Study Details | Pathways to Work

5962.04-Study of U.S. Depart

Study quality: Low

Low

Reason for the rating: This study received a low study quality rating because it is a quasi-experimental design that does not demonstrate that the program and comparison groups were sufficiently similar before the program.

Program: U.S. Department of Veterans Affairs (VA) Individual Placement and Support (IPS) Employment Services [as compared with Transitional Work Experience (TWE) followed by Typical Services for Competitively Employed Veterans (CE)]

Characteristics of study participants:

Disability(ies), Homelessness, Mental health condition, Military veterans

Services provided:

Case management, Job placement, Job search assistance, Mental health services, Treatment or recovery services for substance use disorder

Setting: Tested in multiple settings

Methods and Standards Protocol version used for review: Version 1.0

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Study design

Design:

Quasi-experimental design

Study group formation:

This study is a secondary analysis of data from the Therapeutic Employment Placement and Support (TEPS) demonstration, conducted from 2001 to 2005. The TEPS demonstration focused on veterans experiencing homelessness who (1) were not receiving Department of Veterans Affairs (VA) health services, (2) expressed a desire to participate in competitive employment, and (3) were diagnosed with a psychiatric disability or substance use disorder. Cohort 1 of TEPS included 308 veterans who were offered standard VA services. Cohort 2 of TEPS included 322 veterans who were offered IPS and standard VA services. The study uses data from 440 of the 630 veterans across the two cohorts. Veterans across both cohorts were assigned to five employment groups based on employment patterns in the six months after TEPS enrollment and included (1) 100 veterans not working at any time, (2) 96 veterans working only in TWE, (3) 30 veterans working in TWE followed by CE, (4) 58 veterans working in CE without IPS (Cohort 1 only), and (5) 156 veterans working in CE with IPS (Cohort 2 only). This study contrasts individuals who worked in CE and received an IPS referral (Group 5) with those who were employed in TWE followed by CE (Group 3). Other study reviews examine the other contrasts.

Time period of study:

Individuals enrolled in the study between 2001 and 2003. (The final enrollment date is not provided, but the two-year TEPS follow-up concluded in 2005.) The study examines outcomes for six months after enrollment.

Pathways to Work only reports results from studies with a study quality rating of high or moderate.

Sample characteristics

Sex

Female	9%
Male	91%

Specific employment barriers

Had a disability	86%
Had a mental illness	95%
Were experiencing homelessness	100%
Were military veterans	100%

Program implementation

Implementing organization:

U.S. Department of Veterans Affairs

Program services:

The program group includes individuals recruited into the study during Cohort 2 who were employed during the six months after TEPS enrollment, received an IPS referral. As part of the VA’s IPS program, an employment specialist worked with a larger team of clinicians and support staff to integrate treatment of underlying mental and physical health issues into the employment services for veterans experiencing homelessness. The employment specialist assessed participants’ vocational abilities and helped tailor an accelerated job search based on their strengths and preferences. Employment specialists also cultivated relationships with local employers, developed leads on competitive employment opportunities, and helped participants access other services such as job training and health care available through the VA. Program group members could also access standard VA services, including in TWE.

Mandatory services:

None.

Comparison services:

The comparison group includes all individuals who worked in TWE during the six months after TEPS enrollment and who then engaged in competitive employment but were not referred to IPS during that time. TWE, part of the VA Compensated Work Therapy Program, helped participants develop work restoration plans and provided a real, 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.

Study publications

Leddy, Meaghan, Elina Stefanovics,, and Robert Rosenheck (2014). Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes, Journal of Rehabilitation Research & Development 51(1): 161-174. Available at https://www.rehab.research.va.gov/jour/2014/511/pdf/page161.pdf.

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Study of U.S. Department of Veterans Affairs (VA) Individual Placement and Support (IPS) Employment Services [as compared with Transitional Work Experience (TWE) followed by Typical Services for Competitively Employed Veterans (CE)]