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Volume 42 Number 5, September/October 2005
Pages 673 — 682


Enhanced cognitive-behavioral therapy for vocational rehabilitation in schizophrenia: Effects on hope and work

Paul H. Lysaker, PhD;1-2* Gary Bond, PhD;3 Louanne W. Davis, PsyD;1 Gary J. Bryson, PsyD;4-5
Morris D. Bell, PhD4-5

1Roudebush Department of Veterans Affairs (VA) Medical Center, Indianapolis, IN; 2Indiana University School of Medicine, Indianapolis, IN; 3Indiana University-Purdue University, Indianapolis, IN; 4VA Health Care Connecticut, West Haven, CT; 5Yale University School of Medicine, New Haven, CT
Abstract — To address the effects of dysfunctional cognitions on vocational outcome of people with schizophrenia spectrum disorders, we developed the Indianapolis Vocational Intervention Program (IVIP), a cognitive-behavioral program of group and individual interventions. Fifty participants with schizophrenia or schizoaffective disorder were offered 6-month work placements and randomized to receive IVIP (n = 25) or standard support services (n = 25). Hours worked were measured weekly, and work performance was assessed biweekly with the use of the Work Behavior Inventory. Hope and self-esteem were assessed at baseline and at 5 months with the Beck Hopelessness Scale and the Rosenberg Self-Esteem Schedule. Analysis of variance (ANOVA) revealed that the IVIP group worked significantly more weeks and had better average work performance than the standard support group. Repeated measures ANOVA of baseline and follow-up scores indicated that the IVIP group sustained baseline levels of hope and self-esteem through follow-up, while the standard support group experienced declines. Results provide initial evidence of the effectiveness of the IVIP.
Key words: cognitive-behavioral therapy, dysfunctional beliefs, hope, psychosocial rehabilitation, schizophrenia, self-efficacy, self-esteem, severe mental illness, vocational function, work.

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