Processes towards employment among persons with psychiatric disabilities: a study of two individual placement and support programmes in Sweden

Table 1.

Initial key concepts (IPS principles)Operationalization of key conceptsThemesThe consumer's preference is the guiding light

• Job coaches use open Socratic questions

• Study visits are arranged in a large numbers of workplaces

• Trustful relationships are established between coaches and clients

The IPS coach as a cicerone Time for reflected experiencesConstruction and reconstruction of one's occupational identityIndividualized ongoing support without time limit

• Job coaches and clients evaluate every work placement together – taking care of ‘failures’

• Exposure of a variety of environments – no standardized solutions

• Absence of time limits in the IPS provided leads to feelings of security among clients

• A coach who does not visit the client′s workplace faces difficulties in individualizing the support

Integration of IPS and mental health services

• Weak matching between ongoing psychiatric treatment and job coaching

• Bad treatment from mental health staff when meeting client and coach at the clinic

• Regulations of employment office hamper the rehabilitation process

• A civil servant at the social insurance office works closely with both the IPS team and psychiatric services to solve concerns about the client's financial situation

The importance of coordinated collaboration

Table 2.

Time from baseline to 24 monthsOccupation024681012141618202224EmploymentEEC,ECC,EC,EC,EC,EC,EC,EB,CB,CB,CEducationDDB,DB,DB,DBBB,DB,DB,DWork practiceB,C,D,EEA,EA,EAA,DA,DA,DA,DESheltered workBEEEENo occupationA,C,DA,BA,B,DBBAAA,E

Table 3.

BaselineMedian value24 monthsMedian valueBPRS (psychiatric symptoms)35303128GAF (global psychosocial functioning)54556565Rosenberg (self-esteem)2.302.402.702.70MANSA (quality of life)4.004.505.204.58OSA (occupational competence)0.570.841.840.92OSA (occupational value)1.701.552.011.84IPS provided in hours/year106 (0–12 m)6365 (13–24 m)37

Table 4.

BaselineMedian value24 monthsMedian valueBPRS (psychiatric symptoms)30302628GAF (global psychosocial functioning)65558065Rosenberg (self-esteem)2.602.403.602.70MANSA (quality of life)5.254.505.334.58OSA (occupational competence)1.700.842.410.92OSA (occupational value)3.151.551.401.84IPS provided in hours/year91 (0–12 m)6317 (13–24 m)37

Table 5.

BaselineMedian value24 monthsMedian valueBPRS (psychiatric symptoms)27303028GAF (global psychosocial functioning)68555465Rosenberg (self-esteem)2.602.401.802.70MANSA (quality of life)5.584.504.504.58OSA (occupational competence)2.870.840.840.92OSA (occupational value)0.841.551.551.84IPS provided in hours/year31 (0–12 m)6334 (13–24 m)37

Table 6.

BaselineMedian value24 monthsMedian valueBPRS (psychiatric symptoms)30302728GAF (global psychosocial functioning)55556865Rosenberg (self-esteem)1.802.401.602.70MANSA (quality of life)3.914.504.084.58OSA (occupational competence)−0.120.84−0.230.92OSA (occupational value)0.151.550.171.84IPS provided in hours/year76 (0–12 m)6337 (13–24 m)37

Table 7.

BaselineMedian value24 monthsMedian valueBPRS (psychiatric symptoms)34303228GAF (global psychosocial functioning)55555565Rosenberg (self-esteem)2.702.402.202.70MANSA (quality of life)4.504.503.174.58OSA (occupational competence)−0.500.840.040.92OSA (occupational value)0.841.551.701.84IPS provided in hours/year97 (0–12 m)6370 (13–24 m)37