***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: In this paper , we employ a classical experiment to determine if welfare reform causes poor women to experience increased levels of clinical anxiety and depression . We organize our analyses around the insights provided by lifestyle change and ecosocial theories of illness . Our data come from the New Jersey Family Development Program  ( FDP ) , one of the most highly publicized welfare experiments in the U.S. A sample of 8393 women was r and omly assigned into two groups , one which stressed welfare-to-work and the other which offered traditional welfare benefits . These women were followed from 1992 through 1996 and information on clinical diagnoses was collected quarterly from physician treatment cl aims to the government Medicaid program . Our intention-to-treat estimates show that for short-term welfare recipients FDP decreased the prevalence of anxiety by 40 % and increased depression by 8 % . For black women both anxiety and depression diagnoses declined while Hispanic women experienced a 68 % increase in depression . We discuss several public policy implication s which arise from our work This study aim ed to investigate ( a ) whether it is possible to increase  emotional competence  ( EC ) in adulthood ; ( b ) whether this improvement results in better mental , physical , and social adjustment ; ( c ) whether this improvement can be maintained 1 year later ; and ( d ) whether these benefits are accompanied by a reduction in stress-hormone secretion ( i.e. , cortisol ) . One hundred and thirty-two participants were r and omly assigned to an  EC-enhancing intervention ( in group format ) or to a control group .  Participants in the intervention group underwent a specifically design ed 15-hr intervention targeting the 5 core emotional competencies , complemented with a 4-week e-mail follow-up . Results reveal that the level of emotional competencies increased significantly in the intervention group in contrast with the control group . This increase result ed in lower cortisol secretion , enhanced subjective and physical well-being , as well as improved quality of social and marital relationships in the intervention group . No significant change occurred in the control group . Peer reports on EC and quality of relationships confirmed these results . These data suggest that emotional competencies can be improved , with effective benefits on personal and interpersonal functioning lasting for at least 1 year . The theoretical implication s of these results as well as their practical implication s for the construction and the development of effective emotional competencies interventions are discussed Background In the developing world , access to small , individual loans has been variously hailed as a poverty-alleviation tool – in the context of " microcredit " – but has also been criticized as " usury " and harmful to vulnerable borrowers . Prior studies have assessed effects of access to credit on traditional economic outcomes for poor borrowers , but effects on mental health have been largely ignored . Methods Applicants who had previously been rejected ( n = 257 ) for a loan ( 200 % annual percentage rate – APR ) from a lender in South Africa were r and omly assigned to a " second-look " that encouraged loan officers to approve their applications . This r and omized encouragement result ed in 53 % of applicants receiving a loan they otherwise would not have received . All subjects were assessed 6–12 months later with questions about demographics , socio-economic status , and two indicators of mental health : the Center for Epidemiologic Studies – Depression Scale ( CES-D ) and Cohen 's Perceived Stress scale . Intent-to-treat analyses were calculated using multinomial probit regressions . Results R and omization into receiving a " second look " for access to credit increased perceived stress in the combined sample of women and men ; the findings were stronger among men . Credit access was associated with reduced depressive symptoms in men , but not women . Conclusion Our findings suggest that a mechanism used to reduce the economic stress of extremely poor individuals can have mixed effects on their experiences of psychological stress and depressive symptomatology . Our data support the notion that mental health should be included as a measure of success ( or failure ) when examining potential tools for poverty alleviation . Further longitudinal research is needed in South Africa and other setting s to underst and how borrowing at high interest rates affects gender roles and daily life activities . CCT : IS RCT N The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . This study evaluated benefits of a preventive intervention to the living st and ards of recently separated mothers . In the Oregon Divorce Study 's r and omized experimental design , data were collected 5 times over 30 months and evaluated with Hierarchical Linear Growth Models . Relative to their no-intervention control counterparts , experimental mothers had greater improvements in gross annual income , discretionary annual income , poverty threshold , income-to-needs ratios , and financial stress . Comparisons showed the intervention to produce a greater increase in income-to-needs and a greater rise-above-poverty threshold . Benefits to income-to-needs were statistically independent of maternal depressed mood , divorce status , child support , and repartnering . Financial stress reductions were explained by the intervention effect on income-to-needs . The importance of helping disadvantaged families with evidence -based programs is discussed Analyses of data from a r and omized field experiment with 1,801 participants ( A.D. Vinokur , R.H. Price . & Y.Schul , 1995 ) examined the long-term effects of a job- search workshop ( JOBS )  and the independent effects of demographic and psychological factors on reemployment and mental health outcomes . Two years after the JOBS workshop , the experimental group had significantly higher levels of reemployment and monthly income , lower levels of depressive symptoms , lower likelihood of experiencing a major depressive episode in the last year , and better role and emotional functioning compared with the control group .  Baseline job- search motivation and sense of mastery had both direct and interactive effects ( with experimental condition ) on reemployment and mental health outcomes , respectively . The interactive effects demonstrated larger benefits for those who had initial low levels of job- search motivation and mastery Conducted process analysis of treatment mediation effects ( Judd & Kenney , 1981 ) on longitudinal data from a large r and omized field experiment with 928 recently unemployed persons . The experimental treatment included an intervention that succeeded in promoting quality reemployment outcomes , as described in earlier reports ( Caplan et al. , 1989 ; Vinokur et al. , 1991 ) . Using Ajzen 's theory of planned behavior ( Ajzen , 1985 , 1988 ) , the analyses examined the mediating effects of job- search self-efficacy , attitude , norms , and intention on job- search behavior . The results provided substantial support for the theory of planned behavior and demonstrated the mediational role of job- search self-efficacy . For both 1- and 4-month posttests , job- search self-efficacy was shown to mediate the effects of the intervention through its direct effects on job- search intention and on short term job- search behavior , as well as through its indirect effects on subjective norms and attitude . However , in the longer term 4-month posttest , exposure to the intervention had a direct effect on job- search behavior . This long-term direct effect of the intervention was hypothesized to reflect the influence of inoculation against setbacks which is essential for sustaining the long-term behavioral efforts involved in job seeking PURPOSE The purpose of this study was to determine the relationship between the working alliance and employment outcomes in persons with severe mental illness receiving vocational services . Another purpose of this study was to determine whether working alliance differences exist between clients receiving evidence -based supported employment services  and those receiving traditional stepwise vocational services .  DESIGN This study was a secondary analysis of a 2-year r and omized controlled trial comparing two employment programs providing services to people with severe mental illness . RESULTS Contrary to expectations , no overall relationship was found between the working alliance and employment outcomes . As predicted , supported employment participants each assigned to a single vocational worker had more positive working alliances than participants served by a team of vocational workers in the traditional vocational program . CONCLUSIONS / IMPLICATION S The lack of an association between the working alliance and employment outcomes is inconsistent with previous literature . Further research is needed using st and ardized working alliance measures and larger sample s that include both working and nonworking clients . Evidence -based supported employment , which employs individual caseloads , seems to foster better relationships than a team-based vocational approach , although future research is needed to replicate this finding The impact of preventive interventions for the unemployed may vary depending on the context of the labor policies and benefit systems of the country where it is implemented . The Työhön Job Search Program was based on a method developed in the United States for recently unemployed workers . This study examined outcomes of the intervention in the context of the European labor market for participants who had been unemployed for a longer period . A total of 1,261 unemployed Finnish job seekers participated in a r and omized field study . At the 6-month follow-up , the program had a beneficial impact on the quality of reemployment , especially among those who had been unemployed for a moderate time period . The program also significantly decreased psychological distress Drawing on coping re sources theory , we evaluate the impact of a  job search intervention on  depressive symptoms  in a r and omized field experiment at three follow-up periods covering two and one-half years . Baseline depressive symptoms , low social assertiveness , and financial hardship were identified as significant risk variables predicting depressive symptoms at follow-up . These variables then were used to identify high- and low-risk individuals in both experimental and control groups . Results indicated that the job search intervention had its primary impact on persons identified as being at higher risk for depression . Furthermore , the intervention had an impact on both the incidence and prevalence of more severe depressive symptoms among high-risk individuals The process linking unemployment and economic hardship to depression and marital or relationship satisfaction in couples was examined . Using structural equation modeling , the authors tested models in which financial strain and partners ' symptoms of depression influence the behavioral exchange of the couples in terms of social support and social undermining and , in turn , the effects of support and undermining on relationship satisfaction and depressive symptoms . The analyses were based on longitudinal data from 815 recently unemployed job seekers and their spouses or partners . The results demonstrated that financial strain had significant effects on depressive symptoms of both partners , which in turn led the partner to withdraw social support and increase social undermining . Reduced supportive and increase undermining behaviors had additional adverse effects on satisfaction with the relationship and on depressive symptoms Cognitive theories of adherence to difficult courses of action and findings from previous survey research on coping with a major life event -- job loss -- were used to generate a preventive intervention , tested by a r and omized field experiment . The aim was to prevent poor mental health and loss of motivation to seek reemployment among those who continued to be unemployed and to promote high- quality reemployment . Ss were 928 recently unemployed adults from southeastern Michigan , representing a broad range of demographic characteristics ; they were r and omly assigned to either the experimental or control condition . The experimental intervention included training in job seeking with a problem-solving process emphasizing inoculation against setbacks and positive social reinforcement . A pretest was administered , followed by posttests 1 and 4 months after the experiment . The experimental condition yielded higher quality reemployment in terms of earnings and job satisfaction , and higher motivation among those who continued to be unemployed TOPIC Supported Employment ( SE ) can help transition age youth and young adults to obtain employment and develop meaningful careers and financial security . PURPOSE The purpose of this analysis is to examine the role of SE in achieving employment outcomes for youth ( ages 18 - 24 ) and young adults ( ages 25 - 30 ) , compared to outcomes for older adults . Given the importance of employment to the quality of life of young people in establishing work histories and starting careers , it is important to have a better underst and ing of what client and program characteristics result in better employment outcomes . SOURCES USED Data are from the Employment Intervention Demonstration Program ( EIDP ) , a multisite r and omized controlled trial of SE  among 1,272 individuals with psychiatric disabilities in 7 states . CONCLUSIONS AND IMPLICATION S FOR PRACTICE Among all study participants , youth and young adults had significantly better outcomes in terms of any employment and competitive employment than older ( > 30 years ) adults . However , in multivariable models of participants r and omly assigned to SE , young adults had significantly better outcomes than youth or older adults . Other significant predictors of employment and competitive employment were future work expectations , not receiving Supplemental Security Income , and receipt of more hours of SE services . Characteristics of youth , young adults and SE programs that enhance employment are discussed in terms of policy and practice Objectives : The aim of the present study was to examine and compare the long-term effectiveness of the Integrated Supported Employment ( ISE ) programme , which consists of individual placement and support ( IPS ) and work-related social skills training , with the IPS programme on the vocational and non-vocational outcomes among individuals with severe mental illness ( SMI ) over a period of 3 years . Method : One hundred and eighty-nine participants with SMI were recruited from two non-government organizations and three day hospitals in Hong Kong and r and omly assigned into the ISE ( n = 58 ) , IPS ( n = 65 ) and traditional vocational rehabilitation ( TVR ) ( n = 66 ) groups . Vocational and non-vocational outcomes of the ISE and IPS participants were collected by a blind and independent assessor at 7 11 , 15 , 21 , 27 , 33 and 39 months after their admission , whereas the TVR groups were assessed only up to the 15th month follow up . Results : After 39 months of service provision , ISE participants obtained higher employment rate ( 82.8 % vs 61.5 % 
    Output:
    
There was mixed evidence for effectiveness of group CBT on symptoms of depression .
An RCT of debt advice found no effect but had poor uptake .
' Job-club ' interventions may be effective in reducing depressive symptoms in unemployed people , particularly those at high risk of depression .