Skip to main content
Log in

Work therapy for schizophrenic patients: Results of a 3-year prospective study in Germany

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Work therapy is a widespread form of sociotherapy. In contrast to pharmacological and somatic forms of treatment, proof of efficacy is difficult to produce in multimodal therapy of schizophrenic patients on account of the many methodological problems involved. Within the framework of an extensive study on the vocational rehabilitation of mentally ill patients, we carried out a naturalistic follow-up study of 83 schizophrenic patients attending outpatient work therapy. The sample, which comprised 44 men and 38 women with a mean age of 35 years (± 8.5 years), can be seen as regionally representative. The courses of illness and rehabilitation were documented prospectively at annual follow-ups over a 3-year period. Most of the probands were chronically mentally ill patients with a history of frequent and long-term hospitalisation. At the end of the 3-year period, 22% of the patients were integrated into the open labour market, 26% were working in sheltered employment, 23% were still in work therapy, and 29% were unemployed. Two-thirds had achieved their stated rehabilitation objectives. The 3-year rehabilitation outcome was strongly dependent on the patients’ subjective expectations. Other factors proving to be predictors of successful rehabilitation were less pronounced psychopathological symptoms (ADMP), better social functioning (GAS), a higher level of education and an early introduction to work therapy. Work therapy appears to have a favourable impact on hospitalisation rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie AMDP (1981) Das AMDP-System. Manual zur Dokumentation psychiatrischer Befunde. Springer, Berlin Heidelberg New York

    Google Scholar 

  2. Becker RE (1967) An evaluation of a rehabilitation program for chronically hospitalized psychiatric patients. Soc Psychiatry 2: 32–38

    Article  Google Scholar 

  3. Bell MD, Ryan ER (1984) Integrating psychosocial rehabilitation into the hospital psychiatric service. Hosp Community Psychiatry 35: 1017–1028

    PubMed  CAS  Google Scholar 

  4. Bell MD, Lysaker PH, Milstein RM (1996) Clinical benefits of paid work affectivity in schizophrenia. Schizophr Bull 22 (1): 51–67

    PubMed  CAS  Google Scholar 

  5. Bennett DH (1975) Techniques of industrial therapy, ergotherapy and recreative methods. In: Kisker KP et al (eds) Psychiatrie der Gegenwart III. Springer, Berlin Heidelberg New York, pp 743–778

    Google Scholar 

  6. Bond GR, Boyer SL (1988) Rehabilitation programs and outcomes. In: Ciardiello JA, Bell MD (eds) Vocational rehabilitation of persons with prolonged psychiatric disorders. Johns Hopkins University Press, Baltimore, pp 231–271

    Google Scholar 

  7. Bond GR (1991) Vocational rehabilitation. In: Liberman RP (eds) Handbook of psychiatric rehabilitation. Allyn and Bacon, Boston, pp 244–275

    Google Scholar 

  8. Buell G, Anthony WA (1973) Demographic characteristics as predictors of recidivism, and post-hospital employment. J Couns Psychol 20: 361–365

    Article  Google Scholar 

  9. Dion GL, Anthony WA (1987) Research in psychiatric rehabilitation: A review of experimental and quasi-experimental studies. Rehab Counsel Bull 30: 177–203

    Google Scholar 

  10. Eikelmann B, Reker Th (1993) A second labour market? Vocational rehabilitation and work integration of chronically mentally ill people in Germany. Acta Psychiatr Scand 88: 124–129

    Article  PubMed  CAS  Google Scholar 

  11. Endicott JR, Spitzer MD, Fleiss JL, Cohen J (1976) The Global Assessment Scale. Arch Gen Psychiatry 33: 766–771

    PubMed  CAS  Google Scholar 

  12. Fabian ES (1992) Longitudinal outcomes in supportes employment: a survival analysis. Rehab Psychol 37: 23–35

    Article  Google Scholar 

  13. Fidler GS, Fidler JW (1994) A retrospective view of the affiliation of occupational therapy and psychiatry. Hosp Community Psychiatry 45: 978–980

    PubMed  CAS  Google Scholar 

  14. Freudenberg RK. (1967) Theory and practice of the rehabilitation of the psychiatrically disabled. Psychiatr Q: 698–710

  15. Gebhardt R, Pietzcker A, Strauss A, Stoeckel M, Langer C, Freudenthal K (1983) Skalenbildung im AMDP-System. Arch Psychiatr Nervenkr 233: 233–245

    Google Scholar 

  16. Goldberg SC, Schooler NR, Hogarty GE, Roper M (1977) Prediction of relapses in schizophrenic outpatients treated by drug and sociotherapy. Arch Gen Psychiatry 34: 171–184

    PubMed  CAS  Google Scholar 

  17. Harlfinger H (1968) Arbeit als Mittel psychiatrischer Therapie. In: Wiesenhütter E (ed) Schriftenreihe zur Theorie und Praxis der Medizinischen Psychologie. Bd. 13, Hippokrates Verlag, Stuttgart

    Google Scholar 

  18. Hubschmid T, Aebi E (1986) Berufliche Wiedereingliederung von psychiatrischen Langzeitpatienten, Eine katamnestische Untersuchung. Soc Psychiatry 21: 152–157

    Article  PubMed  CAS  Google Scholar 

  19. Johnson RF, Lee H (1965) Rehabilitation of chronic schizophrenics. Arch Gen Psychiatry 12: 237–240

    PubMed  CAS  Google Scholar 

  20. Kiresuk TJ, Lund S (1979) Goal attainment scaling: research, evaluation and utilization. In: Schulberg C, Baker F (eds) Program evaluation in the health fields, 2. Human Sciences, New York

    Google Scholar 

  21. Kuldau JM, Dirks StJ (1977) Controlled evaluation of a hospital-originated community transitional system. Arch Gen Psychiatry 34: 1331–1340

    PubMed  CAS  Google Scholar 

  22. Lamb HR (1994) A century and a half of psychiatric rehabilitation in the United States. Hosp Community Psychiatry 45: 1015–1020

    PubMed  CAS  Google Scholar 

  23. Lee LL, Romney DM (1990) Personal factors related to premature withdrawal from a vocational rehabilitation centre. Can J Rehab 3: 141–149

    CAS  Google Scholar 

  24. Lehmann F (1996) Vocational rehabilitation in schizophrenia. Schizophr Bull 21 (4): 645–656

    Google Scholar 

  25. Lewandowski L, Buchkremer G, Hermann T (1992) Zur Wirksamkeit ambulanter arbeitstherapeutischer Massnahmen für schizophrene Patienten. Psychiatr Prax 19: 122–128

    PubMed  CAS  Google Scholar 

  26. Lewis AB, Spencer JH, Haas L, DiVittis A(1987) Goal attainment scaling. Relevance and replicability in follow-up of inpatients. J Nerv Ment Dis: 408–418

  27. Lysaker P, Bell M (1995) Work rehabilitation and improvements in insight in schizophrenia. J Nerv Ment Dis 183: 103–106

    Article  PubMed  CAS  Google Scholar 

  28. Marx AJ, Test MA, Stein LI (1973) Extrahospital management of severe mental illness: feasibility and effects of social functioning. Arch Gen Psychiatry 29: 505–511

    PubMed  CAS  Google Scholar 

  29. Mintz J, Mintz LI, Phipps C (1991) Treatments of mental disorders and the functional capacity to work. In: Liberman RP (eds) Handbook of psychiatric rehabilitation. Allyn and Bacon, Needham Heights, pp 290–316

    Google Scholar 

  30. Neuberger O, Allerbeck M (1978) Messung und Analyse von Arbeitszufriedenheit mit dem ABB. Erfahrungen mit dem Arbeitsbeschreibungsbogen ABB. Huber, Bern

    Google Scholar 

  31. Reker T, Mues Ch, Eikelmann B (1990) Perspektiven der Arbeitsrehabilitation psychisch Kranker und Behinderter — ein Überblick über den Stand und die Probleme im Landesteil Westfalen. Öffentliches Gesundheitswesen 12(52): 691–695

    Google Scholar 

  32. Reker T, Eikelmann B (1994) Ambulante Arbeitstherapie. Ergebnisse einer multizentrischen, prospektiven Evaluationsstudie. Nervenarzt 65: 329–337

    PubMed  CAS  Google Scholar 

  33. Schulze-Mönking H, Buchkremer G, Krawietz Ch (1987) Aspekte ambulanter Arbeitstherapie. Psychiatr Prax 14: 14–17

    PubMed  Google Scholar 

  34. Scottish Schizophrenia Research Group (1992) The Scottish First Episode Schizophrenia Study. VIII. Five-year follow-up: clinical and psychosocial findings. Br J Psychiatry 161: 496–500

    Article  Google Scholar 

  35. Steinhart I, Terhorst B (1988) Die arbeitstherapeutische Werkstatt als Teil eines psychiatrischen Versorgungssystems — Ihr Beitrag zur Integration medizinischer, beruflicher und sozialer Rehabilitation. Rehabilitation 27: 152–159

    PubMed  CAS  Google Scholar 

  36. Stevens BC (1973) Evaluation of rehabilitation for psychotic patients in the community. Acta psychiatr. Scand 49: 169–180

    Article  PubMed  CAS  Google Scholar 

  37. Trotter S, Minkoff K, Harrison K, Hoops J (1988) Supported work: an innovative approach to the vocational rehabilitation of persons who are psychiatrically disabled. Rehab Psychol 33: 27–36

    Article  Google Scholar 

  38. Watts F, Bennett DH (1977) Previous occupational stability as a predictor of employment after psychiatric rehabilitation. Psychol Med 7: 709–712

    PubMed  CAS  Google Scholar 

  39. Watts F, Bennett DH (1983) Theory and practice of psychiatric rehabilitation. Wiley, New York

    Google Scholar 

  40. Wing JK (1960) Pilot experiment in the rehabilitation of longhospitalized male schizophrenic patients. Br J Med 14: 173–180

    CAS  Google Scholar 

  41. Wing L, Wing JK, Stevens B, Griffiths D (1972) An epidemiological and experimental evaluation of industrial rehabilitation of chronic psychotic patients in the community. In: Wing JK, Hailey AM (eds) Evaluating a community psychiatric service. The Camberwell register. University Press, Oxford, pp 283–308

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reker, T., Eikelmann, B. Work therapy for schizophrenic patients: Results of a 3-year prospective study in Germany. Eur Arch Psychiatry Clin Neurosci 247, 314–319 (1997). https://doi.org/10.1007/BF02922261

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02922261

Key words

Navigation