OBJECTIVE: To examine if supported employment (SE) remains more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI) at 2-year follow-up. DESIGN: Prospective, randomized, controlled, multisite trial of SE versus TAU with 24 months of follow-up. SETTING: SCI centers. PARTICIPANTS: Subjects (n = 201) were enrolled and completed baseline interviews. At interventional sites, subjects were randomized to SE (n = 81) or TAU (n = 76). At observational sites, 44 subjects were enrolled in a nonrandomized TAU condition. INTERVENTION: The intervention was a SE program called the SCI Vocational Integration Program, which followed the principles of the individual placement and support model of SE for persons with mental illness. MAIN OUTCOME MEASURES: Competitive employment in the community within 2 years. RESULTS: For the entire 2-year follow-up period, SE subjects were significantly more likely to achieve employment (30.8%; 95% confidence interval (CI) 21.8 to 41.6) than either the TAU subjects at the intervention sites (10.5%; 95% CI 5.2 to 19.7; p < 0.001) or the TAU subjects at the observational sites (2.3%; 95% CI 0.0 to 12.9; p < 0.002). Most subjects who obtained competitive employment did so in year 1, and the average time to first employment was about 17 weeks. CONCLUSIONS: SE was better than usual practices in improving employment outcomes for veterans with SCI across a 2-year follow-up period. Although SE continued to be superior to traditional practices over the entire study, the first year of participation in SE may represent a critical window for achieving employment after SCI.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher