Career Counseling for Mental Illness

Not currently recruiting at 1 trial location

Overseen By Brian J Stevenson, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Acute suicide/homicide risk, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve job outcomes for Veterans with psychiatric disorders by adding career counseling and development to existing vocational rehabilitation services. The researchers seek to determine if this added support helps Veterans set clearer career goals and overcome mental barriers to employment. Veterans who are unemployed, underemployed, or struggling at work due to mental health issues and are already receiving transitional work experience services might be suitable candidates. The trial will test whether these interventions can enhance job engagement and long-term career success. As an unphased trial, this study offers Veterans a unique opportunity to enhance their career prospects and personal growth.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on career counseling and development, so it's likely you can continue your current treatments, but you should confirm with the trial coordinators.

What prior data suggests that this career counseling intervention is safe for Veterans with psychiatric disorders?

Research has shown that career counseling and development services can be safe and helpful for veterans, particularly those facing mental health challenges. Other studies have found that these services are well-received and can improve job-related outcomes. They assist individuals in setting clear career goals and overcoming obstacles to employment. No major reports of negative effects from these services exist, suggesting that veterans participating in career counseling can generally expect a safe experience. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Career Counseling & Development for Veterans (CCD-V) intervention because it offers a tailored approach specifically for veterans with mental illness, combining career counseling with transitional work experience. Unlike standard treatments that may focus solely on mental health or job readiness separately, CCD-V integrates both, aiming to improve veterans' mental health while also boosting their employment prospects. This dual approach could lead to better long-term outcomes by addressing both the psychological and practical challenges veterans face when re-entering the workforce.

What evidence suggests that this trial's treatments could be effective for Veterans with psychiatric disorders?

Research has shown that career counseling and development services benefit people with mental health issues. These services help set job goals, build confidence in work skills, and encourage active job searching. Studies with non-military groups indicate that career counseling also helps individuals find better-suited jobs, leading to longer job retention. In this trial, Veterans in the CCD-V Group will receive both the Career Counseling & Development for Veterans intervention, known as Purposeful Pathways, and the Transitional Work Experience intervention. Early results suggest that the Purposeful Pathways program might improve job outcomes by addressing mental barriers to work. This program aims to increase Veterans' participation in job training and help them secure more suitable and lasting employment. ^{1 2 6 7 8}

Who Is on the Research Team?

Brian J Stevenson, PhD

Principal Investigator

VA Bedford HealthCare System, Bedford, MA

Are You a Good Fit for This Trial?

This trial is for Veterans with psychiatric disorders like PTSD, mood or anxiety-related disorders, psychotic disorders, substance use disorders who are unemployed or struggling at work due to their condition. They must plan to work for three years post-study and be eligible for Transitional Work Experience (TWE). Those at acute risk of harm to self/others, currently in supported employment services, or unlikely to complete the study due to deployment/incarceration/hospitalization/relocation are excluded.

Inclusion Criteria

Eligibility for, and planning to enroll in TW, or within 16 weeks of having enrolled in TW

I am mentally capable of understanding and signing a consent form.

Self-identification as either unemployed, underemployed, or employed but functioning poorly at work as a result of mental illness or substance use

Exclusion Criteria

Not otherwise eligible for TW services

I am not willing to participate in weekly career development sessions.

Your score on the Symptom Checklist-6 is higher than 26.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Development

Develop a career counseling and development treatment manual for Veterans with psychiatric disorders

Several months

Pilot Testing

Pilot test the manual by treating a small number of Veterans in an open trial

8 weeks

Randomized Controlled Trial

Conduct a randomized controlled pilot study comparing Purposeful Pathways to treatment as usual

3 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Career Counseling & Development for Veterans
• Transitional Work Experience

Trial Overview The 'Purposeful Pathways' intervention is being tested alongside existing VHA vocational rehabilitation services. It includes up to 12 individual sessions aimed at improving job fit and tenure by addressing psychological barriers. The study will develop this intervention with veteran input and test its feasibility and impact on functional improvement in a small randomized controlled trial.

How Is the Trial Designed?

Group I: CCD-V Group Experimental Treatment 2 Interventions

Veterans in this arm will receive treatment as usual, which is transitional work experience intervention, as well as the CCD-V intervention

Group II: Treatment as Usual Active Control 1 Intervention

Veterans in this arm will receive treatment as usual, which is transitional work experience intervention.

Career Counseling & Development for Veterans is already approved in United States for the following indications:

Approved in United States as Vocational Rehabilitation and Employment (VR&E) for:

• Psychiatric Disorders
• Vocational Rehabilitation

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Published Research Related to This Trial

A survey of 233 vocational providers in the Veterans Health Administration revealed that job development practices are perceived as difficult, with an average of only 11 employer contacts made every two weeks, mostly through face-to-face interactions.

Effective job development strategies identified include an employer-focused approach, targeted marketing, genuine interpersonal engagement, and tailored communication techniques, which can enhance the success of job placements for veterans with mental illness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Helping veterans achieve work: A Veterans Health Administration nationwide survey examining effective job development practices in the community. Kukla, M., McGuire, AB., Strasburger, AM., et al.[2018]

A new vocational potential assessment tool and counselling module for individuals with severe mental disorders was developed and validated through input from 38 stakeholders, including patients, caregivers, and mental health professionals.

The tool is user-friendly, requiring about 45 minutes to 1 hour for assessment, and includes a scoring key to assist professionals in evaluating vocational potential effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of vocational potential assessment tool and counseling module for persons with severe mental disorders. Harish, N., Jagannathan, A., Kumar, CN., et al.[2020]

The Successful Living skills training group, designed for chronic mental patients at a Veterans Administration hospital, effectively helps participants set and achieve personal goals through behavioral rehearsal and homework assignments.

Out of 22 initial participants, 88% completed their homework assignments, leading to positive outcomes for 49% of the total assignments, demonstrating a strong desire for social change among chronic patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Successful living: a social skills and problem-solving group for the chronic mentally ill. Hierholzer, RW., Liberman, RP.[2019]

The Purposeful Pathways intervention is designed specifically for veterans with psychiatric disorders to enhance their career development and is currently being evaluated for feasibility and acceptability in a pilot study involving 50 participants.

This study will assess various outcomes, including vocational functioning and mental health, over a 12-week period, with data collection expected to be completed by February 2026, providing valuable insights into the effectiveness of tailored career counseling for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of a Career Development Intervention for Veterans in Vocational Rehabilitation: Protocol for a Pilot Randomized Controlled Trial. Stevenson, B., Teravainen, T., Kathawalla, UK., et al.[2023]

Veterans with mental health conditions have strong career aspirations and seek support tailored to their interests, highlighting a gap in effective career development models for this population.

The study, involving 13 veterans and vocational counselors, identified key barriers and recommended strategies for enhancing career development, providing valuable insights for researchers and practitioners in the field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Career Development in Transitional Work Settings: A Qualitative Investigation Among Veterans and Vocational Counselors. Stevenson, BJ., Kathawalla, U., Smith, C., et al.[2023]

A study involving 76 adults with serious mental illness revealed that their perspectives on work align with key concepts of social cognitive career theory (SCCT), suggesting that this theory can inform vocational services for this population.

The research identified important factors influencing work-related self-efficacy, such as personal accomplishments and social support, indicating that addressing these factors could enhance vocational outcomes for individuals with mental illness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the work lives of adults with serious mental illness from a vocational psychology perspective. Millner, UC., Rogers, ES., Bloch, P., et al.[2018]

Project WINS integrates vocational services into case management teams, employing both Vocational Specialists and Peer Support Specialists to enhance employment opportunities for individuals with psychiatric conditions.

The program aims to improve client outcomes in both mental health and vocational areas, although it faces challenges and barriers in its implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Project WINS: integrating vocational services on mental health case management teams. Mowbray, CT., Rusilowski-Clover, G., Arnold, J., et al.[2019]

The Motivational Aftercare Planning (MAP) intervention significantly changed the focus of mental health recovery plans from clinical stability and symptom management to promoting general wellness and social connections, based on a qualitative analysis of 110 recovery plans.

The shift in language from third to first person in the recovery plans indicates a greater emphasis on consumer involvement and personal agency in the recovery process, suggesting that MAP may enhance collaboration between consumers and clinicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The language we use - the effect of writing mental health care plans in the first person. Wyder, M., Kisely, S., Meurk, C., et al.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11823284/

Purposeful Pathways: An Integrative Career Development ... This paper introduces a novel intervention that supports career development of veterans with mental health and substance use concerns: Purposeful Pathways.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10365634/

Feasibility of a Career Development Intervention for Veterans ... This study protocol aims to (1) evaluate the feasibility and acceptability of the Purposeful Pathways intervention for veterans living with psychiatric ...

3. journals.sagepub.com journals.sagepub.com/doi/abs/10.1177/08948453241313192

Purposeful Pathways: An Integrative Career Development ... This paper introduces a novel intervention that supports career development of veterans with mental health and substance use concerns: ...

4. research.va.gov research.va.gov/about/funded_research/proj-details-FY2025.cfm?pid=702593

Improving Vocational Outcomes of Veterans with Psychiatric ... Title: Improving Vocational Outcomes of Veterans with Psychiatric Disorders: Career Counseling & Development ; Principal Investigator: Brian J Stevenson.

5. researchgate.net researchgate.net/publication/341188273_Providing_Career_Development_Services_to_Veterans_Perceived_Need_Acceptability_and_Demand

Providing Career Development Services to Veterans ... Purposeful Pathways intervention for veterans living with psychiatric disorders and (2) explore preliminary clinical outcome data.

6. journals.sagepub.com journals.sagepub.com/doi/10.1177/08948453241313192

Purposeful Pathways: An Integrative Career Development ... Veterans who are unemployed and living with mental health or substance use conditions are in need of integrative interventions that support ...

7. samhsa.gov samhsa.gov/technical-assistance/smvf

Service Members, Veterans, and their Families Technical ... The SMVF TA Center works with other agencies and groups to improve behavioral health services and supports for veterans and their families ...

8. nami.org nami.org/your-journey/veterans-active-duty/

Veterans & Active Duty On this page we focus on questions that military personnel often ask, concerning treatment resources, disclosure and staying healthy during the transition ...