Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Vocational instability in Veterans with serious mental illness (SMI) is pervasive, costly, and harmful. Over 75% of Veterans with SMI are unemployed, resulting in economic difficulties and trouble meeting basic needs. Overall, among adults with depression, work dysfunction results in a 36 to 51 billion dollar loss annually. Unemployed Veterans with SMI also suffer major health consequences, including a more severe course of illness and poor recovery over time, leading to increased inpatient and emergency service use. The WORKWELL study will synergistically address these deficits in health, recovery, and work functioning by testing the Cognitive Behavioral Therapy for Work Success (CBTw) intervention. Using a pragmatic design, this project will address work as a major social determinant of health and close the health disparity gap among people with SMI. Further, through promotion of work and healthy thinking, CBTw holds promise to reduce risk of suicide among vulnerable veterans with SMI.
Project background: Work is a major social determinant of health. In people with serious mental illness (SMI), work is associated with better wellbeing, physical and mental health, quality of life, and may prevent the onset of disability. Among Veterans with SMI, work is a protective factor against suicide.
Most veterans with SMI are unemployed and suffer substantially worse health and recovery across key domains. Despite quality VHA vocational services, such as supported employment (SE), two-thirds or more of Veterans who receive these services experience work dysfunction. A probable explanation lies in unsolved cognitive and behavioral barriers, such as low work-related self-efficacy, ineffective coping skills, little hope that work is attainable, poor work motivation and sense of self.
The Cognitive Behavioral Therapy for Work Success (CBTw) intervention was designed to target these problems and augment VHA SE services to synergistically improve work, as well as health and recovery, in Veterans with SMI. In an open trial pilot, CBTw was associated with significant increases in hours worked and wages earned and the majority of CBTw participants became steady workers. Veterans also experienced improvements in symptoms, recovery, and quality of life.
Project goals: Using Hybrid 1 RCT design, this project will test the effects of CBTw on competitive work and health and recovery outcomes over a 12-month study period at 3 VA SE programs. Informed by the RE-AIM framework, an implementation evaluation will examine the success of using SE staff to deliver CBTw, barriers and facilitators to implementation, and strategies utilized.
Relevance to priorities: This project has high implementation potential and is responsive to the VHA priority regarding Health Equity, as it will address work functioning, an under studied social determinant of health. WORKWELL also holds promise to improve health and recovery outcomes among Veterans with SMI, another HSR&D area of emphasis. Lastly, this study is consistent with the goal of finding novel strategies toward suicide prevention among vulnerable Veteran groups, including those with SMI.
Objectives: Aim 1: Test the effects of CBTw + SE compared to a control of psychoeducation + SE on work. Hypotheses: Participants in the CBTw+ SE arm will work significantly more total weeks in competitive jobs (primary study outcome) and will be more likely to become steady workers.
Aim 2: Test the effects of CBTw + SE on health and recovery. Hypotheses: Participants in the CBTw + SE arm will have greater improvements on subjective recovery and health-related quality of life, and decreases in symptoms, suicidal ideation, and inpatient service utilization.
Aim 3: Guided by the RE-AIM implementation science framework, conduct an evaluation of the implementation of CBTw, including examination of the feasibility of using SE staff to deliver CBTw, and related barriers and facilitators. The objective is to spur future wide scale CBTw implementation.
Project Methods: WORKWELL is a pragmatic, Hybrid 1 design RCT. CBTw will be tested at 3 SE sites-Roudebush VA Medical Center, the Edward J. Hines VA Medical Center, and the VA St. Louis Health Care System. 276 unemployed Veterans with SMI will be randomly assigned to receive CBTw plus SE or a control of psychoeducation plus SE. Outcomes including total weeks worked in competitive jobs (primary), achievement of steady work, symptoms, recovery, health related quality of life, suicidal ideation, and service utilization will be assessed at posttreatment (12 weeks), 6 months (primary endpoint), and 9 months (to examine sustained effects). Primary work outcomes will be collected monthly over a 12-month period. CBTw implementation planning, training, and consultation will be provided. CBTw implementation (fidelity), barriers and facilitators to implementation, and other RE-AIM elements will be examined using mixed methods.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cognitive Behavioral Therapy For Work Success (CBTw) | Experimental | Veterans will participate in 12 weekly group sessions to discuss thoughts, feelings, and behaviors that promote work success in the community |
|
| Psychoeducation | Active Comparator | Veterans in the control group will participate in 12 weekly group sessions in which they will learn more about their mental health conditions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cognitive Behavioral Therapy For Work Success (CBTw) | Behavioral | Veterans will go to 12 weekly group sessions and will learn healthy thinking about work, positive behavioral coping related to work, and will form a work success plan based on their work goals. |
| Measure | Description | Time Frame |
|---|---|---|
| Total Weeks Worked in Competitive Jobs | Mean number of weeks worked in competitive jobs. Competitive jobs are regular jobs open to all that pay at least minimum wage. More total weeks worked in competitive jobs is indicative of a positive outcome. | Baseline to 3 months |
| Total Weeks Worked in Competitive Jobs | Mean number of weeks worked in competitive jobs. | 3 to 6 Months |
| Total Weeks Worked in Competitive Jobs | Mean number of weeks worked in competitive jobs. | 6 to 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Short Employment Hope Scale (EHS-14) | The Short Employment Hope Scale (EHS-14) measures employment hope, defined as the psychological construct characterized by possession of work-related empowerment and motivation for the future, envisionment of meaningful and satisfying employment, job-based goal orientation, and progress toward employment using skills and resources. The EHS-14 is comprised of two subscales-Psychological Empowerment and Goal-oriented pathways (7 items each). The EHS-14 is made up of a total of 14 items scored on a 0 (minimum) to 10 (maximum) scale with total scores comprised of a mean of all 14 items. Higher scores indicate better (increased) employment hope and lower scores indicate worse (decreased) employment hope. |
Not provided
Inclusion Criteria:
Unemployment, defined as no current participation in a competitive job
A competitive work goal, which denotes a goal of a regular job in the community that pays at least minimum wage
Presence of a serious mental illness including one or more of the following conditions:
Currently enrolled in and receiving VA vocational rehabilitation services
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Marina Elizabeth Kukla, PhD MS BS | Richard L. Roudebush VA Medical Center, Indianapolis, IN | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Edward Hines Jr. VA Hospital, Hines, IL | Hines | Illinois | 60141-5000 | United States | ||
| Richard L. Roudebush VA Medical Center, Indianapolis, IN |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38540549 | Result | Kukla M, McGuire AB, Weber KC, Hatfield J, Henry N, Kulesza E, Rollins AL. An Investigation of Employment Hope as a Key Factor Influencing Perceptions of Subjective Recovery among Adults with Serious Mental Illness Seeking Community Work. Behav Sci (Basel). 2024 Mar 19;14(3):246. doi: 10.3390/bs14030246. | |
| Result | Kukla ME, Rollins AL, Weber K, Hatfield J, Wu W, Faith L. A., Carter J. L., Wiesepape C, Connors MJ, Wahle SS, Pashka NJ, McGuire AB. A Pragmatic Randomized Controlled Trial Investigating Work Enhanced Cognitive Behavioral Therapy for People with Serious Mental Illness (WORKWELL): Background, Design, and Baseline Outcomes. Journal of Vocational Rehabilitation. 2025 Nov 1; 63(3):299-311, DOI: 10.1177/10522263251376530 |
Not provided
Not provided
Upon request, the Research Service will consider requests for the final data sets underlying the publications to be provided to the public. The limited dataset will include de-identified data relevant to the specific request. Independent research groups can view relevant data to evaluate the extent that data sources support conclusions made by authors in published studies as well as observe additional emergent themes and view supplemental details that might not be included in publications.
The data will become available once the study team completes all analyses.
The Research Service will evaluate individual requests.
Not provided
Not provided
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Cognitive Behavioral Therapy For Work Success (CBTw) | Cognitive Behavioral Therapy For Work Success (CBTw): Veterans will go to 12 weekly group sessions and will learn healthy thinking about work, positive behavioral coping related to work, and will form a work success plan based on their work goals. |
| FG001 | Psychoeducation (Control Group) | Psychoeducation: Veterans will go to 12 weekly group sessions and will learn more information about their mental health conditions. Psychoeducation modules are from the Illness Management and Recovery program. |
| FG002 | Provider | Vocational Rehabilitation provider participants |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Provider participants (n=22) arm did not have baseline characteristics collected.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Cognitive Behavioral Therapy For Work Success (CBTw) | Cognitive Behavioral Therapy For Work Success (CBTw): Veterans will go to 12 weekly group sessions and will learn healthy thinking about work, positive behavioral coping related to work, and will form a work success plan based on their work goals. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Provider participants (n=22) arm did not have baseline characteristics collected. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Total Weeks Worked in Competitive Jobs | Mean number of weeks worked in competitive jobs. Competitive jobs are regular jobs open to all that pay at least minimum wage. More total weeks worked in competitive jobs is indicative of a positive outcome. | This outcome was only examined for patient participants and not for the provider participants arm. | Posted | Mean | Standard Deviation | Weeks Worked | Baseline to 3 months |
|
baseline to 9 month follow up
Adverse event data was not collected for provider participants (n=22).
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cognitive Behavioral Therapy For Work Success (CBTw) | Cognitive Behavioral Therapy For Work Success (CBTw): Veterans will go to 12 weekly group sessions and will learn healthy thinking about work, positive behavioral coping related to work, and will form a work success plan based on their work goals. |
Not provided
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Substance Use Relapse | Psychiatric disorders | Non-systematic Assessment | Participant was hospitalized due relapse and potential to harm others. |
There are no limitations to this study.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Marina Kukla | Department of Veterans Affairs | 317-478-4750 | mkukla@iu.edu |
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jul 11, 2022 | Feb 10, 2026 | Prot_001.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Sep 30, 2025 | Feb 10, 2026 | SAP_002.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jul 11, 2022 | Oct 23, 2023 | ICF_000.pdf |
Not provided
| ID | Term |
|---|---|
| D013313 | Stress Disorders, Post-Traumatic |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
Not provided
Not provided
| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
Not provided
Not provided
Unemployed participants with serious mental illness will be randomized to receive group-based cognitive behavioral therapy geared toward improving competitive work outcomes or a time and format matched psychoeducation intervention
Not provided
Not provided
Research personnel conducting outcomes assessments will be blinded to condition assignment
| Psychoeducation | Behavioral | Veterans will go to 12 weekly group sessions and will learn more information about their mental health conditions. Psychoeducation modules are from the Illness Management and Recovery program. |
|
| baseline to 9 months |
| Recovery Assessment Scale (RAS) | The Recovery Assessment Scale (RAS) measures subjective mental health recovery. The RAS consists of 41 items and an overall score is calculated using a mean of all items, with scores ranging from 1 (maximum) to 5 (minimum). Higher RAS scores indicate better (increased) subjective recovery with lower RAS scores indicating worse (decreased) subjective recovery. This outcome was only examined for patient participants and not for provider participants arm. | baseline to 9 months |
| Scale for Suicidal Ideation Change | Outcome measure is a 21-item interviewer rated measure of a continuum of suicidal ideation, including thoughts, attitudes, plans, and behaviors. Total scores range from 0 to 42 with higher scores indicating more suicidal ideation. | baseline to 9 months |
| Cognitive Behavioral Therapy for Work Success (CBTw) Fidelity | Fidelity to the Cognitive Behavioral Therapy for Work Success (CBTw) model was measured using the Cognitive Therapy Scale-Revised. The Cognitive Therapy Scale-Revised is comprised of 8 items gauging core components of the CBTw intervention and overall fidelity is measured as a mean of the 8 items. Total fidelity scores range from 0 (minimum) to 6 (maximum) with higher scores indicating greater adherence and proficiency to the CBTw model. Scores of 3 or higher indicate adequate fidelity in which the CBTw intervention is considered delivered as intended. Fidelity was only measured for provider participants and was not measured for participants in the Cognitive Behavioral Therapy for Work Success and Psychoeducation arms. | 12 weeks (during the CBTw intervention period) |
| Indianapolis |
| Indiana |
| 46202-2884 |
| United States |
| St. Louis VA Medical Center John Cochran Division, St. Louis, MO | St Louis | Missouri | 63106 | United States |
| Psychoeducation (Control Group) |
Psychoeducation: Veterans will go to 12 weekly group sessions and will learn more information about their mental health conditions. Psychoeducation modules are from the Illness Management and Recovery program. |
| BG002 | Provider Participants | Vocational rehabilitation providers |
| BG003 | Total | Total of all reporting groups |
| Mean |
| Standard Deviation |
| years |
|
| Sex: Female, Male | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Ethnicity (NIH/OMB) | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Race (NIH/OMB) | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Martial Status | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Education | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Housing History | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Weeks Enrolled in Vocational Services at Baseline | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Weeks |
|
| VA Service Connected Disability | VA service connected disability is disability level (and corresponding compensation) received by veterans based on health conditions deemed related to their military service. It ranges from 0% to 100%, with 0% representing no disability related to a service related medical condition to 100%, a disabling medical condition related to military service. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Percentage |
|
| SSI and/or SSDI Receipt | This measure denotes whether participants were recipients of social security income (SSI) and/or social security disability insurance (SSDI). | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants |
|
| Combat Experience | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Time Since Military Separation | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Weeks |
|
| Months of Military Service | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Months |
|
| Military Branch | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Diagnosis | Provider participants (n=22) arm did not have baseline characteristics collected. | Count of Participants | Participants | No |
|
| Age at First Hospitalization | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Age in Years |
|
| Lifetime Psychiatric Hospitalizations | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Psychiatric Hospitalizations |
|
| Months Since Last Psychiatric Hospitalization | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Months Since Last Hospitalization |
|
| Substance Use History | Provider participants (n=22) arm did not have baseline characteristics collected. | Number | Use Illicit Drugs |
|
| Number of Alcoholic Drinks per Week | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Alcoholic Drinks per Week |
|
| Number of Felony Convictions | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Number of Felony Convictions |
|
| Number of Misdemeanors | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Number of Misdemeanors |
|
| Total Convictions | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Total Felony and Misdemeanor Convictions |
|
| Length of Employment | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Weeks |
|
| Weeks Worked 6 Months Prior to Baseline | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Weeks |
|
| Longest Held Civilian Job | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Months |
|
| Average Hours Worked per Week | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Hours |
|
| Average Hourly Wage | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | US Dollars |
|
| Recovery Assessment Scale | The Recovery Assessment Scale (RAS) measures subjective mental health recovery. The RAS consists of 41 items and an overall score is calculated using a mean of all items, with scores ranging from 1 (minimum) to 5 (maximum), and total scores ranging from 41-205. Higher RAS scores indicate better (increased) subjective recovery with lower RAS scores indicating worse (decreased) subjective recovery. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Short Employment Hope Scale - Psychological Empowerment subscale | The Short Employment Hope Scale, psychological empowerment subscale, assesses a subjective sense of one's worth, perceived capability, and hopeful outlook for future work. The psychological empowerment subscale consists of 7 items scored on a 0 (minimum) to 10 (maximum) scale with scores comprised of a mean of the 7 items. Higher scores indicate better (increased) employment hope-psychological empowerment and lower scores indicate worse (decreased) employment hope-psychological empowerment. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Short Employment Hope - Goal Oriented Pathways subscale | The Employment Hope Scale - goal oriented pathways subscale, assesses awareness and utilization of skills and resources toward finding employment, as well as self focus on work and career specific goals. The goal oriented pathways subscale consists of 7 items scored on a 0 (minimum) to 10 (maximum) scale with scores comprised of a mean of the 7 items. Higher scores indicate better (increased) employment hope-goal oriented pathways and lower scores indicate worse (decreased) employment hope-goal oriented pathways." | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Scale for Suicidal Ideation (SSI-21) | The Scale for Suicidal Ideation (SSI) measures suicidality and self directed violence including suicide thoughts, actions toward suicide, and suicide attempts. The SSI consists of 21 items and an overall SSI score is calculated by summing items 1 through 19, with total scores ranging from 0 (minimum) to 38 (maximum). Higher SSI scores indicate more severe suicidality with lower SSI scores indicating less severe suicidality | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Veterans RAND 12 item Health Survey - Physical Component Summary | The Veterans Rand 12 (VR-12) Physical Component Summary measures patient reported physical health related quality of life in the areas of physical health, functioning, and pain. The VR-12 Physical Component Scale consists of 12 items with total scores on a 0 (minimum) to 50 (maximum) scale. Higher scores indicate better physical health related quality of life, whereas lower scores indicate worse physical health related quality of life. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Veterans RAND 12 item Health Survey - Mental Component Summary | The Veterans Rand 12 (VR-12) Mental Component Summary measures patient reported mental health related quality of life in the areas of psychological distress, social functioning, well-being, and energy. The VR-12 Mental Component Scale consists of 12 items with total scores on a 0 (minimum) to 50 (maximum) scale. Higher scores indicate better mental health related quality of life whereas lower scores indicate worse mental health related quality of life | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Depression | The cross-cutting symptom measure Depression domain measures patient reported depression symptoms and consists of two items with total scores ranging from 0 (minimum) to 4 (maximum). Scores are calculated by taking a mean of the item scores. Higher scores indicate more severe depression symptoms whereas lower scores indicate less severe depression symptoms | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Anger | The cross-cutting symptom measure Anger domain measures patient reported anger symptoms and consists of one item with scores ranging from 0 (minimum) to 4 (maximum). Higher scores indicate more severe anger symptoms whereas lower scores indicate less severe anger symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Mania | The cross-cutting symptom measure Mania domain measures patient reported mania symptoms and consists of two items with total scores ranging from 0 (minimum) to 4 (maximum). Scores are calculated by taking a mean of the item scores. Higher scores indicate more severe mania symptoms whereas lower scores indicate less severe mania symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Anxiety | The cross-cutting symptom measure Anxiety domain measures patient reported anxiety symptoms and consists of three items with total scores ranging from 0 (minimum) to 4 (maximum). Domain scores are calculated by taking a mean of the item scores. Higher domain scores indicate more severe anxiety symptoms whereas lower scores indicate less severe anxiety symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Somatic Symptoms | The cross-cutting symptom measure Somatic Symptoms domain measures patient reported bodily symptoms and consists of two items with total scores ranging from 0 (minimum) to 4 (maximum). Domain scores are calculated by taking a mean of the item scores. Higher domain scores indicate more severe somatic symptoms whereas lower scores indicate less severe somatic symptoms | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Suicidal Ideation | The cross-cutting symptom measure Suicidal Ideation domain measures patient reported suicidal thoughts and consists of one item with scores ranging from 0 (minimum) to 4 (maximum). Higher domain scores indicate more severe suicidal ideation symptoms whereas lower scores indicate less severe suicidal ideation symptoms | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Psychosis | The cross-cutting symptom measure Psychosis domain measures patient reported psychosis symptoms and consists of two items with total scores ranging from 0 (minimum) to 4 (maximum). Domain scores are calculated by taking a mean of the item scores. Higher domain scores indicate more severe psychosis symptoms whereas lower scores indicate less severe psychosis symptoms | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Sleep Problems | The cross-cutting symptom measure Sleep Problems domain measures patient reported sleep-related symptoms and consists of one item with total scores ranging from 0 (minimum) to 4 (maximum). Higher domain scores indicate more severe sleep problems whereas lower scores indicate less severe sleep problems | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Memory | The cross-cutting symptom measure Memory domain measures patient reported memory symptoms and consists of one item with total scores ranging from 0 (minimum) to 4 (maximum). Higher domain scores indicate more severe memory symptoms whereas lower scores indicate less severe memory symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Repetitive Thoughts and Behaviors | The cross-cutting symptom measure Repetitive Thoughts and Behaviors domain measures patient reported repetitive thoughts and behaviors symptoms and consists of two items with total scores ranging from 0 (minimum) to 4 (maximum). Domain scores are calculated by taking a mean of the item scores. Higher domain scores indicate more severe repetitive thoughts and behaviors symptoms whereas lower scores indicate less severe repetitive thoughts and behaviors symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Dissociation | The cross-cutting symptom measure Dissociation domain measures patient reported dissociative symptoms, or detachment from one's self identity, emotions, or reality, and consists of one item with total scores ranging from 0 (minimum) to 4 (maximum). Higher domain scores indicate more severe dissociative symptoms whereas lower scores indicate less severe dissociative symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Personality Functioning | The cross-cutting symptom measure Personality Functioning domain measures patient reported personality functioning symptoms, characterized by lack of a cohesive sense of self, and consists of two items with total scores ranging from 0 (minimum) to 4 (maximum). Domain scores are calculated by taking a mean of the item scores. Higher domain scores indicate more severe personality functioning symptoms whereas lower scores indicate less severe personality functioning symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Cross-cutting Symptom Measure - Substance Use | The cross-cutting symptom measure Substance Use domain measures patient reported substance use symptoms and consists of three items with total scores ranging from 0 (minimum) to 4 (maximum). Domain scores are calculated by taking a mean of the item scores. Higher domain scores indicate more severe substance use symptoms whereas lower scores indicate less severe substance use symptoms. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | units on a scale |
|
| Recovery Assessment Scale - Confidence and Hope | 41 items. Assesses subjective (self-report) recovery. Minimum is 1; Maximum is 5 with higher scores better (i.e. higher subjective recovery). For mean scores, this is applicable to overall scores and all subscale scores. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | score on a scale |
|
| Recovery Assessment Scale - Willingness to Ask for Help | 41 items. Assesses subjective (self-report) recovery. Minimum is 1; Maximum is 5 with higher scores better (i.e. higher subjective recovery). For mean scores, this is applicable to overall scores and all subscale scores. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Score on a scale |
|
| Recovery Assessment Scale - Goal and Success Orientation | 41 items. Assesses subjective (self-report) recovery. Minimum is 1; Maximum is 5 with higher scores better (i.e. higher subjective recovery). For mean scores, this is applicable to overall scores and all subscale scores. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Score on a scale |
|
| Recovery Assessment Scale - Reliance on Others | 41 items. Assesses subjective (self-report) recovery. Minimum is 1; Maximum is 5 with higher scores better (i.e. higher subjective recovery). For mean scores, this is applicable to overall scores and all subscale scores. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Score on a scale |
|
| Recovery Assessment Scale - No Domination by Symptoms | Minimum is 1; Maximum is 5 with higher scores better (i.e. higher subjective recovery). For mean scores, this is applicable to overall scores and all subscale scores. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Score on a scale |
|
| Recovery Assessment Scale - Mean | 41 items. Assesses subjective (self-report) recovery. Minimum is 1; Maximum is 5 with higher scores better (i.e. higher subjective recovery). For mean scores, this is applicable to overall scores and all subscale scores. | Provider participants (n=22) arm did not have baseline characteristics collected. | Mean | Standard Deviation | Score on a scale |
|
| Psychoeducation (Control Group) |
Psychoeducation: Veterans will go to 12 weekly group sessions and will learn more information about their mental health conditions. Psychoeducation modules are from the Illness Management and Recovery program. |
|
|
| Primary | Total Weeks Worked in Competitive Jobs | Mean number of weeks worked in competitive jobs. | This outcome was only examined for patient participants and not for the provider participants arm. | Posted | Mean | Standard Deviation | Weeks Worked | 3 to 6 Months |
|
|
|
| Primary | Total Weeks Worked in Competitive Jobs | Mean number of weeks worked in competitive jobs. | This outcome was only examined for patient participants and not for provider participants arm. | Posted | Mean | Standard Deviation | Weeks Worked | 6 to 9 months |
|
|
|
| Secondary | Short Employment Hope Scale (EHS-14) | The Short Employment Hope Scale (EHS-14) measures employment hope, defined as the psychological construct characterized by possession of work-related empowerment and motivation for the future, envisionment of meaningful and satisfying employment, job-based goal orientation, and progress toward employment using skills and resources. The EHS-14 is comprised of two subscales-Psychological Empowerment and Goal-oriented pathways (7 items each). The EHS-14 is made up of a total of 14 items scored on a 0 (minimum) to 10 (maximum) scale with total scores comprised of a mean of all 14 items. Higher scores indicate better (increased) employment hope and lower scores indicate worse (decreased) employment hope. | This outcome was only examined for patient participants and not for provider participants arm. | Posted | Mean | Standard Deviation | score on a scale | baseline to 9 months |
|
|
|
| Secondary | Recovery Assessment Scale (RAS) | The Recovery Assessment Scale (RAS) measures subjective mental health recovery. The RAS consists of 41 items and an overall score is calculated using a mean of all items, with scores ranging from 1 (maximum) to 5 (minimum). Higher RAS scores indicate better (increased) subjective recovery with lower RAS scores indicating worse (decreased) subjective recovery. This outcome was only examined for patient participants and not for provider participants arm. | This outcome was only examined for patient participants and not for provider participants arm. | Posted | Mean | Standard Deviation | score on a scale | baseline to 9 months |
|
|
|
| Secondary | Scale for Suicidal Ideation Change | Outcome measure is a 21-item interviewer rated measure of a continuum of suicidal ideation, including thoughts, attitudes, plans, and behaviors. Total scores range from 0 to 42 with higher scores indicating more suicidal ideation. | This outcome was only examined for patient participants and not for provider participants arm. | Posted | Mean | Standard Deviation | score on a scale | baseline to 9 months |
|
|
|
| Secondary | Cognitive Behavioral Therapy for Work Success (CBTw) Fidelity | Fidelity to the Cognitive Behavioral Therapy for Work Success (CBTw) model was measured using the Cognitive Therapy Scale-Revised. The Cognitive Therapy Scale-Revised is comprised of 8 items gauging core components of the CBTw intervention and overall fidelity is measured as a mean of the 8 items. Total fidelity scores range from 0 (minimum) to 6 (maximum) with higher scores indicating greater adherence and proficiency to the CBTw model. Scores of 3 or higher indicate adequate fidelity in which the CBTw intervention is considered delivered as intended. Fidelity was only measured for provider participants and was not measured for participants in the Cognitive Behavioral Therapy for Work Success and Psychoeducation arms. | Vocational Rehabilitation Providers who delivered the Cognitive Behavioral Therapy Intervention during the study period. | Posted | Mean | Standard Deviation | score on a scale | 12 weeks (during the CBTw intervention period) |
|
|
|
| 0 |
| 136 |
| 0 |
| 136 |
| 2 |
| 136 |
| EG001 | Psychoeducation (Control Group) | Psychoeducation: Veterans will go to 12 weekly group sessions and will learn more information about their mental health conditions. Psychoeducation modules are from the Illness Management and Recovery program. | 0 | 136 | 0 | 136 | 1 | 136 |
|
| Suicidal Ideation | Psychiatric disorders | Non-systematic Assessment | Participant presented to the ER with suicidal thoughts and was subsequently hospitalized. |
|
| Psychiatric Hospitalization | Psychiatric disorders | Non-systematic Assessment | Participant was experiencing psychotic symptoms and hospitalized. |
|
Not provided
Not provided
| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Separated |
|
| Widowed/Widower |
|
| Bachelors Degree |
|
| Associates Degree |
|
| Masters and Above |
|
| Technical School or Certification |
|
| Live Alone |
|
| Supported Housing |
|
| Live with a Friend |
|
| Live with Family |
|
| Live with Partner/Spouse |
|
| Other |
|
| Marines |
|
| Air Force |
|
| other (not identified) |
|
| Bipolar Disorders |
|
| Schizophrenia Spectrum Disorder |
|