Vocational Peer Support for Adults With Psychiatric Disabilities: Results of a Randomized Trial

Objective: Peer support services for individuals with psychiatric conditions have burgeoned and now are proliferating within mental health systems nationally and internationally. More recently, variations of peer support have been developed, including those that focus on vocational outcomes. Methods: We conducted a randomized clinical trial in two mental health programs to test a newly developed model of vocationally oriented peer support. We recruited, randomly assigned, and followed 166 individuals for 12 months; 83 received Vocational Peer Support (the experimental condition, VPS) and 83 received peer support services-as-usual. Peer support specialists (PSS) delivering VPS were trained and supervised. We examined vocational and educational outcomes as well as work hope, quality of life, and work readiness at baseline, 6- and 12-month postrandomization. We assessed the working alliance as well. Results: We found a group-by-time effect on domains of work readiness and modest differences in vocational activity. Secondary analyses revealed that VPS resulted in a stronger working alliance with the peer specialist, which mediated some aspects of a better quality of life and greater work hope. Conclusions and Implications for Practice: In the context of the peer relationship, peer specialists are often called upon to support individuals who are pursuing employment, often without adequate preparation or training. Our findings suggest that vocationally oriented peer support affects several aspects of readiness to pursue work-related goals and mediates some aspects of vocational hope and quality of life. VPS may assist individuals receiving peer support as they choose, get, and keep employment. Impact and Implications Peer support is burgeoning nationally but few initiatives are designed to test its role in promoting vocational outcomes. We developed an intervention that would extend the skills and knowledge of trained peer specialists to deliver support to individuals wishing to engage in a process of choosing, getting, or keeping employment. We conducted a randomized trial of Vocational Peer Support and found some evidence for its effectiveness.