Implementing evidence-based interventions to improve vocational recovery in early psychosis: A quality-improvement report

D. van Duin*, A. van Wamel, Lars De Winter, Hans Kroon, W. Veling, J. van Weeghel

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective:
After young adults experience a first episode of psychosis, many express a need for help with education and employment. A quality improvement collaborative (QIC) launched in the Netherlands aimed to reinforce vocational recovery by improving participation in education and employment and by enhancing cognitive skills and self-management. This study examined methods used to implement interventions, barriers and facilitators, and implementation outcomes (fidelity, uptake, and availability).

Methods:
The Breakthrough Series was the model for change. Three evidence-based interventions were implemented to achieve targeted goals: individual placement and support (IPS), cognitive remediation, and shared decision making. Fidelity scores were obtained with fidelity scales.

Results:
Eighty-five professionals and 332 patients representing 14 teams treating patients with early psychosis were included in the 24-month QIC. Of this group, 252 patients participated in IPS, 52 in cognitive remediation, and 39 in shared decision making. By month 22, teams attained moderate-to-high mean fidelity scores, with an average of 3.2 on a 4-point scale for cognitive remediation, 3.7 on a 5-point scale for IPS, and 4.9 on a 6-point scale for shared decision making.

Conclusions:
Over 24 months, use of a Breakthrough QIC to implement three interventions aimed at improving vocational recovery in teams delivering services for early psychosis yielded mixed results in terms of uptake and availability and moderate-to-high results in terms of fidelity. When implementing these types of interventions in this population, a multifaceted implementation model and a focused testing phase for computerized interventions appear needed, preferably with a maximum of two interventions implemented simultaneously.
Original languageEnglish
Pages (from-to)1168-1177
JournalPsychiatric Services
Volume72
Issue number10
DOIs
Publication statusPublished - 2021

Keywords

  • COGNITIVE REMEDIATION
  • COLLABORATIVES
  • FIDELITY
  • INFORMATION
  • OUTCOMES
  • PSYCHOMETRIC PROPERTIES
  • QUESTIONNAIRE
  • SCHIZOPHRENIA
  • SHARED DECISION-MAKING
  • SUPPORTED EMPLOYMENT

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