Becker (one of the founders of IPS). Their specific tasks were to: I ) lead 9‐session goal‐setting groups; 2) work with each individual to identify and contact potential employers; 3) work on job development for the entire cohort, to find co‐operative potential employers; 4) coach participants on and off the job site in the initial month or two of employment; 5) provide technical assistance to their team‐mates in job‐coaching; and 6) develop methods for assessing work‐readiness, preparing resumes, and practicing interviewing skills TVR (N = 32) TVR with referral to state VR service often leading to placement in sheltered workshop. Case loads were heavier |
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| Outcomes | Number of participants who obtained competitive employment Weeks in competitive employment Number of participants who obtained non‐competitive employment |
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| Notes | No definition of competitive employment described, but they made a difference between type of employment (sheltered employment, supported employment, vocational training, competitive employment) No IPS fidelity measurements reported Part of Employment Intervention Demonstration Project (EIDP) |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Participants were randomly assigned |
| Allocation concealment (selection bias) | Unclear risk | No details |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel could identify the given intervention by contents of the programme |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Clinicians completed employment trackings form for each subject |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | No details about attrition rate |
| Selective reporting (reporting bias) | Low risk | All listed outcomes were reported |
| Other bias | Low risk | Supported by grant R18 SM 47642 from the National Institute of Mental Health |