EFFECT OF COGNITIVE-BEHAVIORAL TRAINING ON JOB-FINDING AMONG LONG-TERM UNEMPLOYED PEOPLE

Background The principles of cognitive-behavioural therapy (CBT) have been applied successfully through individual psychotherapy to several psychiatric disorders. We adapted these principles to create a group-t raining programme for a non-psychiatric group-long-term (>12 months) u nemployed people. The aim was to investigate the effects of the progra mme on measures of mental health, job-seeking, and job-finding. Method s 289 volunteers (of standard occupational classification professional groups) were randomly assigned to a CBT or control programme, matched for all variables other than specific content, that emphasised social support. 244 (134 CBT, 110 control) people started the programmes and 199 (109 CBT, 90 control) completed the whole 7 weeks of weekly 3 h s essions (including three CBT, seven control participants who withdrew because they obtained employment or full-time training). Questionnaire s completed before training, on completion, and 3-4 months later (foll ow-up data available for 94 CBT, 89 control) assessed mental health, j ob-seeking activities, and success in job-finding. Analyses were based on those who completed the programmes. Participants were not aware th at two interventions were being used. Investigators were aware of grou p allocation, but were accompanied in all programmes by co-trainers wh o were non-investigators. Findings Before training, 80 (59%) CBT-group participants and 59 (54%) controls scored 5 or more on the general he alth questionnaire (GHQ; taken to define psychiatric caseness). After training, 29 (21%) and 25 (23%), respectively, scored 5 or more (p<0.0 01 for both decreases). Improvements in mean scores with training on t he GHQ (between-group difference 3.91, p=0.05) and in other measures o f mental health were significantly greater in the CBT group than in th e control group. There were no significant differences between the gro ups in job-seeking activity during or after training, but significantl y more of the CBT group than of the control group had been successful in finding full-time work (38 [34%] vs 13 [13%], p<0.001), by 4 months after completion of training. Interpretation These results suggest th at group CBT training can improve mental health and produce tangible b enefits in job-finding. Application of CBT among the unemployed is lik ely to benefit both individuals and society in general.