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Vocational Interventions for Unemployed: Effects on Work Participation and Mental Distress. A Systematic Review

Abstract

Introduction Unemployment is a growing problem worldwide. Unemployment or job loss is one of the most stressful of life events and can lead to diminished social status, disturbed social role patterns, financial debt, reduced self-esteem and feelings of guilt. The purpose of this review was to determine the effectiveness of vocational interventions on work participation and mental distress for unemployed adults and to provide an overview of the characteristics of these interventions. Methods Medline, EMBASE and PsycINFO were systematically searched for studies published between 1990 and August 2008. Intervention studies aimed at work participation and helping with mental distress for the unemployed were included. Methodological quality of the included studies was assessed. Results Six articles based on five intervention studies, of which two randomized controlled trials, fulfilled all inclusion criteria. The methodological quality of the studies ranged from good to poor. All five interventions applied group training techniques aimed at promoting re-employment and/or improving mental health. The duration of the interventions varied from 1 week to 6 months. The interventions focused on acquiring job-search skills, maintaining paid work, personal development and preparedness against setbacks during the job-search process. Only one intervention study (randomized controlled trial) reported a significant effect on re-employment. Conclusions Based on our review, we conclude that there is weak evidence to support the use of vocational interventions to improve work participation and limited evidence to reduce mental distress for the unemployed. We recommend further development and evaluation of return to work intervention strategies for unemployed individuals.

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Acknowledgments

Appreciation is extended to Monique L.A. Broekhuizen and Birgit Donker-Cools for their help with the literature search.

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Correspondence to Selwin S. Audhoe.

Appendix: Search Strategy

Appendix: Search Strategy

Medline

Limitations: Publication date: 1 January 1990 to 15 August 2008; Language: English, German, French and Dutch

(“unemployment”[MeSH]) OR (“unemployment”) OR (“unemployed”) OR (“job loss”) OR (unemploy*)

AND

(“psychological ill health”) OR (“adaptation, psychological”[MeSH]) OR (“adaptation, psychological”) OR (“psychological problem*”) OR (“psychological factor*”) OR (“stress, psychological”[MeSH]) OR (“stress, psychological”) OR (“coping behavior”) OR (coping) OR (“well being”) OR (“psychological symptom*”) OR (“psychosocial problem*”) OR (“psychosocial factor*”) OR (“psychosocial aspect*”) OR (“psychosocial complaint*”) OR (“mental ill health”) OR (“mental problem*”) OR (“social problems”[MeSH]) OR (“social problems”) OR (“mental aspect*”) OR (“emotional problems”) OR (“emotional aspects”) OR (“emotional depression”) OR (“depression”[MeSH]) OR (“depression”) OR (“emotional stress”) OR (“minor psychiatric morbidity”) OR (“minor psychiatric problems”) OR (“stress related disorders”) OR (“mental distress”) OR (“emotional distress”) OR (“emotional difficulties”) OR (“adjustment disorders”[MeSH]) OR (“adjustment disorders”) OR (“depressive disorder”[MeSH]) OR (“depressive disorder”) OR (“minor depression”)

AND

(“sickness absence”) OR (“sick leave”[MeSH]) OR (“sick leave”) OR (“sickness leave”) OR (“sickness duration”) OR (“sickness leave duration”) OR (“average number of days of sick leave”) OR (“return to work”) OR (“time to return to work”) OR (“partial and full return to work”) OR (“reemployment”) OR (“work ability”) OR (“work participation”) OR (“functional performance”) OR (“functioning”) OR (“absenteeism”[MeSH]) OR (“absenteeism”) OR (“work disability”) OR (“disability leave”) OR (“job resume”) OR (“job application”[MeSH]) OR (“job application”) OR (unemploy*) OR (“Unemployment”[Mesh]) OR (“Unemployment”) OR (“Employment”[Mesh]) OR ((Employment) OR (“work resumption”) OR (“Rehabilitation, Vocational”[Mesh]) OR (“vocational rehabilitation”) OR (“job seeking”) OR (“Activities of Daily Living”[Mesh]) OR (“Activities of Daily Living”) OR (“Activity, Daily Living”) OR (“Human Activities”) OR (“level of functioning”) OR (“Quality of Life”[Mesh]) OR (“quality of life”)

EMBASE

Limitations: Publication date: 1 January 1990 to 18 August 2008; Language: English, German, French and Dutch

exp UNEMPLOYMENT/OR unemployed.mp. OR unemployment.mp. OR (job adj loss).mp. OR unemploy*.mp.

AND

exp Psychological Aspect/OR (psychological adj aspect).mp. OR exp Mental Health/OR (mental adj health).mp. OR (psychic adj health).mp. OR (mental adj tension).mp. OR (nervous adj stress).mp. OR (psychic adj stress).mp. OR (psychic adj tension).mp. OR (psychological adj stress).mp. OR psychologic adj stress).mp. OR stress, psychologic.mp. OR stress, psychological.mp. OR tension, mental.mp. OR tension, psychic.mp. OR exp Mental Load/OR (mental adj load).mp. OR (psychological adj ill adj health).mp. OR (psychological adj problems).mp. OR (psychological adj symptoms).mp. OR (psychosocial adj problems).mp. OR exp MALADJUSTMENT/co, di, dm, rh, th OR maladjustment.mp. OR maladaptation.mp. OR maladaption.mp. OR (psychosocial adj complaints).mp. OR exp DEPRESSION/OR depression.mp. OR exp Mood Disorder/OR (mood adj disorder).mp. OR (mental adj ill adj health).mp. OR (mental adj problems).mp. OR (emotional adj problems).mp. OR exp Adjustment Disorder/OR (adjustment adj disorder).mp. OR (adjustment adj reaction).mp. OR (transient adj situational adj disorder).mp. OR exp Emotional Stress/OR (emotional adj stress).mp. OR stress, emotional.mp. OR (emotional adj distress).mp. OR (emotional adj tension).mp. OR (minor adj psychiatric adj morbidity).mp. OR (minor adj psychiatric adj problems).mp. OR stress related disorders.mp. OR mental distress.mp. OR emotional difficulties.mp. OR minor depression.mp.

AND

exp ABSENTEEISM/OR absenteeism.mp. OR (sickness adj absence).mp. OR (sickness adj absenteeism).mp. OR (work adj absence).mp. OR (work adj absenteeism).mp. OR (work adj day adj loss).mp. OR (work adj time adj loss).mp. OR long term sickness absence.mp. OR (sick adj leave).mp. OR (sickness adj leave).mp. OR (sickness adj duration).mp. OR (sickness adj leave adj duration).mp. OR average number of days of sick leave.mp. OR return to work.mp. OR time to return to work.mp. OR (partial and full return to work).mp. OR reemployment.mp. OR workability.mp. OR (work adj participation).mp. OR (functional adj performance).mp. OR daily life activity.mp. OR activities of daily living.mp. OR activity, daily living.mp. OR daily living activity.mp. OR (human adj activities).mp. OR (work adj performance).mp. OR functioning.mp. OR unemploy*.mp. OR exp UNEMPLOYMENT/OR unemployment.mp. OR exp EMPLOYMENT/OR employment.mp. OR exp Work Resumption/OR (work adj resumption).mp. OR exp Vocational Rehabilitation/OR (Vocational adj Rehabilitation).mp. OR exp Job Finding/OR (job adj seeking).mp.

PsycINFO

Limitations: Publication date: 1 January 1990 to 22 August 2008; Language: English, German, French and Dutch

(unemployment) OR (“Unemployment-” in MJ,MN) OR (unemployed) OR (unemploy*) OR (employment status) OR (“Employment-Status” in MJ,MN) or (job loss) OR (personnel termination) OR (“Personnel-Termination” in MJ,MN)

AND

(coping behavior) OR (“Coping-Behavior” in MJ,MN) OR (psychological ill health) OR (mental health) OR (“Mental-Health” in MJ,MN) OR (distress) OR (“Distress-” in MJ,MN) OR (depression) OR (psychological adjustment) OR (emotional adjustment) OR (“Emotional-Adjustment” in MJ,MN) OR (psychological problems) OR (psychosocial problems) OR (psychosocial factors) OR (“Psychosocial-Factors” in MJ,MN) OR (psychosocial complaints) OR (mental ill health) OR (mental load) OR (“Human-Channel-Capacity” in MJ,MN) OR (mental problems) OR (adjustment) OR (“Adjustment-” in MJ,MN) OR (emotional problems) OR (emotional control) OR (“Emotional-Control” in MJ,MN) OR (emotional maladjustment) OR (“Emotional-Adjustment” in MJ,MN) OR (emotional responses) OR (minor psychiatric morbidity) OR (psychiatric symptoms) OR (“Psychiatric-Symptoms” in MJ,MN) OR (minor psychiatric symptoms) OR (stress related disorders) OR (psychological stress) OR (“Psychological-Stress” in MJ,MN) OR (social stress) OR (“Social-Stress” in MJ,MN) OR (“Emotional-Responses” in MJ,MN) OR (stress management) OR (“Stress-Management” in MJ,MN) OR (well being) OR (“Well-Being” in MJ,MN) OR (mental distress) OR (emotional distress) OR (emotional difficulties) OR (adjustment disorders) OR (“Adjustment-Disorders” in MJ,MN) OR (personal adjustment) OR (emotional adjustment) OR (minor depression) OR (reactive depression) OR (“Reactive-Depression” in MJ,MN) OR (depressive reaction) OR (“Major-Depression” in MJ,MN)

AND

(sickness absence) OR (absenteeism) OR (“Employee-Absenteeism” in MJ,MN) OR (long term sickness absence) OR (sick leave) OR (sickness leave) OR (employment status) OR (“Employment-Status” in MJ,MN) OR (sickness duration) OR (sickness leave duration) OR (average number of days of sick leave) OR (return to work) OR (time to return to work) OR (partial and full return to work) OR (job search) OR (“Job-Search” in MJ,MN) OR (job reentry) OR (job applicant attitudes) OR (“Job-Applicant-Attitudes” in MJ,MN) OR (reemployment) OR (“Reemployment-” in MJ,MN) OR (quality of life) OR (“Quality-of-Life” in MJ,MN) OR (ability level) OR (“Ability-Level” in MJ,MN) OR (work ability) OR (work disability) OR (work participation) OR (functional performance) OR (activities of daily living) OR (“Activities-of-Daily-Living” in MJ,MN) OR (functional status) OR (level of functioning) OR (functioning) OR (ability level) OR (disabilities) OR (“Disabilities-” in MJ,MN) OR (unemploy*) OR (unemployment) OR (“Unemployment-” in MJ,MN) OR (employment) OR (employment-status) OR (“Employment-Status” in MJ,MN) OR (vocational-rehabilitation) OR (“Vocational-Rehabilitation” in MJ,MN) OR (job-seeking)

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Audhoe, S.S., Hoving, J.L., Sluiter, J.K. et al. Vocational Interventions for Unemployed: Effects on Work Participation and Mental Distress. A Systematic Review. J Occup Rehabil 20, 1–13 (2010). https://doi.org/10.1007/s10926-009-9223-y

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Keywords

  • Unemployment
  • Participation
  • Mental distress
  • Re-employment
  • Intervention
  • Vocational rehabilitation