Study Details | Pathways to Work

21831-Study of Vocational

Study quality: High

High

Reason for the rating: This study received a high study quality rating because it is a randomized controlled trial with low attrition, suggesting the findings can be attributed to the program.

Program: Vocational Coaches to Enhance Multisystemic Therapy for Emerging Adults (MST-EA)

Characteristics of study participants:

Young adults (age 16-24)

Services provided:

Employment coaching, Financial education, Job readiness, Job search assistance, Mental health services

Setting: Tested in multiple settings

Methods and Standards Protocol version used for review: Version 1.0

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Study design

Design:

Randomized controlled trial

Study group formation:

Individuals who were receiving case management services in a northeastern state were recruited for the study. Recruitment occured from March 2011 to January 2013. To be eligible for the study, individuals were required to be 17 to 20 years old, have been arrested or released from incarceration within the past 18 months, be diagnosed with a severe mental health condition, and be residing in a stable community setting. Individuals were randomly assigned to one of two study groups after a baseline interview. Sixteen individuals were randomly assigned to each of the two study groups. Coaches were also randomly assigned to deliver either vocational or standard coaching. Follow-up interviews occurred one and four months after program completion.

Time period of study:

Recruitment occurred from March 1, 2011, to January 31, 2013. The final follow-up interview occurred an average of 11 months after services began and 4 months after an individual exited treatment.

Primary outcome domains examined:

Increase short-term employment

Other outcome domains examined:

None

Study funded by:

The study was supported by grants from the National Institute of Mental Health (R34MH081374) and the National Institute on Disability, Independent Living, and Rehabilitation Research (H133B090018).

Results

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Outcome domain	Measure	Timing	Study quality by finding	Impact	Units	Findings	Sample size
Increase short-term employment	Currently employed	Month 11	High	14.30	percentage points		28

Short-term outcomes are those measured 18 months or fewer after participants are first offered services. Long-term outcomes are those measured between 18 months and 5 years after participants are first offered services. Very long-term outcomes are those measured 5 years or more after participants are first offered services.

Means are not displayed when not reported or not aligned with the impact estimates. For example, if the impact estimate is regression-adjusted but only unadjusted means are reported in the study, the unadjusted means are not displayed as they are not aligned with the adjusted impact estimate.

Impact estimates are not shown when the estimate units cannot be converted to natural units.

Findings quality key:

High
Moderate

Study quality terms?

The findings quality describe our confidence that a given study’s finding is because of the program. We do not display findings that rate low.

Findings key:

A moderate-to-large favorable finding that is unlikely to be due to chance
A moderate-to-large favorable finding that might to be due to chance
A small favorable finding that is unlikely to be due to chance
A small favorable finding that might be due to chance
A favorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
A favorable finding that might be due to chance, but we cannot determine the standardized effect size
A moderate-to-large unfavorable finding that is unlikely to be due to chance
A moderate-to-large unfavorable finding that might to be due to chance
A small unfavorable finding that is unlikely to be due to chance
A small unfavorable finding that might be due to chance
An unfavorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
An unfavorable finding that might be due to chance, but we cannot determine the standardized effect size
A finding that is unlikely to be due to chance, but we cannot determine the standardized effect size or direction
A finding of no effect that might be due to chance

Favorable findings are impacts in a direction that is socially desirable. Statistical significance indicates the likelihood that a study finding is due to the program, rather than due to chance. Findings are described as moderate-to-large if the program produced a sufficiently large change in the outcome. An impact receives this designation if the standardized effect size is equal to or greater than 0.25 or equal to or less than -0.25.

Sample characteristics

All individuals were ages 17 to 20 (average age 18), had been involved in the justice system (with 63 percent having been in juvenile detention and 36 percent having been to jail or prison), and had a mental health condition (with 50 percent having a major depressive disorder, 25 percent having an anxiety disorder, and 16 percent having a bipolar disorder). Most participants in the study were male (78 percent), and most were of a minority racial or ethnic background (47 percent Black, 3 percent Asian, 19 percent Hispanic, 6 percent more than one race, and 44 percent White).

Age

Mean age	18 years
Young adults (age 16-24)	100%

Sex

Male

78%

Race and ethnicity

Black or African American	47%
White, not Hispanic	44%
Hispanic or Latino of any race	19%
Asian	3%
More than one race	6%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

Specific employment barriers

Had a mental illness	100%
Were involved with the justice system	100%
Were fomerly incarcerated	100%

Program implementation

Implementing organization:

An unspecified private nonprofit organization.

Program history:

Both the program and comparison conditions were pilot programs, although Multisystemic Therapy (MST) has been implemented since at least the 1990s.

Program services:

Youth in the program group received Multisystemic Therapy for Emerging Adults (MST-EA) with additional coaching. MST-EA is designed to help individuals improve recidivism, mental illness, substance use, education, and employment outcomes using several types of therapy. Therapists were continually available to participants and met over the phone and in person with participants several times each week. Vocational coaches provided services to individuals in the program group, meeting with clients for two one-hour sessions each week. Coaches covered a wide variety of domains, including (but not limited to) employment, education, health, housing, parenting, and financial literacy. Each domain was the focus of between three and seven sessions. Participants in the program condition were not connected to state vocational rehabilitation services.

Mandatory services:

None.

Comparison services:

Youth in the comparison group also received MST-EA but with standard coaching. Standard coaches provided the same skills development services as the vocational coaches but did not provide coaching related to vocational domains. If participants in this group were interested in employment services, their MST-EA therapist connected them to the state vocational rehabilitation agency, which would then provide support.

Service receipt duration:

Emerging adults typically received services through MST, including contact with therapists and coaches, over an average of seven to eight months.

Program funding:

Unspecified state agency.

Study publications

Davis, Maryann, Ashli J. Sheidow, Michael R. McCart and Rachael T. Perrault (2018). Vocational coaches for justice-involved emerging adults, Psychiatric Rehabilitation Journal 41(4): 266-276.

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Study of Vocational Coaches to Enhance Multisystemic Therapy for Emerging Adults (MST-EA)