A randomized controlled trial of individual placement and support in Japan

摘要

Objective: The individual placement and support (IPS) model of supported employment has been implemented throughout North America and Europe, with multiple randomized controlled trials documenting its effectiveness, but it has not been widely implemented in Asia. To date, no rigorous evaluations of IPS have been conducted in Japan. We sought to evaluate whether IPS could be implemented in Japan and produce superior competitive employment outcomes compared with conventional vocational services. Method: We employed a randomized controlled trial with a 6-month follow-up; 18 participants were randomly assigned to IPS and 19 to conventional vocational services. We assessed competitive employment rates, hours and weeks worked, and wages earned. Results: Over the 6-month follow-up period, IPS participants were more likely than those in usual care to work competitively (44.4% for IPS vs. 10.5% for controls, p =.022), work more hours (mean of 168 hr for IPS vs. 41 hr for controls, p =.002), and work more weeks (mean of 6.4 weeks for IPS vs. 1.8 weeks for controls, p =.003). Conclusions and Implications for Practice: IPS can be implemented in Japan and yield better competitive employment outcomes than conventional vocational services. Adoption of the IPS model might have a dramatic impact on the mental health service system in Japan where psychiatric hospitals play a central role in mental health care.