VA research in action
Individual Placement and Support to help Veterans find jobs
Photo for illustrative purposes only. ©iStock/alvarez
VA researchers have developed an Individual Placement and Support program to help Veterans with PTSD find sustainable competitive employment.
IPS, developed in the 1990s outside VA, was created to help people with serious mental illness (e.g., schizophrenia, bipolar disorder, and depression) find employment. It starts with in-depth interviews to explore a person's interests and aspirations. The model relies heavily on individualized job development by employment specialists, who spend most of their time in the community, networking and developing job possibilities geared to each individual's experiences, interests, and backgrounds. The outreach and support is more intensive in the first few months; it then tapers off as the participant gets stabilized in the work setting. Long-term career development continues even once the participant is placed.
"IPS is very individualized and meets the Veteran at their point in the recovery process to help them attain the goals that they personally set in terms of jobs that match with their preferences, skills, and abilities." –Dr. Lori L. Davis
VA recently began offering IPS to Veterans with PTSD. A study that ran from 2013 to 2017 showed that IPS is more effective than older vocational programs that used transitional work for people with PTSD. In the study of 541 Veterans with PTSD, 39 percent of those in the IPS program found steady work, compared with only 23 percent of those doing one-size-fits-all transitional work. For the IPS group, 69 percent found competitive jobs, compared with 57 percent in the transitional work group. The IPS group also had a higher average income. After the program showed success at 12 VA medical centers, plans were put in place to implement it throughout the VA health care system.
Although IPS was designed for people with mental health problems, VA has also used it to help Veterans with spinal cord injuries find work. A 2014 study found that IPS was more effective than vocational rehabilitation at helping Veterans with SCI find work. In a 2017 study, almost half of Veterans with SCI participating in a 24-month IPS program found competitive employment. The researchers concluded that offering IPS as part of ongoing SCI care can help spinal cord-injured Veterans achieve better employment outcomes.
Principal investigator: Lori L. Davis, M.D.; Tuscaloosa VA Medical Center
Lisa Ottomanelli, Ph.D.; James A. Haley Veterans' Hospital
Davis LL, Kyriakides TC, Suris AM, Ottomanelli LA, Mueller L, Parker PE, Resnick SG, Toscano R, Scrymgeour AA, Drake RE. Effect of evidence-based supported employment vs transitional work on achieving steady work among Veterans with posttraumatic stress disorder. JAMA Psychiatry. 2018;75(4):316-324.
Davis LL, Leon AC, Toscano R, Drebing CE, Ward LC, Parker PE, Kashner TM, Drake RE. A randomized controlled trial of supported employment among veterans with posttraumatic stress disorder. Psychiatr Serv. 2012;63(5):464-70.
Davis LL, Pilkinton P, Poddar S, Blansett C, Toscano R, Parker PE. Impact of social challenges on gaining employment for veterans with posttraumatic stress disorder: an exploratory moderator analysis. Psychiatr Rehabil J. 2014 Jun;37(2):107-9.
Ottomanelli L, Goetz LL, Barnett SD, Njoh E, Dixon TM, Holmes SA, LePage JP, Ota D, Sabharwal S, White KT. Individual Placement and Support in spinal cord injury: a longitudinal observational study of employment outcomes. Arch Phys Med Rehabil. 2017 Aug;98(8):1567-1575.
Ottomanelli L, Barnett SD, Toscano R. Individual placement and support (IPS) in physical rehabilitation and medicine: the VA spinal cord injury experience. Psychiatr Rehabil J. 2014 Jun;37(2):110-2.