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Effectiveness
Implementation

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Summary

TWE followed by CE provided up to one year of vocational activities, work placements, and case management to help veterans experiencing homelessness and mental health or substance use disorders find and maintain competitive employment, after which participants received standard VA services indefinitely. This evaluation directly compared TWE followed by CE to a separate intervention, CE only, in order to better understand which of the two interventions might be more effective; the distinctive features of TWE followed by CE were vocational rehabilitation activities and therapeutic work placements.

TWE, part of the VA’s Compensated Work Therapy Program, helped participants develop work restoration plans and provided a rehabilitative work setting within the VA, other federal agencies, or private businesses in the community. After their participation in TWE, participants moved into CE, during which they could receive standard VA services (including the VA health care, education benefits, home loan assistance, disability compensation, and vocational rehabilitation and employment assistance). TWE participants received at least 30 hours per week of structured vocational rehabilitation activities and were assigned to therapeutic work placements for six months to one year. Participants also received case management to help them gain and enhance their employment skills and find and maintain competitive employment. Length of participation in TWE depended on participants’ vocational goals and needs but did not exceed one year, though once in CE, participants could receive standard VA services indefinitely. As of 2020, the VA continues to offer similar services to eligible participants. The target population for TWE followed by CE included veterans experiencing homelessness who met all three of the following criteria: (1) they were not receiving VA health services, (2) they expressed a desire to participate in competitive employment, and (3) they were diagnosed with a psychiatric disability or substance use disorder. TWE followed by CE was implemented in nine VA medical centers across the United States.

The effectiveness of TWE followed by CE when compared with CE only indicates the effect of the services that are unique to TWE followed by CE, or how much better TWE followed by CE meets participants’ needs than CE only. Participants in TWE followed by CE received structured vocational rehabilitation services and therapeutic work placements, whereas participants in CE only did not.

This study was part of the Therapeutic Employment Placement and Support demonstration, which also evaluated the Individual Placement and Support program, TWE only, and CE only.

5962.06-Effectiveness of Tra

Populations and employment barriers: Homelessness, Military veteran

Quick info

Intervention services

Case management, Employment retention services, Health services (Substance use disorder treatment and mental health services), Work and work-based learning (Individual Placement and Support, Transitional jobs), Work readiness activities (Job development/job placement, Job search assistance)

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Setting(s)

Tested in multiple settings

Year evaluation began

2001

Implementing organization(s)U.S. Department of Veterans Affairs

All outcome domains received a rating of no evidence to assess support. We did not find any studies that rated moderate or high that studied the intervention's effect on outcomes in outcome domains assessed by Pathways. This intervention needs further study to support conclusions about its effectiveness.

Studies of this intervention

Study quality rating	Study counts per rating
Low	1

Implementation details

The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.