Study Details | Pathways to Work

5962.04R - U.S. Department of V

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 intervention and comparison groups were sufficiently similar before the intervention.

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

Population and employment barriers:

Specific employment barriers (Homelessness, Military veteran)

Services provided:

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

Setting: Tested in multiple settings

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 TWE followed by CE (Group 3) with those who received an IPS referral (Group 5). 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 only reports results from studies with a study quality rating of high or moderate.

Sample characteristics

The study included 440 veterans experiencing homelessness who (1) were not receiving VA health services; (2) expressed interest in seeking competitive employment; and (3) had been diagnosed with a psychiatric disability and/or substance use disorder. The study did not report the characteristics of the overall sample of 440 individuals. Within the group who worked in TWE followed by competitive employment, 93 percent were male, 47 percent were White, and 80 percent had received an honorable discharge. Within the group who worked in competitive employment and received an IPS referral, 91 percent were male, 41 percent were White, and 86 percent had received an honorable discharge.

Specific employment barriers

Were experiencing homelessness	100%
Were military veterans	100%

Intervention implementation

Implementing organization:

U.S. Department of Veterans Affairs

Intervention services:

The intervention 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.

Mandatory services:

None

Comparison services:

The comparison 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. Intervention group members could also access standard VA services, including in TWE.

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.

View the glossary for more information about these and other terms used on this page.

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.

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