***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There is evidence from North American trials that supported employment using the individual placement and support ( IPS ) model is effective in helping individuals with severe mental illness gain competitive employment . There have been few trials in other parts of the world . Aims To investigate the effectiveness and cost-effectiveness of IPS in the UK . Method Individuals with severe mental illness in South London were r and omised to IPS or local traditional vocational services ( treatment as usual ) ( IS RCT N96677673 ) . Results Two hundred and nineteen participants were r and omised , and 90 % assessed 1 year later . There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment ( 13 % in the intervention group and 7 % in controls ; risk ratio 1.35 , 95 % CI 0.95–1.93 , P = 0.15 ) , nor in secondary outcomes . Conclusions There was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up , which may reflect suboptimal implementation . Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services , and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals BACKGROUND An international six-centre r and omised controlled trial comparing individual placement and support ( IPS ) with usual vocational rehabilitation  for people with serious mental illness found IPS to be more effective for all vocational outcomes . AIMS To determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes . METHOD Patient characteristics and early process variables were tested as predictors of employment outcomes . Service characteristics were explored as predictors of the effectiveness of IPS . RESULTS Patients with previous work history , fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer . Remission and swifter service uptake were associated with working more . Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness . CONCLUSIONS The IPS service was found to be more effective for all vocational outcomes . In addition , maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions , leading to improved employment outcomes . Motivation to find work may be decreased by satisfaction with current life circumstances This report describes the results of a r and omized controlled feasibility study of the Mindfulness Intervention for Rehabilitation and Recovery in Schizophrenia ( MIRRORS ) . MIRRORS is an adaptation of Mindfulness-Based Stress Reduction design ed to help persons with schizophrenia to persist and perform better at work . Thirty-four participants with schizophrenia or schizoaffective disorder who were engaged in outpatient services were enrolled in a vocational rehabilitation program that included a  job placement  and then were r and omized to receive MIRRORS ( n = 18 ) or Intensive Support ( n = 16 ) over a period of 16 weeks . The number of hours worked was recorded weekly and job performance was assessed monthly using the Work Behavior Inventory . Results of t-tests revealed that participants in the MIRRORS group worked a significantly greater number of hours and performed significantly better at the end of the 4-month intervention than those in the Intensive Support condition . Repeated- measures analysis of variance revealed that the MIRRORS group worked more hours each week on average and that this difference increased over time as well as having generally better work performance compared with the Intensive Support group . Results suggest a link between MIRRORS and higher levels of work performance and persistence in people with schizophrenia . Further research is indicated to evaluate MIRRORS in a fully powered r and omized controlled trial OBJECTIVE This purpose of this study was to determine whether participation in the Work-Ordered Day program of the Clubhouse model has a positive effect on vocational outcomes . METHOD The longitudinal study followed a group of individuals with severe mental illness who were r and omly assigned either to a Clubhouse program or a Program of Assertive Community Treatment team .  Study participants were tracked for 135 weeks . These analyses evaluated the relationship between Work-Ordered Day participation and employment duration for the 43 study participants enrolled in the Clubhouse program who were active throughout the study and competitively employed during the study . RESULTS Participation in the Work-Ordered Day program had a significant positive impact on average duration of employment . On average , a 1-hr increase in participation prior to employment led to an increase of 2.3 weeks in competitive employment . CONCLUSIONS AND IMPLICATION S FOR PRACTICE Participants with more Work-Ordered Day program participation prior to employment had significantly longer average competitive employment duration even when controlling for prior work history . Participation in the Work-Ordered Day program is likely to improve work readiness . Further research is warranted to study which elements of the program may foment employment success . This could lead to increased implementation of the Work-Ordered Day program and its elements as precursors to employment for adults with severe mental illness OBJECTIVES The present study aims to investigate the synergistic effects of cognitive remediation training ( CRT ) on Integrated Supported Employment ( ISE ) . ISE blends individual placement support service with work-related social skills training for Chinese people suffering from schizophrenia or schizoaffective disorder . METHOD Ninety participants with schizophrenia or schizoaffective disorders were recruited from two psychiatric outpatient services in Hong Kong . They were r and omly assigned into the ISE+CRT ( n=45 ) and ISE ( n=45 ) conditions . Blinded assessment s on vocational , clinical , psychological , and neurocognitive outcomes were conducted by independent assessors . The two groups were followed up at 7 and 11months . RESULTS Both groups yielded similar improvements across several outcome domains assessed immediately after the interventions and at 7 and 11month follow-ups , but no significant group differences were found . Significant positive trends over time in vocational , clinical and cognitive outcomes consistently favored the ISE+CRT condition . CONCLUSION While both the ISE+CRT and ISE groups demonstrated improvement in vocational , clinical , psychological , and neurocognitive outcomes , there was no evidence to show that cognitive remediation facilitated further improvement in these domains beyond gains associated with ISE alone . Further investigation is needed to fully exploit the synergistic potential of ISE combined with CRT , and to better underst and which individuals experience a maximal benefit from the specific rehabilitation program components OBJECTIVE Schizophrenia is a mental disorder and characterized by abnormal social behavior and failure to recognize what is real . The current study was to explore the long-term effects of cognitive rehabilitation training on schizophrenia . METHODS Eighty six cases of hospitalized patients with schizophrenia were r and omly divided into study group and control group . The relapse and employment ( attending school ) rates were used as indicators to assess the treatment effect . All patients were followed up by 2 years . Kaplan-Meier survival analysis was conducted with relapse and employment ( attending school ) rates . RESULTS The rates of relapse in the study group and the control group were 18 % and 41 % , and relapse free survival time was 22.22 months and 18.55 months ; the rates of employment ( attending school ) were 64 % and 43 % , and not employment ( attending school ) time were 10.68 months and 15.74 months , respectively . There was significant difference between the two groups ( P<0.05 ) . CONCLUSIONS We found that the cognitive rehabilitation training could significantly reduce  schizophrenic relapse rate , prolong the time of patients without relapse , improve the employment ( attending school ) rate , and shorten the discharged time , which is a powerful treatment method to improve social competence in schizophrenia patients Hoffmann H , Jäckel D , Glauser S , Kupper Z. A r and omised controlled trial of the  efficacy  of supported employment Abstract Background Although the effectiveness of individual placement and support ( IPS ) has been well established , little is known about clients ’ perceptions of the model compared to usual vocational rehabilitation , nor about their experiences of search ing for and returning to work with this kind of support . This qualitative study aim ed to explore clients ’ views of the difficulties of obtaining and maintaining employment , their experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients ’ lives . MethodS emi-structured interviews were conducted with 48 people with psychotic disorders participating in a six-centre international r and omised controlled trial of IPS compared to usual vocational rehabilitation .  To assess their experiences of the services and the perceived effects of working , two  IPS  and two Vocational Service clients at each centre who had found work during the study period were interviewed , along with two IPS and two Vocational Service clients at each centre who had not . Results IPS clients reported having received more help seeking and maintaining employment , whereas Vocational Service clients reported having received more help in finding sheltered employment or placements . Clients who had worked associated this with financial stability , improved social lives , increased self-esteem , integration into society and amelioration of their symptoms , as well as reduced feelings of boredom and isolation , but also reported increased levels of stress .  IPS clients as well as Vocational Service ones reported not receiving enough follow-up support , despite this being proposed as a key feature of the model . Conclusion Findings from the in-depth interviews reflect differences in service models that have also been tested quantitatively but further work in disaggregating the IPS model and assessing the impact of each component would be valuable Several studies in schizophrenia found a positive association between cognitive performance and work status , and it has been reported that good cognitive performance at the outset does predict the success of vocational interventions . However little has been done to investigate whether vocational interventions itself benefit cognitive performance . To test this hypothesis we performed a r and omized , placebo-controlled trial to investigate in remitted schizophrenic patients the effect of a 6-months vocational rehabilitation program on cognitive performance . We recruited 112 remitted and clinical ly stable schizophrenic patients who aim ed to enter a vocational rehabilitation program .  From these , 57 immediately entered a 6-months vocational rehabilitation program , whereas the remaining 55 were allocated to a waiting-list ; the latter formed our control group , which received during the 6 months out-clinic follow-up treatment . Before and after the 6-months period we assessed changes in cognitive performance through a neuropsychological test battery , as well as changes in the psychopathological status and in quality of life . We found that vocational rehabilitation significantly improved patients ' performance in cognitive measures that assess executive functions ( concept formation , shifting ability , flexibility , inhibitory control , and judgment and critics abilities ) . Moreover , after 6 months the vocational group improved significantly in the negative symptoms and in quality of life , as compared to controls . Together with results from the literature , our findings reinforce the notion that the inclusion of vocational interventions may enhance the effectiveness of therapeutic strategies for schizophrenia patients BACKGROUND Concerns are frequently expressed that working might worsen the mental health of people with severe mental illness ( SMI ) . Several studies of Individual Placement and Support ( IPS ) , however , have found associations between working and better nonvocational outcomes . IPS has been found to double the return to work of people with SMI in 6 European countries . AIMS To explore separately associations between IPS , returning to work , and clinical and social outcomes . METHODS Patients ( n = 312 ) in a r and omized controlled trial of IPS in 6 European centers were followed up for 18 months . RESULTS There were no differences in clinical and social functioning between IPS and control patients at 18 months . Those who worked had better global functioning , fewer symptoms , and less social disability at final follow-up ; greater job tenure was associated with better functioning . Working was associated with concurrently better clinical and social functioning , but this contrast was stronger in the control group , suggesting that IPS was better than the control service at helping more unwell patients into work . Working was associated with having been in remission and out of hospital for the previous 6 months . It was also associated with a slight decrease in depression and with being in remission over the subsequent 6 months . CONCLUSIONS Concerns among clinicians about possible detrimental effects of working and supported employment have been misplaced . Although some of the associations found may have been selection effects , there is sufficient evidence of work having beneficial effects on clinical and social functioning to merit further exploration OBJECTIVE Despite the large number of Latinos living in the United States , little research has evaluated the effectiveness of different vocational rehabilitation programs for individuals with severe mental illness in this rapidly growing minority population . This article presents a secondary analysis of a r and omized , controlled trial comparing supported employment with 2 other vocational rehabilitation programs in 3 ethnic/racial groups of participants with severe mental illness : Latinos , non-Latino African Americans , and non-Latino Whites . METHOD The data were drawn from a previously published r and omized , controlled trial comparing supported employment with st and ard vocational rehabilitation services and a psychosocial clubhouse program in persons with severe mental illness ( Mueser et al. , 2004 ) , including 64 Latinos , 91 non-Latino African Americans , and 43 non-Latino Whites . Comparisons were made between the 3 groups at baseline on demographic characteristics , clinical and psychosocial functioning , and quality of life . Within each ethnic/racial group , competitive employment and all paid employment outcomes were compared between the 3 vocational rehabilitation programs over the 2-year study period . RESULTS At baseline , the Latino participants had lower levels of education and disability income , were less likely to have worked competitively over the previous 5 years , had more severe symptoms , and worse psychosocial functioning than the non-Latino African American or non-Latino White participants . Latinos r and omized to supported employment had better competitive and all-paid work outcomes than those assigned to either st and ard services or the 
    Output:
    
For employment , strong evidence was found for the Individual Placement and Support ( IPS ) model and cognitive interventions .
For education , moderate evidence was found for supported education interventions .
This systematic review supports the role of occupational therapy practitioners in promoting the implementation of IPS , cognitive‐based , and social skills programs to improve vocational and educational outcomes for adults with SMI .
& NA ; Evidence supports the role of occupational therapy practitioners in promoting the implementation of IPS , cognitive‐based , and social skills programs to improve vocational and educational outcomes for adults with SMI