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Who (or does) Psychotherapy Help During an Employment Transition? Presentation at Cannexus 2012 January 23, 2012 John Griffiths – Goodwill Career Centre.

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Presentation on theme: "Who (or does) Psychotherapy Help During an Employment Transition? Presentation at Cannexus 2012 January 23, 2012 John Griffiths – Goodwill Career Centre."— Presentation transcript:

1 Who (or does) Psychotherapy Help During an Employment Transition? Presentation at Cannexus 2012 January 23, 2012 John Griffiths – Goodwill Career Centre Rebecca Machado – King’s University College

2 Goodwill International 1902 –Goodwill was founded in Boston by Reverend Edgar Helms –He saw a way to help people struggling with poverty by providing them with opportunities to work in a social enterprise that refurbished and sold donated goods.

3 Goodwill International Today Goodwill International Today North America’s largest non-profit provider of employment services 183 member organizations in 16 countries 183 member organizations in 16 countries 166 autonomous Goodwill organizations in North America, of which 7 are in Canada 166 autonomous Goodwill organizations in North America, of which 7 are in Canada 2009 Goodwill served 1.9 million people placing someone in a job every 50 seconds 2009 Goodwill served 1.9 million people placing someone in a job every 50 seconds

4 Goodwill Industries, Ontario Great Lakes 1943 London Goodwill Industries began in a church basement through the collaboration of nine local social service agencies in London Today $11 million social enterprise $11 million social enterprise 330 people employed, approximately 6,000 clients served 330 people employed, approximately 6,000 clients served 10,000 visits per year to our Employment Resource Centre 10,000 visits per year to our Employment Resource Centre

5 Daya Counselling Founded in 1985 as Interfaith Counselling, with the goal of providing personal counselling services to those who might not be able to afford to pay. Founded in 1985 as Interfaith Counselling, with the goal of providing personal counselling services to those who might not be able to afford to pay. In 2008 changed to Daya Counselling In 2008 changed to Daya Counselling Employs qualified counsellors at the masters level or above Employs qualified counsellors at the masters level or above

6 Partnership: HRDC, Daya, Goodwill 1998 –Goodwill Career Centre funded by HRDC to provide assessment, case management, and employment counselling to unemployed individuals. –Goodwill Career Centre has worked with just over 12,000 clients –HRDC funded Daya Counselling to provide personal counselling services Career Centre clients –Over the duration of that partnership, just over 650 clients were referred to Daya and 260 people accessed personal counselling

7 Transition to Employment Ontario The EO transformation (August 2010) ended government support for the partnership between Daya and Goodwill The EO transformation (August 2010) ended government support for the partnership between Daya and Goodwill

8 Research Partnership: Daya, Goodwill, Kings University College Daya and Goodwill sought partnerships to support research, including appropriate ethical oversight Daya and Goodwill sought partnerships to support research, including appropriate ethical oversight King’s University College Thanatology program was interested in research regarding responses to non-death loss, including job loss King’s University College Thanatology program was interested in research regarding responses to non-death loss, including job loss

9 Research Areas Experience of Job Loss (length of notice, sense of control/choice) Experience of Job Loss (length of notice, sense of control/choice) Present Employment Status (employed, self- employed, full or part time, unemployed) Present Employment Status (employed, self- employed, full or part time, unemployed) Depression Depression Grief Grief Self-efficacy Self-efficacy Hope Hope Optimism Optimism

10 Method Timeline T1 = date participant lost their job (24 participants had pending unemployment, and were excluded from analyses) T2 = date of initial participation in research T3 = date of second participation in research (approximately six months after T2) (approximately six months after T2)

11 Method Participant recruitment occurred in two phases Phase One: (February 22, 2010 – September 28, 2010, n = 674) Phase One: (February 22, 2010 – September 28, 2010, n = 674) Workshop registration -> STUDY INVITATION & PARTICIPATION (T2) -> Workshop participation -> Individual session with Employment Counsellor -> Psychotherapy referral offered if relevant Phase Two: (February 4, 2011 – December 31, 2011, n = 36) Phase Two: (February 4, 2011 – December 31, 2011, n = 36) Workshop registration -> Workshop participation -> Individual session with Employment Counsellor -> Psychotherapy referral offered if relevant -> STUDY INVITATION & PARTICIPATION (T2) *Invitation to participate in Follow up study (T3) issued via telephone, , or mail 6 months after participation in initial study (T2)

12 Starting Demographics (T2) vs Follow-up Demographics (T3) TOTAL participants = 668/129 TOTAL participants = 668/129 Gender Gender  Male = 432 (64.7%)  Female = 235 (35.2%)  Male = 71 (55%)  Female = 58 (45%) Age Age  M = years, SD =11.21 (n = 635)  M = years, SD =10.17 (n = 126)

13 Duration of Unemployment T2 M = 7.29 months, SD =10.93 (based on n = 635) *42 are considered outliers based on designation after UpperQuartile(9) + 1.5x IQ range(7) = 19.5 T3 M = months, SD =9.44 (based on n = 123)

14 Starting Demographics (T2) vs Follow-up Demographics (T3) Race (2 unknown/3 unknown) Race (2 unknown/3 unknown)  White = 564 (84.4%) vs 113 (89.7%)  Black =17 (2.5%) vs 2 (1.6%)  Asian =20 (3.0%) vs 3 (2.4%)  First Nations =6 (0.9%) vs 0  Hispanic =31 (4.6%) vs 5 (4.0%)  Other =28 (4.2%) vs 3 (2.4%) Language (53 unknown/7 unknown) Language (53 unknown/7 unknown)  English first language = 572 (85.6%) vs 107 (82.9%)  Other first language = 88 (13.2%) vs 16 (12.4%) Residency Status (1 unknown) Residency Status (1 unknown)  Canadian Citizen = 638 (95.5%) vs 118 (92.9%)  Landed Immigrant = 5 (0.7%) vs 1 (0.8%)  Permanent Resident = 22 (3.3%) vs 8 (6.3%);  Refugee = 2 (0.3%) vs 0

15 Starting Demographics (T2) vs Follow-up Demographics (T3) Educational Attainment:  Primary School = 10 (1.5%) vs 2 (1.6%)  High School = 265 (39.7%) vs 35 (27.3%)*  Technical/Trade School = 57 (8.5%) vs 10 (7.8%)  College = 186 (27.8%) vs 54 (42.2%)*  University = 87 (13.0%) vs 22 (17.2%)  Graduate School = 10 (1.5%) vs 2 (1.6%)  Other = 51 (7.6%) vs 3 (2.3%)  Unknown = 2 (0.3%) vs 0 (0%)

16 Starting Demographics (T2) Follow-up Demographics (T3) Marital Status (12 unknown vs 3 unknown) Marital Status (12 unknown vs 3 unknown)  Married = 228 (34.1%) vs 50 (39.4%)  Common-law = 76 (11.4%) vs 8 (6.3%)  Single = 244 (36.5%) vs 39 (30.7%)  Divorced = 54 (8.1%) vs 18 (14.2%)  Separated = 50 (7.5%) vs 11 (8.7%)  Widowed = 4 (0.6%) vs 1 (0.8%)  *10 participants reported a change in marital status Number of Dependents Number of Dependents  M = 1.10, SD =1.27 (based on n = 564)  M = 0.87, SD =1.15 (based on n = 126)  *12 participants reported an additional dependant at T3  *15 participants reported a decrease between 1 and 4 dependents at T3

17 Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy T2: # of participants Gender M= 395, F= 197 M= 25, F= 19 M= 12, F= 19 Age (years) p<.05) M = 39.54, SD = 11.15, n = 566 M = 43.10, SD = 10.59, n = 42 M = 43.93, SD = 12.10, n = 27 Duration of Unemployment at T2 (months) (ns) M = 7.09, SD = 10.85, n = 560 M = 8.98, SD = 10.16, n = 44 M = 8.52, SD = 13.28, n = 31 T3: # of participants

18 Depression Measured via Centre for Epidemiological Studies Depression Scale (CES-D; National Institute of Mental Health, Radloff, 1977) Measured via Centre for Epidemiological Studies Depression Scale (CES-D; National Institute of Mental Health, Radloff, 1977) 20 items (4 reverse coded) 20 items (4 reverse coded)  E.g., “I was bothered by things that usually don’t bother me” Participants rate how frequently they have experienced each item in the previous week. Participants rate how frequently they have experienced each item in the previous week.  4 response choices:  Rarely or none of the time (less than 1 day)  Some or a little of the time (1-2 days)  Occasionally or a moderate amount of time (3-4 days)  Most or all of the time (5-7 days) Scoring: Sum of scores indicates prevalence or intensity of depression symptomology; higher scores indicate greater report of depression symptomology Scoring: Sum of scores indicates prevalence or intensity of depression symptomology; higher scores indicate greater report of depression symptomology  Minimum score = 20, Maximum score = 80 Acceptable internal consistency reliability: T2 - Cronbach’s a =.80 T3 - Cronbach’s a =.83

19 Depression & Employment Status At T2: At T2:  Depression scores were positively correlated with duration of unemployment at T2 (r =.11, p <.01)  Depression scores were NOT correlated with employment status (full time, part time, unemployed) At T3: At T3:  Depression scores were associated with employment status. Full time employment (M = 34.11, SD = 15.02, n= 27) was associated with significantly lower scores on the CES-D than unemployment (M = 43.22, SD = 15.69, n= 74). Participants who had obtained part- time employment reported scores in between these; difference from either alternative was not statistically significant.  Depression scores were not significantly correlated with duration of unemployment at T3

20 Depression & Other Factors Depression scores were correlated with age (r =.12, p <.01) Depression scores were correlated with age (r =.12, p <.01) Depression scores were not associated with: Depression scores were not associated with:  Amount of household income previously derived from job (in 20% categorical intervals labelled all, most, about half, less than half, and very little)  Amount of daily activity related to the job (in 20% categorical intervals labelled all, most, about half, less than half, and very little)  Gender

21 Depression and Control Degree of control over leaving a job was associated with mean depression scores at T2. Degree of control over leaving a job was associated with mean depression scores at T2. –Statistically significant differences between “unsure” and “completely voluntary” –Trend of increasing depression scores with decreasing choice –Similar trend at T3, although only 2 participants in “completely voluntary” category prevent model from reaching significance

22 Depression & Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy T2 CES-D scores** M = 37.90, SD = 11.98, n = 560 M = 50.65, SD = 9.75, n = 43 M = 47.53, SD = 14.46, n = 30 T3 CES-D scores* M = 37.72, SD = 14.92, n = 98 M = 52.50, SD = 17.26, n = 8 M = 51.64, SD = 11.15, n = 14 *significant differences, p <.05; **significant differences, p <.01 In both cases “no psychotherapy group” reports lower incidence of depression symptoms

23 Depression & Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy Individual change in CES-D score M = 0.72, SD = 10.64, n = 94 M = -2.00, SD = 18.55, n = 8 M = 1.57, SD = 14.55, n = 14 Change calculated as T2 – T3 = change. No statistically significant differences observed A lot of variability in reported experience, and few participants in psychotherapy related groups Trend: Improvement/fewer symptoms reported by those who attended psychotherapy and by those who never requested it; poorer scores/more symptoms reported by those who requested psychotherapy but did not attend.

24 Optimism Measured via Life Orientation Test-Revised (LOT-R;Scheier, Carver & Bridges, 1994) Measured via Life Orientation Test-Revised (LOT-R;Scheier, Carver & Bridges, 1994) 10 item scale, with 6 relevant items and 4 filler items 10 item scale, with 6 relevant items and 4 filler items 5 response options offered as a rating scale: 5 response options offered as a rating scale:  strongly disagree  Disagree  neutral  Agree  strongly agree Scoring: sum of scores of 6 relevant items Scoring: sum of scores of 6 relevant items  Increase in scores represents increased report of positive life orientation  Minimum = 6, Maximum = 30 Acceptable internal consistency reliability: T2 - Cronbach’s a =.82 T3 - Cronbach’s a =.88

25 Optimism and Employment Status At T2: At T2:  LOT-R scores were negatively correlated with duration of unemployment at T2 (r = -0.08, p <.05)  LOT-R scores were NOT correlated with employment status (full time, part time, unemployed) at T2 At T3: At T3:  LOT-R scores were not significantly correlated with duration of unemployment at T3  LOT-R scores were NOT correlated with employment status (full time, part time, unemployed) at T3 LOT-R scores at T2 were strongly, positively correlated with LOT-R scores at T3 (r = 0.70, p <.001), suggesting this may be fairly stable over time

26 Optimism and Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy T2 LOT-R scores** M = 20.02, SD = 4.81, n = 573 M = 16.16, SD = 3.94, n = 43 M = 17.97, SD = 6.06, n = 29 T3 LOT-R scores** M = 19.88, SD = 5.08, n = 96 M = 13.00, SD = 2.88, n = 8 M = 17.00, SD = 5.84, n = 14 **significant differences, p <.01 In both cases “no psychotherapy referral” group reports more positive life orientation than those who “requested psychotherapy but did not attend.” Those who requested and attended at least one session of psychotherapy fell in the middle

27 Optimism and Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy Individual change in LOT-R score M = 0.41, SD = 4.28, n = 92 M = 0.25, SD = 3.62, n = 8 M = 0.71, SD = 3.22, n = 14 No statistically significant differences observed Minimal variability in reported experience, corroborating the stability of this element on an individual level over time.

28 Hope Measured via the Adult Hope Scale (AHS;Snyder, Cheavens & Sympson, 1997) Measured via the Adult Hope Scale (AHS;Snyder, Cheavens & Sympson, 1997) 12 item scale, with 4 items assessing “agency,” 4 items assessing “pathways” and 4 filler items 12 item scale, with 4 items assessing “agency,” 4 items assessing “pathways” and 4 filler items 8 response options offered as a rating scale: 8 response options offered as a rating scale:  Definitely false, mostly false, somewhat false, slightly false, slightly true, somewhat true, mostly true, definitely true Acceptable internal consistency reliability: T2 - Cronbach’s a =.87 T3 - Cronbach’s a =.92

29 Hope Agency: expectation that one will be able to take the necessary action (e.g., “I meet the goals I set for myself”) Agency: expectation that one will be able to take the necessary action (e.g., “I meet the goals I set for myself”) Pathway: availability to find pathways toward the desired goal (e.g., “I can think of many ways to get the things in life that are important to me”) Pathway: availability to find pathways toward the desired goal (e.g., “I can think of many ways to get the things in life that are important to me”) Scoring: sum of scores of relevant items Scoring: sum of scores of relevant items  Increase in scores represents increased report of positive life orientation  Subscale Minimum = 4, Maximum = 32  Total scale minimum = 8, Maximum = 64

30 Hope and Employment Status At T2: At T2:  AHS total scores were negatively correlated with duration of unemployment at T2 (r = -0.11, p <.01); As well, AHS-Pathway scores were negatively correlated with duration of unemployment at T2 (r = -0.10, p <.05)  AHS scores were NOT correlated with employment status (full time, part time, unemployed) at T2 At T3: At T3:  AHS scores were not significantly correlated with duration of unemployment at T3  AHS scores were NOT correlated with employment status (full time, part time, unemployed) at T3 AHS scores at T2 were strongly, positively correlated with AHS scores at T3 (r = 0.68, p <.001), suggesting this may be fairly stable over time

31 Hope and Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy T2 AHS total scores** M = 48.67, SD = 8.95, n = 564 M = 40.05, SD = 9.03, n = 42 M = 43.68, SD = 10.12, n = 28 T3 AHS total scores** M = 47.84, SD = 10.38, n = 97 M = 39.13, SD = 11.32, n = 8 M = 40.40, SD = 12.47, n = 15 **significant differences, p <.01 In both cases “no psychotherapy referral” group reports more positive life orientation than those who “requested psychotherapy but did not attend.” Those who requested and attended at least one session of psychotherapy fell in the middle, but were only significantly different from the “no referral” group

32 Hope and Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy Individual change in AHS score M = 2.22, SD = 8.18, n = 94 M = 0.38, SD = 12.12, n = 8 M = 3.43, SD = 8.03, n = 14 No statistically significant differences observed Minor variability in reported experience, corroborating the stability of this element on an individual level over time. Trend: perhaps a greater increase in hope for those who attended psychotherapy? Nearly 10x the change for those who did not attend, but could just be “noise”

33 General Self-Efficacy Measured via the General Perceived Self-Efficacy Scale (GSE;Schwarzer & Jerusalem, 1995) Measured via the General Perceived Self-Efficacy Scale (GSE;Schwarzer & Jerusalem, 1995) 10 item scale 10 item scale 4 response options offered as a rating scale: 4 response options offered as a rating scale:  Not at all true, hardly true, moderately true, exactly true Sample item: “I can usually handle whatever comes my way” Sample item: “I can usually handle whatever comes my way” Scoring: sum of scores of all items Scoring: sum of scores of all items  Increase in scores represents increased report of general self-efficacy  Total scale minimum = 10, Maximum = 40 Acceptable internal consistency reliability: T2 - Cronbach’s a =.90 T3 - Cronbach’s a =.94

34 General Self-Efficacy and Employment Status At T2: At T2:  GSE total scores were negatively correlated with duration of unemployment at T2 (r = -0.09, p <.05)  GSE scores were NOT correlated with employment status (full time, part time, unemployed) at T2 At T3: At T3:  GSE scores were not significantly correlated with duration of unemployment at T3  GSE scores were NOT correlated with employment status (full time, part time, unemployed) at T3 GSE scores at T2 were strongly, positively correlated with GSE scores at T3 (r = 0.62, p <.001), suggesting this may be fairly stable over time

35 General Self-Efficacy and Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy T2 GSE total scores** M = 31.79, SD = 4.54, n = 560 M = 28.44, SD = 5.32, n = 41 M = 29.62, SD = 5.14, n = 29 T3 GSE total scores M = 31.46, SD = 5.21, n = 97 M = 26.63, SD = 9.26, n = 8 M = 28.00, SD = 6.16, n = 13 **significant differences, p <.01 In T2 the “no psychotherapy referral” group reported greater general self-efficacy than those who “requested psychotherapy but did not attend.” Those who attended at least one session of psychotherapy fell in the middle (ns).

36 General Self-Efficacy and Psychotherapy No Psychotherapy Requested psychotherapy but did not attend Attended at least one session of psychotherapy Individual change in GSE score M = 0.99, SD = 4.71, n = 93 M = 0.57, SD = 5.03, n = 7 M = 0.69, SD = 5.95, n = 13 No statistically significant differences observed Minimal variability in reported experience, corroborating the stability of this element on an individual level over time.

37 Employment and Psychotherapy No statistically significant differences in employment outcome based on referral or attendance in psychotherapy No statistically significant differences in employment outcome based on referral or attendance in psychotherapy

38 General Observations Those who requested psychotherapy displayed a trend toward reporting more depression symptoms, and reporting less self-efficacy, positive life orientation (optimism), and hope Generally, from “best off” to “worst off”: Generally, from “best off” to “worst off”: No Psychotherapy requested Psychotherapy requested and attended Psychotherapy requested but not attended

39 General implication: those who used psychotherapy services were appropriate recipients (i.e., not just using it because it was there) General implication: those who used psychotherapy services were appropriate recipients (i.e., not just using it because it was there) Additional barriers may exist for those who are most distressed, as they were least likely to follow through on available support. Additional barriers may exist for those who are most distressed, as they were least likely to follow through on available support.

40 Observation from workshops suggested that many of those who declined to participate were among those visibly distressed at the time; these individuals were not included or counted in any way. Observation from workshops suggested that many of those who declined to participate were among those visibly distressed at the time; these individuals were not included or counted in any way. Follow up study enabled tracking of numbers who declined to participate: Follow up study enabled tracking of numbers who declined to participate:  7 out of 25 referred participants declined to participate in T2/chose not to complete the questionnaire  5 of these 7 did not attend counselling, despite requesting a referral  this is proportionate to those who did participate in the study/complete the T2 questionnaire for this portion of the study, but high compared to the original study.

41 A note on control: Of 125 participants who completed this question at T2 and T3, 26 reported a different amount of control over having ended their previous employment situation. Of 125 participants who completed this question at T2 and T3, 26 reported a different amount of control over having ended their previous employment situation.

42 Unanswered Questions More conclusive data desirable in order to establish: More conclusive data desirable in order to establish: –differences in employment outcomes for those who attended counselling vs not –change in emotional wellbeing for those who attended counselling vs not –interaction between supportive services (e.g., psychotherapy, employment counselling, educational opportunities), employment status, and wellbeing

43 Plans going forward Project continues to July 2012 Project continues to July 2012 Hope to have T3 completed by approximately 20 additional participants across counselling conditions Hope to have T3 completed by approximately 20 additional participants across counselling conditions Acquire additional “baseline” data about employment outcomes for the agency and community hosting this research for comparison Acquire additional “baseline” data about employment outcomes for the agency and community hosting this research for comparison Open to suggestions from Cannexus 2012 attendees! Open to suggestions from Cannexus 2012 attendees!

44 Big Issues with Small Numbers Numbers at T3 – too low for many comparisons to be made. Numbers at T3 – too low for many comparisons to be made. Unknown reasons for completing/not completing T3… are the 20% of participants who chose to participant significantly different from the 80% who did not? Unknown reasons for completing/not completing T3… are the 20% of participants who chose to participant significantly different from the 80% who did not?  E.g., unknown employment status for those who did not complete T3 – did people who got jobs not come back for the follow up study? Or were those who were too discouraged refuse to participate?

45 Employment Outcomes at GCC Prior to Aug 1/10Since Aug Current Study - T3 12 week follow up EO 0 weeks/e xit 12 week follow up 6 month follow-up employed3415 (68%)332 (50%)340 (61%)43 (34%) training/school na self-employed not searching/unable to work 2517na unemployed/job searching unknown/lost contact(1590)(62)(68)(669) TOTAL

46 Beyond the Present Research Replication – new sites, larger numbers, varied methodology Replication – new sites, larger numbers, varied methodology Need for qualitative research to confirm meaning of some of the quantitative ideas Need for qualitative research to confirm meaning of some of the quantitative ideas Engage practitioners in discussion, planning (any volunteers?) Engage practitioners in discussion, planning (any volunteers?)

47 Interested in more information? John Griffiths – John Griffiths – Rebecca Machado - Rebecca Machado -


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