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High unemployment is a hallmark of psychotic illness. Individual placement and support (IPS) may be effective at assisting the vocational recoveries of young people with first-episode psychosis (FEP).
Aims
To examine the effectiveness of IPS at assisting young people with FEP to gain employment (Australian and Clinical Trials Registry ACTRN12608000094370).
Method
Young people with FEP (n = 146) who were interested in vocational recovery were randomised using computer-generated random permuted blocks on a 1:1 ratio to: (a) 6 months of IPS in addition to treatment as usual (TAU) or (b) TAU alone. Assessments were conducted at baseline, 6 months (end of intervention), 12 months and 18 months post-baseline by research assistants who were masked to the treatment allocations.
Results
At the end of the intervention the IPS group had a significantly higher rate of having been employed (71.2%) than the TAU group (48.0%), odds ratio 3.40 (95% CI 1.17–9.91, z = 2.25, P = 0.025). However, this difference was not seen at 12- and 18-month follow-up points. There was no difference at any time point on educational outcomes.
Conclusions
This is the largest trial to our knowledge on the effectiveness of IPS in FEP. The IPS group achieved a very high employment rate during the 6 months of the intervention. However, the advantage of IPS was not maintained in the long term. This seems to be related more to an unusually high rate of employment being achieved in the control group rather than a gross reduction in employment among the IPS group.
Background: Clark and Wells' (1995) cognitive model of social anxiety (CWM) explains the maintenance of social anxiety and has been used as a guide for treatment of Social Anxiety Disorder (SAD). Few studies have examined the components of the model together across different samples. Aims: This study had two distinct aims: to test the components of CWM and to examine how the variables of CWM may differ between clinical and non-clinical samples with varying levels of social anxiety. Method: Hypothesized relationships between three groups (i.e. a clinical sample of individuals diagnosed with SAD (ClinS), n = 40; socially anxious students (HSA), n = 40; and, non-anxious students (LSA), n = 40) were investigated. Results: Four out of five CWM variables tested were able to distinguish between highly socially anxious and non-anxious groups after controlling for age and depression. Conclusions: CWM variables are able to distinguish between high and low levels of social anxiety and are uniquely related to social anxiety over depression.
Background: High quality randomized controlled trials (RCT) of psychotherapeutic interventions should ensure that the therapy being tested is what is actually delivered. However, contamination of one therapy into the other, a critical component of treatment adherence, is seldom measured in psychotherapy trials of psychosis. Aims: The aim of the study was to determine whether a purpose-designed measure, the ACE Treatment Integrity Measure (ATIM) could detect therapy contaminations within a controlled trial of cognitive behavioural therapy (CBT) versus Befriending for first-episode psychosis and to compare the ATIM to a more traditional adherence measure, the Cognitive Therapy Scale (CTS). Method: Therapy sessions were audio-recorded and at least one therapy session from 53 of the 62 participants in the RCT was rated by an independent rater using the CTS and ATIM. Results: Ninety-nine therapy sessions were rated. All Befriending sessions and all but three CBT sessions were correctly identified. The ATIM showed that 29 of the 99 (29%) sessions were contaminated by techniques from the other therapy. Within the CBT sessions, 19 of the 51 sessions (37%) were contaminated by one or more Befriending techniques. Of the Befriending sessions, 10 of 48 (21%) were contaminated by ACE techniques. The mean CTS score was higher in the CBT than the Befriending group. Conclusions: The ATIM was able to detect contaminations and revealed more meaningful, fine-grained analysis of what therapy techniques were being delivered and what contaminations occurred. The study highlights the benefit of employing purpose-designed measures that include contamination when assessing treatment adherence.
Founded in 1868 by the Cambridge scholars John Eyton Bickersteth Mayor (1825–1910), William George Clark (1821–78), and William Aldis Wright (1831–1914), this biannual journal was a successor to The Journal of Classical and Sacred Philology (also reissued in the Cambridge Library Collection). Unlike its short-lived precursor, it survived for more than half a century, until 1920, spanning the period in which specialised academic journals developed from more general literary reviews. Predominantly classical in subject matter, with contributions from such scholars as J. P. Postgate, Robinson Ellis and A. E. Housman, the journal also contains articles on historical and literary themes across the 35 volumes, illuminating the growth and scope of philology as a discipline during this period. Volume 20, comprising issues 39 and 40, was published in 1892.
Founded in 1868 by the Cambridge scholars John Eyton Bickersteth Mayor (1825–1910), William George Clark (1821–78), and William Aldis Wright (1831–1914), this biannual journal was a successor to The Journal of Classical and Sacred Philology (also reissued in the Cambridge Library Collection). Unlike its short-lived precursor, it survived for more than half a century, until 1920, spanning the period in which specialised academic journals developed from more general literary reviews. Predominantly classical in subject matter, with contributions from such scholars as J. P. Postgate, Robinson Ellis and A. E. Housman, the journal also contains articles on historical and literary themes across the 35 volumes, illuminating the growth and scope of philology as a discipline during this period. Volume 22, comprising issues 43 and 44, was published in 1894.
Founded in 1868 by the Cambridge scholars John Eyton Bickersteth Mayor (1825–1910), William George Clark (1821–78), and William Aldis Wright (1831–1914), this biannual journal was a successor to The Journal of Classical and Sacred Philology (also reissued in the Cambridge Library Collection). Unlike its short-lived precursor, it survived for more than half a century, until 1920, spanning the period in which specialised academic journals developed from more general literary reviews. Predominantly classical in subject matter, with contributions from such scholars as J. P. Postgate, Robinson Ellis and A. E. Housman, the journal also contains articles on historical and literary themes across the 35 volumes, illuminating the growth and scope of philology as a discipline during this period. Volume 18, comprising issues 35 and 36, was published in 1890.