We use cookies on our website to provide you with the best possible user experience. Disabling these cookies may prevent our site from working efficiently. To find out more about our cookies read our privacy policy.

Journal article review: Supported education for adults with psychiatric disabilities

Genevieve SmythSupported education for adults with psychiatric disabilities: Effectiveness of an occupational therapy program, reviewed by Genevieve Smythe of The College of Occupational Therapists.

The authors of this study set out to assess the effectiveness of a supported education program for adults with psychiatric disabilities in the USA. They randomly assigned 21 service users to an experimental group that received a program of supported education and 17 service users to a control group who received treatment as usual. Using a variety of assessment tools they found statistically significant differences between the experimental and control groups and report that at six month follow up, 63% of those who had completed the supported education programme were in education or employment while only 6% of the control group were in education. They advocate repeating the study with larger samples to be better able to generalise the findings.

The authors offer a fair critique of their study including the fact that only three of the measures used were standardised.  I would add the following comments on the quality of this research.  Generally there is sufficient information provided to replicate this study apart from information about how they conducted their literature review or recruited their participants. My main concern however with the article’s assertion about the success of the program versus treatment as usual is there is no comparison of hours of face to face contact received. For example, a participant on the training program received six hours of contact a week, a large amount of input by UK standards. If the group receiving treatment as usual only received one hour of contact a week, the results may be due to increased contact rather than the specific intervention.

Additionally, as the training programme was delivered by occupational therapy students, the authors have used the opportunity to rate their attitudes to mental illness before and after the programme delivery, coming to the unsurprising conclusion that their attitudes improved by the end of the course. As this has nothing to do with the aim of the research it is not clear why it has been included in the report.

Lastly, the authors have only one article in their reference list which considers the Individual placement and support model where lengthy training periods to increase skill levels are replaced with rapid job search, placement and increased emphasis on post employment support (“place then train” rather than “train then place”). It is interesting that the authors make no comment on this alternative, American model particularly as they assert that improving access to education, by for example, completing their course, will improve service user’s employment prospects.  The debate about the respective evidence bases for different methods to increase mainstream participation cannot be avoided for much longer  but may have been beyond the remit of this paper! 

If you would like to read this research article the reference is:

Gutman SA, Kerner R, Zombek I, Dulek J, Ramsey AC (2009)  Supported education for adults with psychiatric disabilities: Effectiveness of an occupational therapy program. American Journal of Occupational Therapy, 63, 245-254.