1/2 A Multi-site Systems Intervention for Unemployed Persons With Social Anxiety
Condition: Social Anxiety
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      Social anxiety disorder is a highly prevalent condition that interferes with employment.
      Prior research indicates that social anxiety disorder interferes with work attainment. This
      project involves a two-site randomized trial of a community-based cognitive-behavioral
      intervention to reduce social anxiety and improve employment outcomes among unemployed
      persons with social anxiety disorder.
    

Detailed description: 
      The goal of the proposed research is to conduct a multi-site trial of a cognitive-behavioral
      intervention for enhancing employment success among unemployed persons whose job attainment
      efforts have been undermined by social anxiety disorder. Social anxiety disorder is a very
      common and impairing condition, with negative impacts on occupational functioning.
      Work-related impairments include turning down job offers and promotions, reduced productivity
      and job performance, lowered educational attainment, increased unemployment, financial
      dependence, and reduced income. The investigators have shown that social anxiety disorder was
      the strongest psychiatric predictor of sustained reliance on welfare for support. In response
      to these documented employment-related impairments, the investigators produced an
      eight-session work-related group cognitive behavioral therapy (WCBT) that, when coupled with
      standard vocational rehabilitation services, significantly improved social anxiety,
      depression, job search behaviors and job search self-confidence compared to a control group
      of socially anxious jobs seekers who received only vocational services as usual (VAU).

      Participants in this pilot R34 study were all homeless, primarily African American,
      urban-based job-seekers with high levels of psychiatric comorbidity and limited education and
      employment histories. WCBT is designed in a context and style that overcomes accessibility
      and stigma-related obstacles with special focus on employment-related targets. The current
      collaborative RO1 will involve two academic, investigative teams and the staff of two
      community-based employment service agencies to further evaluate WCBT compared to VAU.

      This two-region study will address whether WCBT enhances job placement and retention assessed
      over a one-year interval. In addition, this trial will test the implementation of WCBT in a
      new vocational service agency that was not involved in the development of WCBT, and whether
      the effects of WCBT generalize to a new population of urban-based, racially diverse
      job-seekers with educational and educational histories that differ from the original WCBT
      study site. The investigators will also investigate the system effects of WCBT in the new
      site that will be informative for broad implementation of WCBT nationwide. Finally, as an
      innovative extension from the R34, this project will incorporate implementation tools of
      technology-assisted provider training and delivery of WCBT.
    

Intervention name(s): Vocational Services as usual plus Cognitive Behavioral Therapy (CBT); Usual Vocational Services
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Teaches thought restructuring and exposure therapy to socially anxious job seekers delivered by vocational service professionals; Vocational services delivered by vocational professionals at vocational service center (e.g., resume assistance, job leads)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: social anxiety; unemployment; cognitive behavioral therapy; group therapy; work; vocation