Study Protocol: A Multisite Trial of Work-Related Cognitive Behavioral Therapy for Unemployed Persons with Social Anxiety

Joseph A. Himle, University of Michigan
Richard T. LeBeau, University of California Los Angeles
Addie Weaver, University of Michigan
Daphne M. Brydon, University of Denver
Deborah Bybee, Michigan State University
Amy M. Kilbourne, Medical School, University of Michigan
Raphael D. Rose, University of California Los Angeles
Katherine M. Tucker, University of Michigan
Richard Kim, University of California Los Angeles
Marcelina Perez, University of California Los Angeles
Fonda N. Smith, University of Michigan
Brandy R. Sinco, University of Michigan
Scott Levine, JVS SoCal (JVS), Los Angeles
Nicole Hamameh, JVS Human Services (JVS), Detroit
Monique McKiver, JVS Human Services (JVS), Detroit
Paul T. Wierzbicki, JVS SoCal (JVS), Los Angeles
Anni M. Hasratian, Southern Methodist University
Michelle G. Craske, University of California Los Angeles

Abstract

This paper provides a methodological description of a multi-site, randomized controlled trial (RCT) of a cognitive-behavioral intervention for enhancing employment success among unemployed persons whose employment efforts have been undermined by social anxiety disorder (SAD). SAD is a common and impairing condition, with negative impacts on occupational functioning. In response to these documented employment-related impairments, in a previous project, we produced and tested an eight-session work-related group cognitive-behavioral therapy provided alongside vocational services as usual (WCBT + VSAU). WCBT is delivered by vocational service professionals and is designed in a context and style that overcomes accessibility and stigma-related obstacles with special focus on employment-related targets. Our previous project found that WCBT + VSAU significantly improved social anxiety, depression, and a range of employment-related outcomes compared to a control group of socially anxious job-seekers who received vocational services as usual without WCBT (VSAU-alone). Participants in this study were all homeless, primarily African American job-seekers with high levels of psychiatric comorbidity and limited education and employment histories. The present, two-region study addresses whether WCBT + VSAU enhances job placement, job retention and mental health outcomes in a larger sample assessed over an extended follow-up period. In addition, this trial evaluates whether the effects of WCBT + VSAU generalize to a new population of urban-based, racially diverse job-seekers with vocational and educational histories that differ from our original sample. This study also investigates the system-effects of WCBT + VSAU in a new site that will be informative for broad implementation of WCBT + VSAU. Finally, this project involves a refined, technology-assisted form of WCBT + VSAU designed to be delivered more easily by vocational services professionals.