Implementing evidence-based interventions to improve vocational recovery in early psychosis: A quality-improvement report
van Duin,D. van Wamel,A. De Winter,Lars Kroon,Hans Veling,W. van Weeghel,J.
van Duin,D.
van Wamel,A.
De Winter,Lars
Kroon,Hans
Veling,W.
van Weeghel,J.
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.
Description
Date
2021
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Volume Title
Publisher
Research Projects
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Keywords
COGNITIVE REMEDIATION, COLLABORATIVES, FIDELITY, INFORMATION, OUTCOMES, PSYCHOMETRIC PROPERTIES, QUESTIONNAIRE, SCHIZOPHRENIA, SHARED DECISION-MAKING, SUPPORTED EMPLOYMENT, SDG 4 - Quality Education
Citation
van Duin, D, van Wamel, A, De Winter, L, Kroon, H, Veling, W & van Weeghel, J 2021, 'Implementing evidence-based interventions to improve vocational recovery in early psychosis : A quality-improvement report', Psychiatric Services, vol. 72, no. 10, pp. 1168-1177. https://doi.org/10.1176/appi.ps.201900342