ENDEAVOR
Enhancing Delivery and Outcomes of Vocational Rehabilitation: improving employment for young
people with a first episode of psychosis
Research Question
Design
Does ‘Motivational Interviewing’ (MI) help to improve vocational
outcomes of young people who have experienced a first episode
of psychosis?
ENDEAVOR
Abstract
ENDEAVOR is multi-centre, randomised trial to assess
whether additional team training in Motivational Interviewing (MI) techniques enhances the effectiveness of
a supported employment intervention (Individual
Placement and Support – IPS) for young people experiencing their first episode of psychosis. Employment
outcomes are compared between sites providing both
IPS and MI (Birmingham and Wandsworth, London)
and those providing IPS alone (Worcester and LEO service, London). It is hypothesised that the combination
of IPS+MI will result in at least a 20% improvement in
the proportion of individuals in employment/
educational activity at 12 months compared with that
attained by IPS alone. The study aims to recruit a total
of 160 participants (40 per site) and monitor their vocational development over a 12 month period. Baseline
data is collected from each participant including previous education and vocational experiences, current activities and future plans. Further vocational information
is obtained at 6 and 12 month follow-up interviews. The
study also aims to map the general vocational trends
in these four sites.
(Vocational Approach (IPS) +
Motivational Interviewing)
Birmingham East & North
EI Service
n=40
Worcester
EI Service
n=40
Lambeth Early Onset
Service London
n=40
Inclusion Criteria
Each participant completes baseline measures
and is then followed up at 6 and 12 months
Baseline
Initial Motivation Scale - for employment
and education
Consent - A copy for participant, participant’s file and researcher
 Demographics - Including diagnosis and
number of hospital stays
 Employment History
 Education History
 Achievement Expectation Scale - Including employment, education and finance
 Time Budget - How an individual spends
their time and quantifying this based on
required planning and effort for a task
 PANSS - Positive and Negative Symptom
Scale
 Maudsley Addiction Profile
 AUDIT - The Alcohol Use Disorders Identification Test
 Resource Generator UK
 Global Assessment of Functioning - To be
completed by Early Intervention staff
member with researcher
Wandsworth EI Service
London
n=40
Participants should:
 Be currently receiving treatment from

early intervention services

 Aged 18-35

 Have expressed an interest in returning
to education / work
 Have no issues of immigration status
Measures
Participant
(IPS Vocational Approach
only)
etc that could prevent access to work
Be able to provide informed consent
Be well enough to participate
Be in first or second year of treatment
6 Months
Employment History
Education History
Time Budget
CSRI - Client Service Receipt Inventory
 Global Assessment of Functioning


12 Months
Employment History
Education History
Achievement Expectation Scale
Time Budget
 PANSS
 Maudsley Addiction Profile
 AUDIT
 CSRI
 Global Assessment of Functioning








Background to IPS and MI
Traditional “Train and Place” vocational models assume people with mental illness
require a period of preparation before entering competitive employment, as this has
been shown to have poor outcomes IPS aims to support people’s vocational aspirations in a different way. IPS adheres to the principles that:
 Anyone is capable of working competitively if they are helped to find a job and
working environment that is right for them and if the right kind of support is given.
 The aim is not to change the individual to suit the job but to find a match for the
individuals strengths/experiences and employment in the community .
With IPS the individual experiences “Place and Train”, they are helped to find a job
then supported to keep it. The IPS approach has been shown to help 50-60% of clients achieve meaningful vocational activity
MI is an approach that by communicating with an individual enables them to identify
areas for change in their life, to tackle any ambivalence towards this and help motivate them to make the changes. MI is not taking control from the individual, rather
enabling them to take control themselves, guiding and informing rather than directing and instructing. It has been observed that people with mental illness experience
reduced self efficacy and esteem that may lower their motivation to find work, MI
helps the individual address these feelings and beliefs.
Hypothesis
MI+IPS will result in at least a 20% improvement
in the proportion of patients in employment/
educational activity at 12 months compared with
that attained by IPS alone.
Contact Details
Professor Tom Craig: Chief Investigator: t.craig@iop.kcl.ac.uk
Professor Swaran Singh: Principle Investigator: s.p.singh@warwick.ac.uk
Dr Paddy Power: Principle Investigator: Paddy.power@slam.nhs.uk
Dr Jo Smith: Principle Investigator: joda@lineone.net
Mr Miles Rinaldi: Principle Investigator: Miles.Rinaldi@swlstg-tr.nhs.uk
Professor Geoff Shepherd: Geoff.shepherd@scmh.org.uk
Dr Paul McCrone: Paul.mcrone@kcl.ac.uk
Sarah Carr: Research Assistant: sarah.carr@kcl.ac.uk
Fay Preston: Research Assistant: Fay.Preston@bsmhft.nhs.uk