title: Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study.
abstract: OBJECTIVE
  To examine whether supported employment (SE) is more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI).
  
  
  METHODS
  Prospective, randomized, controlled, multisite trial of SE versus TAU for vocational issues with 12 months of follow-up data.
  
  
  METHODS
  SCI centers in the Veterans Health Administration.
  
  
  METHODS
  Subjects (N=201) were enrolled and completed baseline interviews. In interventional sites, subjects were randomly assigned to the SE condition (n=81) or the TAU condition (treatment as usual-interventional site [TAU-IS], n=76). In observational sites where the SE program was not available, 44 subjects were enrolled in a nonrandomized TAU condition (treatment as usual-observational site [TAU-OS]).
  
  
  METHODS
  The intervention consisted of an SE vocational rehabilitation program called the Spinal Cord Injury Vocational Integration Program, which adhered as closely as possible to principles of SE as developed and described in the individual placement and support model of SE for persons with mental illness.
  
  
  METHODS
  The primary study outcome measurement was competitive employment in the community.
  
  
  RESULTS
  Subjects in the SE group were 2.5 times more likely than the TAU-IS group and 11.4 times more likely than the TAU-OS group to obtain competitive employment.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first and only controlled study of a specific vocational rehabilitation program to report improved employment outcomes for persons with SCI. SE, a well-prescribed method of integrated vocational care, was superior to usual practices in improving employment outcomes for veterans with SCI.
authors.affiliation: Veterans Affairs (VA) North Texas Health Care System, Dallas, TX, USA. lisa.ottomanelli@va.gov
authors.forename: Lisa
authors.initials: L
authors.lastname: Ottomanelli
authors.forename: Lance L
authors.initials: LL
authors.lastname: Goetz
authors.forename: Alina
authors.initials: A
authors.lastname: Suris
authors.forename: Charles
authors.initials: C
authors.lastname: McGeough
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Sinnott
authors.forename: Rich
authors.initials: R
authors.lastname: Toscano
authors.forename: Scott D
authors.initials: SD
authors.lastname: Barnett
authors.forename: Daisha J
authors.initials: DJ
authors.lastname: Cipher
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lind
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Dixon
authors.forename: Sally Ann
authors.initials: SA
authors.lastname: Holmes
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Kerrigan
authors.forename: Florian P
authors.initials: FP
authors.lastname: Thomas
mesh_terms: D000328:Adult; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D016832:Employment, Supported; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*