title: Vocational interventions for unemployed: effects on work participation and mental distress. A systematic review.
abstract: BACKGROUND
  Unemployment is a growing problem worldwide. Unemployment or job loss is one of the most stressful of life events and can lead to diminished social status, disturbed social role patterns, financial debt, reduced self-esteem and feelings of guilt. The purpose of this review was to determine the effectiveness of vocational interventions on work participation and mental distress for unemployed adults and to provide an overview of the characteristics of these interventions.
  
  
  METHODS
  Medline, EMBASE and PsycINFO were systematically searched for studies published between 1990 and August 2008. Intervention studies aimed at work participation and helping with mental distress for the unemployed were included. Methodological quality of the included studies was assessed.
  
  
  RESULTS
  Six articles based on five intervention studies, of which two randomized controlled trials, fulfilled all inclusion criteria. The methodological quality of the studies ranged from good to poor. All five interventions applied group training techniques aimed at promoting re-employment and/or improving mental health. The duration of the interventions varied from 1 week to 6 months. The interventions focused on acquiring job-search skills, maintaining paid work, personal development and preparedness against setbacks during the job-search process. Only one intervention study (randomized controlled trial) reported a significant effect on re-employment.
  
  
  CONCLUSIONS
  Based on our review, we conclude that there is weak evidence to support the use of vocational interventions to improve work participation and limited evidence to reduce mental distress for the unemployed. We recommend further development and evaluation of return to work intervention strategies for unemployed individuals.
authors.affiliation: Coronel Institute of Occupational Health, Research Center for Insurance Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. s.s.audhoe@amc.nl
authors.forename: Selwin S
authors.initials: SS
authors.lastname: Audhoe
authors.forename: Jan L
authors.initials: JL
authors.lastname: Hoving
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001290:Attitude; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D009788:Occupational Therapy; D013315:Stress, Psychological / Q000628:therapy*; D014478:Unemployment / Q000706:statistics & numerical data*; D014937:Work