Objective: The purpose of this study was to determine whether vocational supports for emerging adults with serious mental health conditions who are at high risk for rearrest are more effectively served within Multisystemic Therapy for Emerging Adults (MST-EA) through vocationally enhanced MST-EA Coaches or through referral to state vocational rehabilitation services.
Method: A pilot randomized controlled trial examined two MST-EA Coaching approaches. In the Standard Coach + VR condition (n = 16), MST-EA Coaches delivered standard skills curricula to participants and referred them to state vocational rehabilitation (VR) services for vocational supports. In the Vocational Coach (VC) condition (n = 16), MST-EA Coaches delivered the standard skills curricula enhanced with extensive education/employment components. Analyses included pre- to posttreatment comparisons of vocational outcomes, and between groups comparisons of fidelity, satisfaction, and services utilization.
Results: Those in the VC condition had a 12-fold increase in the odds of posttreatment vocational activity compared with those in the Standard Coach + VR condition (92.9 vs. 57.1% employed or in school, respectively). Subgroup analyses of those who engaged in Coaching showed that there was specifically an increase in the odds of posttreatment educational engagement among those in the VC condition compared with those in Standard Coach + VR.
Conclusions and Implications for Practice: Based on the strength of the findings in this small pilot study the VC should be included in future clinical trials of MST-EA to maximize treatment impact for supporting emerging adult vocational functioning and thus reducing antisocial behavior.