Study quality: High
Population and employment barriers: Former incarceration, Mental illness, Young adults (aged 16-24)
Services provided: Employment coaching
Setting: Tested in multiple settings
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 |
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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.
Findings quality key:
- High
- Moderate
The findings quality describe our confidence that a given study’s finding is because of the intervention. 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
Sample Characteristics
Age
Mean age | 18 years |
Young adults | 100% |
Sex
Female | 22% |
Male | 78% |
Participant race and ethnicity
Black or African American | 47% |
White | 44% |
Hispanic or Latino of any race | 19% |
Asian | 3% |
More than one race | 6% |
Specific employment barriers
Had a mental illness | 100% |
Were formerly incarcerated | 100% |
Were homeless | 16% |
Intervention Implementation
Implementing organization:
An unspecified private nonprofit organization.
Program history:
Both the intervention and comparison conditions were pilot programs, although Multisystemic Therapy (MST) has been implemented since at least the 1990s.
Intervention services:
Youth in the intervention 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 intervention 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 intervention condition were not connected to state vocational rehabilitation services.
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.
Study Publications
Davis, M., A.J. Sheidow, M.R. McCart, and R.T. Perrault (2018). Vocational coaches for justice-involved emerging adults, Psychiatric Rehabilitation Journal 41(4): 266-276.
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21831-Vocational Coaches f