An RCT of Virtual Reality Job Interview Training for Individuals With Serious Mental Illness in IPS Supported Employment

• Published in: Psychiatric services (Washington, D.C.) Vol. 73; no. 9; pp. 1027 - 1038
• Main Authors: Smith, Matthew J., Smith, Justin D., Blajeski, Shannon, Ross, Brittany, Jordan, Neil, Bell, Morris D., McGurk, Susan R., Mueser, Kim T., Burke-Miller, Jane K., Oulvey, Eugene A., Fleming, Michael F., Nelson, Karley, Brown, Adrienne, Prestipino, John, Pashka, Nicole J., Razzano, Lisa A.
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Association 01.09.2022; American Psychiatric Publishing, Inc
• Subjects: Chi-square test; Employment interviews; Employment, Supported; Humans; Inservice Training; Mental disorders; Mental Disorders - therapy; Rehabilitation, Vocational; Simulators; Training; Virtual Reality; Schizophrenia; Bipolar disorder; Social skills training; Vocational rehabilitation; Community mental health services; Virtual reality
• ISSN: 1075-2730; 1557-9700; 1557-9700
• DOI: 10.1176/appi.ps.202100516

Objective:Virtual Reality Job Interview Training (VR-JIT) is a computerized interview simulator with efficacy at enhancing interview skills and employment outcomes. A randomized controlled trial assessed VR-JIT effectiveness for participants in individual placement and support (IPS), in which approximately 55% of individuals with serious mental illness obtain employment.Methods:Ninety participants with serious mental illness were randomly assigned to IPS+VR-JIT (N=54) or IPS as usual (N=36), completing pretest-posttest assessments and an employment evaluation at 9 months. Intent-to-treat chi-square analysis, multivariable logistic regression, Cox proportional hazards models, and mixed-effects linear regressions were conducted. Fifty-one percent were IPS nonresponders (i.e., no employment within the first 90 days of IPS).Results:IPS+VR-JIT participants did not have significantly higher employment rates, compared with IPS-as-usual participants (43% versus 28%). IPS nonresponders (N=46) in the IPS+VR-JIT group had greater odds of obtaining employment (odds ratio [OR]=5.82, p=0.014) and shorter time to employment (hazard ratio=2.70, p=0.044) compared with IPS nonresponders in the IPS-as-usual group. Intent-to-treat mixed-effects linear analyses indicated that IPS+VR-JIT, compared with IPS as usual, significantly improved interview skills (p=0.006), interview confidence (p=0.013), and interview anxiety (p=0.019).Conclusions:VR-JIT’s potential benefits (increased employment in a shorter time) appeared to be specific to IPS nonresponders, whereas employment outcomes for recent IPS enrollees were not affected. VR-JIT could be a valuable resource for employment specialists to support IPS nonresponders, because 47% of participants engaged in mock interview training with their specialist. Future research should focus on evaluating the effectiveness and implementation of VR-JIT among IPS nonresponders.