title: Adapting evidence-based interventions to fit usual practice: staff roles and consumer choice in psychiatric rehabilitation.
abstract: This proof-of-concept study tested the viability of adapting a specialized practice to fit multi-service programs by switching from specialist to generalist staff roles. The intervention under study was supported employment, an evidence-based practice for adults with severe mental illness. Program data on participant characteristics, attendance, staff contact, and employment were retrieved for the 2007 calendar year (N = 99). Two hierarchical regression analyses compared (1) participants with any versus no mainstream employment, and (2) participants who started a new job in 2007 versus all other participants. In both analyses, individual participant counts of days on which employment services were provided and count of different employment service providers independently predicted mainstream employment over and above program attendance and background factors. The study program's employment rate approximated rates published for specialized supported employment programs, suggesting that it is feasible to adapt specialized evidence-based practices to fit multi-service settings without compromising service quality.
authors.affiliation: Department of Behavioral Health and Academic Counseling, Harvard University, Boston, MA, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Barreira
authors.forename: Miriam Cohen
authors.initials: MC
authors.lastname: Tepper
authors.forename: Paul B
authors.initials: PB
authors.lastname: Gold
authors.forename: Dana
authors.initials: D
authors.lastname: Holley
authors.forename: Cathaleene
authors.initials: C
authors.lastname: Macias
mesh_terms: D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000379:methods* / Q000458:organization & administration*; D016832:Employment, Supported / Q000379:methods / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D011369:Professional-Patient Relations; D015397:Program Evaluation; D012046:Rehabilitation / Q000379:methods*