Individual Placement and Support Focusing on Employment and Education for Young People at Clinical High Risk of Psychosis: A Feasibility Study

Objective: This study aimed to assess the feasibility of implementing Individual Placement and Support (IPS) with a focus on educational and employment goals, within a clinical service for the early detection of individuals at clinical high risk (CHR) of psychosis. Method: Between June 2019 and April 2021, participants were recruited and received up to 6 (+/- 2) months support. Primary outcome: Enrolled participants, attended sessions, and disengagement rates were analyzed to assess feasibility. Secondary Outcomes: Enrollment in mainstream education or/and employment, hours spent working or/and studying, salary, level of functioning, and self-efficacy at baseline and follow-up were compared. Results: Thirty-one participants were recruited, 13 of whom were remotely recruited after the first COVID-19 lockdown. Dropout rates were relatively low (16.1%), and 26 participants (83.9%) completed the program. Each participant received on average nine sessions (M = 9.65; SD = 4.92). Secondary outcomes: At follow-up, 73.1% participants were employed, working on average more hours per week, t(25) = -2.725; p = .012, and were earning significantly more money, t(25) = -3.702; p = .001, compared to baseline. Gains in educational outcomes were less clear. Global Assessment of Functioning, t = 248.50; p = .001, and Social Occupational Functioning, t(25) = -3.273; p = .003, were significantly higher at 6-month follow-up compared to baseline. No differences were found in participants' self-efficacy. Conclusions and Implications for Practice: Findings indicate that research procedures are appropriate and that IPS implementation within a CHR clinical team is feasible. Secondary outcomes also suggest that IPS may be a beneficial intervention for young people at CHR. A longer follow-up might be needed to assess its impact on educational outcomes.

Automated summary

This study assessed the feasibility of implementing Individual Placement and Support (IPS) with a focus on educational and employment goals within a clinical service for individuals at clinical high risk (CHR) of psychosis. The findings suggest that IPS implementation within a CHR clinical team is feasible and may be a beneficial intervention for young people at CHR. Longer follow-up is needed to assess its impact on educational outcomes.