Evaluation of a cognitive-behavioural intervention augmenting individual placement and support
| Pages | 119-125 |
| DOI | https://doi.org/10.1108/MHSI-02-2016-0005 |
| Published date | 09 May 2016 |
| Date | 09 May 2016 |
| Author | Naomi Boycott,Justine Schneider,Mary McMurran |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Evaluation of a cognitive-behavioural
intervention augmenting individual
placement and support
Naomi Boycott, Justine Schneider and Mary McMurran
Naomi Boycott is a Clinical
Psychologist at Institute of
Mental Health, University of
Nottingham, Nottingham, UK.
Justine Schneider is a Professor
of Mental Health and Social Care
at School of Sociology and
Social Policy, University of
Nottingham, Nottingham, UK.
Mary McMurran is a Professor
of Personality Disorder
Research at Institute of Mental
Health, University of
Nottingham, Nottingham, UK.
Abstract
Purpose –A feasibility study of cognitive-behavioural therapy (CBT) as an adjunct to individual placement
and support (IPS) with adults with severe mental illness showed that fewer people who received CBT
dropped out and more obtained jobs. The purpose of this paper is to investigate how the adjunct
CBT programme worked. CBT used a problem-solving approach to address common psychological barriers
to employment.
Design/methodology/approach –Baseline and six-month follow-up scores were compared on measures
of problem solving, executive functioning, fear of negative evaluation, self-esteem, and stigma.
Findings –At baseline, the majority of the 23 participants scored within the normal range on measures.
Around half of the participants showed improvement in social problem solving, executive functioning, and
fear of negative evaluation. General improvements in self-esteem were seen. Change in the expected areas
according to module choice was evident, however this was inconsistent.
Research limitations/implications –Many participants were within normal ranges on the measures at
baseline. Offering participants a choice of topics led to some people having few sessions, possibly too few to
produce benefits. Although the modules on offer targeted commonly experienced problems, they may not
have been the most important to these participants.
Practical implications –CBT does appear to enhance IPS but the mechanisms by which this occurs is
unclear. To improve adjunct CBT, there is a need to clarify the most beneficial targets and identify the
mechanisms by which CBT may augment IPS.
Originality/value –This study begins to identify the processes by which CBT can enhance IPS for adults
with severe mental illness.
Keywords Individual placement and support, Cognitive-behaviour therapy, Mental illness
Paper type Research paper
Individual placement and support (IPS)is a standardised approach to employmentsupport aimed
at helping people with severe mental health problems return to competitive employment. IPS has
seven core elements: a focus on competitive employment; acknowledgement of the individual’s
personal interests; a rapid job search; integration of mental health and employment services;
programme entry based on client choice; time-unlimited client support; and benefits counselling.
This approach has been proven to be effective when compared to other styles of vocational
support (Bejerholm et al., 2015), and is a cost-ef fective interventio n (Knapp et al., 2013).
Nonetheless, there is room for improvement in employment rates and job tenures. In order to
improve outcomes, possible adjuncts to the scheme have been suggested, notably cognitive-
behavioural therapy (CBT) (Loveland et al.,2007).
In a rapid evidence assessment of the effectiveness additional interventions delivered alongside
IPS for people with severe mental illness, only six randomised controlled trials (RCTs) were found
This projectwas funded by the
NationalInstitute of Health
Research’s Collaboration for
Leadership in Applied Health
Researchand Care-
Nottinghamshire, Derbyshire, and
Lincolnshire Programme. The views
and opinions e xpressed here are
those of the authors and do not
necessari ly reflect those of th e
CLAHRC-NDL Programme, NIHR,
NationalHealth Service (NHS),or
the Department of Health. The
authorsare indebted to all of the
NHS and University colleagueswho
made the studypossible. Special
thanks to Dr Athfah Akhtar, who
was responsible for theday-to-day
running of the study, all of the
interviews, and the mainanalysis.
Also, thanksto the Early Intervention
in Psychosis and Recovery teams
who joined the st udy, and most
importantly to the participants who
agreed to takepart. Ethical approval
was givenby Derbyshire Research
Ethics Committee
(ISRCTN18240558).
DOI 10.1108/MHSI-02-2016-0005 VOL. 20 NO. 2 2016, pp. 119-125, © Emerald Group Publishing Limited, ISSN 2042-8308
j
MENTALHEALTH AND SOCIAL INCLUSION
j
PAG E 11 9
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