Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society
Sammanfattning
Background: Employment is an important part of recovery for individuals with schizophrenia. The
employment rate for this group is as low as 10% in Norway, and major system related barriers to
employment are evident.
Aims: This study reports the competitive employment outcome at 2-year follow-up of a vocational
rehabilitation study augmented with cognitive remediation (CR) or elements from cognitive behaviour
therapy (CBT) for individuals with schizophrenia spectrum disorders. It also investigates if global functioning,
self-esteem, and depression at baseline predicts employment outcome, and if change in these
variables during the intervention period is associated with employment outcome.
Method: One hundred and forty-eight participants with schizophrenia spectrum disorders in six
Norwegian counties received 10 months vocational rehabilitation augmented with either CBT (n ¼ 84)
or CR (n ¼ 64). Both competitive and sheltered workplaces were used. Participants were assessed at
baseline, at the end of the intervention period, and at 2-year follow-up.
Results: At 2-year follow-up, 21.2% had obtained competitive employment. A further 25.3% had work
placements in competitive workplaces. Significant improvements were found in global functioning,
self-esteem, and depression during the intervention period, but no significant differences between the
two intervention groups. High baseline global functioning and self-esteem, as well as positive change
in these variables during the intervention period, were significantly associated with higher competitive
employment outcome at 2-year follow-up.
Conclusion: The results add to existing evidence that competitive employment is attainable for individuals
with schizophrenia. High global functioning and self-esteem were strongly associated with competitive
employment outcome.