Comparing Outcomes of Supported Education Programs
The aim for this review was to understand (a) what outcomes have been reported for SEd interventions and (b) what components in SEd modality and interventions have been successful.
Figure 1. PRISMA Flow Diagram of Study Selection.
(Click to view Figure 2 in a new window.)
Search Strategy
The search strategy examined literature published in English from 1970 through 2023 focused on supported education interventions, post-secondary students, and mental health conditions.
The sources of the included studies were drawn from the following databases:
A) PubMed. The keyword “supported education” searched in title and abstract
B) PsycINFO. The keyword “supported education” searched in title and abstract
C) EBSCOHost (Academic Search Premier, ERIC, and MEDLINE). The following keywords were grouped into the following four categories:
1. Supported education: “supported education” (in Title or Abstract)
2. Education setting: “university students” / “college students” / “undergraduate students” / “higher education students” (in Abstract)
3. Psychiatric disabilities: “mental health” / “mental illness” / “mental disorder” / “psychiatric illness” (in Abstract)
4. Study type: “trial” / “study” / “experiment” (in Abstract)
The following search string was used to search for relevant articles in EBSCOHost which included Academic Search Premier, ERIC, and MEDLINE: “TI supported education OR AB supported education AND AB (university students or college students or undergraduate students or higher education students) AND AB (mental health or mental illness or mental disorder or psychiatric illness) AND AB (trial or study or experiment ).” The search strategy in EBSCOHost was also supplemented by applying a filter for articles only with a population age over 13 years old.
Eligibility Criteria
Inclusion Criteria:
1. Published between 1970 and 2023 (Papers were included if they were published since 1970. This year was chosen because SEd first emerged as a provisional concept in the 1980s.)
2. Written in English.
3. Examined a supported education intervention.
4. Population included postsecondary education students with mental health conditions.
5. Used RCT, quasi-experimental, experimental designs, open trial, and implementation study design.
Exclusion Criteria:
1. Not related to a supported education intervention, postsecondary education students, or mental health conditions.
2. Focus groups, surveys, individual case studies, review articles, book chapters, editorials, and commentaries.
Abbreviations:
IPS= Individual Placement and Support
SEd=Supported Education
SMHCs= serious mental health conditions
MHCs= Mental Health Conditions
Table 1. Comparing Outcomes of SEd Programs in 17 Randomized Controlled Trial (RCT) Studies
| Author, Year | Program Name | Participants | Staff/Modality | Design | Components | Outcomes | Duration/Frequency /Country |
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| Jäckel et al., 2023 | Supported Employment and Education (SEEearly) | Adolescents/ Young Adults | SEE Specialists (Offsite) | RCT | IPS principles, Engagement techniques |
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| Nuechterlein et al., 2008 | Individual Placement & Support (IPS) Model Adaptation |
First-Episode Schizophrenia (n=69) |
IPS Specialist | RCT | Individualized goals, IPS integrated into treatment |
Competitive employment, Schooling engagement |
*18 months *Weekly for 6mths, then 12mths fading frequency *USA |
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| Nuechterlein et al., 2020 | Individual Placement & Support – Workplace Fundamentals Module (IPS-WFM) |
First-Episode Schizophrenia (n=69) |
IPS Specialist, WFM |
RCT | IPS principles, WFM group sessions | 83% in competitive employment/school | *18 months *Weekly for 7mths, then 1x every 2wk for 4mths, then monthly *USA |
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| Rosenheck et al., 2017 |
Supported Education and Employment Services (SEE) |
First-Episode Psychosis (n=404) |
SEE Specialists |
RCT | Active benefits counseling, Patient preferences |
Increased participation in work/school | *24 months *Weekly *USA |
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| Gill et al., 2021 | College Students | Schizophrenia, Mood, Anxiety Disorders (n=148) | SEd Staff | RCT | Individualized assessment, services | 82% course completion, Improved faculty interaction | *2 years *N/A *USA |
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| Hofstra et al., 2021 | Community Participation through Education (COMPARE) |
Students w/ MHCs (n=100) |
SEd Specialist | RCT | Coaching, Teaching critical skills |
Ongoing study | *12 months *N/A *Netherlands |
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| Collins et al. (1998); Collins et al. (1999); Mowbray (2000); Mowbray et al. (2001); Mowbray et al. (1999); Mowbray et al. (2002) |
Michigan Supported Education (SEd) Program |
Psychiatric Disability (n=397) | SEd Program Staff (Onsite) |
RCT | Classroom, Group, Individual cohorts |
High participant rates, Improved QoL, Self- esteem |
*Two 14-week semesters (approx 7 months) *Twice per week *USA |
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| Ellison et al., 2018 | VetSEd Manual | Veterans w/ PTSD (n=33) | Trained Veteran Peers | RCT | Peer coaching, Personalized educational plans | Reduced time to educational goals, Increased participation | *6 months *Weekly *USA |
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| Otto et al., 2020 | Mindset Training | Students Seeking Mental Health Services (n=60) |
Professionals in cognitive remediation |
RCT | Improving academic outcomes, Formulating personal educational goals |
Ongoing study | *12 weeks *Weekly *Netherlands |
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| Mullen et al., 2017 | Focused Academic Strength Training (FAST) |
College Students w/ Psychiatric Conditions (n=72) |
Not specified | RCT | Concepts taught through interactive exercises |
Increased self-efficacy, ↓ academic difficulties |
*12 weeks *Weekly *USA |
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| Kidd et al., 2014 | Redirection Through Education (RTE) (integrated w/ cognitive remediation (CR)) |
SEd Participants w/ Psychosis (n=37) |
SEd Specialists |
RCT | Cognitive remediation integrated into RTE |
Better retention & improvement |
*10 weeks (CR + SEd) *2x/wk for computer-based cognitive exercise sessions, Weekly group discussion sessions *Canada |
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| Gutman et al., 2009 | Bridge Program | Adults w/ Psychiatric Disabilities (n=38) |
OT Students | RCT | Weekly modules on academic skills & vocational topics |
Improved academic skills, Return to school/work |
*6 weeks *Twice per week, 2- hr training module and 1-hr individual mentoring per session *USA |
Note. Articles are organized based on program type Combined SEd and Supported Employment, blue; Traditional SEd, Green; Self-contained classroom, Orange; Peer-delivered SEd, yellow; Enhanced SEd (i.e. cognitive remediation), purple; Occupational therapy-based SEd, gray. SEd=Supported Education, SMHCs= serious mental health conditions, MHCs= Mental Health Conditions; IPS = Individual Placement & Support; SE = Supported Employment; QOL = Quality of Life; TAY = Transition-age youth; IPS-WFM = Individual Placement & Support-Workplace Fundamentals Model, StAB = Start in education and employment, CAP = Consumer as Provider, CAR = Career Advancement Resources, ACES = Academic Coaching for Educational Success, MHA = Mental Health Association NCT = Non-Cognitive Therapy, ADA = Americans with Disabilities Act SEP = Supported Education Program, RTE = Redirection Through Education, SEER = Supported Education Enhancing Rehabilitation.
Table 2. Comparing Outcomes of SEd Programs in 18 Quasi-Experimental and Open Trial Studies
| Author, Year | Program Name | Participants | Staff/Modality | Design | Components | Outcomes | Duration/Frequency /Country |
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| Killackey et al., 2017 | Adapting Individual Placement & Support to Education (IP Sed) |
Young adults w/ SMI (n=19) | Education specialist | Open Trial | Coaching, Support |
|
*6 months *Not specified *Australia |
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| Rudnick & Gover, 2009 | Supported Employment & Supported Education (SE & SEd) Program |
Individuals w/ psychiatric disabilities (n=96) |
Trained SEd professionals (Onsite) |
Open Trial | Three-stage program |
Competitive employment, Individual training, Job searching |
*Stage 1 – 3 mths; Stage 2 – 1 yr *Stage 1 – 5 days per wk; Stage 2 – 5 days per wk *Israel |
|
| Maru et al., 2018 | Integrated Supported Employment – Supported Education (SE -SEd) |
Participants w/ diagnosed mental illness (n=57) |
Trained specialists (Onsite) |
Open Trial | Psychiatric rehab principles, Individual goals |
Integration of SE/SEd, ↓ Depression, ↑ Stability |
*1 year *Varied meetings based on goals *USA |
|
| Rinaldi et al., 2010 | Individual Placement & Support (IPS) combined w/ Supported Education Combined (SEd) |
Young people with first episode psychosis (n=166) |
Employment specialist (Offsite) | Naturalistic Evaluation | Vocational focus, Individualized goals |
Gaining/retaining open employment & mainstream education | *2 yrs *Fidelity ratings at 6, 12, 18, 24 months *UK |
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| Ow et al., 2022 | Youth Employment Skills Strategy (YESS) |
Youths w/ mental illness (n=110) |
Two IPS specialists, peer support worker, program coordinator (Offsite) |
Open Trial | 5-week program, One- on-one coaching |
More than 25% improved, ~33% gained employment |
*16 weeks (5-wk intervention; 11-wk follow up) *Twice per wk; 1-hr session *Canada |
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| Humensky et al., 2019 | Supported Education and Employment Services (SEE) | Individuals w/ non-affective psychosis (n=779) | SEE specialists (Offsite) | Open Trial | SEE services in coordinated care, On-going support | Use of SEE services for education positively impacted enrollment | *6 mths up to 2 yrs *Not specified *USA |
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| Hoffmann & Mastrianni, 1993 | Four Winds- Saratoga College Service | Young adults (n=97) | Inpatient therapists/ community college faculty (Offsite) |
Quasi- experimental | Affiliated with a local college, Individually focused academic activities |
College Service patients re-entered normative settings & maintained academic aspirations | *Saratoga avg. stay: 19.2 weeks *Westchester avg. stay: 17.5 weeks *Not specified *USA |
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| Schniedermann et al., 2022 | Start in education and employment (StAB) | Adolescents & young adults w/ MHCs (n>75) | Coaches trained by project team (Offsite) | Quasi- experimental | IPS coaching, Address stagnations | Ongoing Study | *2 years *According to participant needs *Germany |
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| Unger & Pardee, 2002 | 3 settings w/ Supported Education (SEd) programs | Students w/ psychiatric disorders (n=124) | Trained staff members (1 Onsite/2 Offsite) | Open Trial | Three settings, Extensive interviews | Successful completion of college credits, Improved life satisfaction | *3 years *Not specified *USA |
|
| Morrison & Clift, 2006 | Supported Education Programme | Students w/ long-term mental illness (n=148) |
Not specified (Onsite) | Open Trial | Antonovsky’s health model, Personal tutor support | Positive gains in Sense of Coherence Scale | *3 academic years *Not specified *UK |
|
| Annapally et al., 2021 | Supported Education Programme (SEP) | College students w/ severe mental diseases (n=14) | Not specified (Onsite) | Open Trial | Two themes, 18 components |
Feasible in helping students reintegrate into academics | *1 year *Not specified *India |
|
| Unger et al., 1991 | Supported Education (SEd) Program | Young adults w/ severe psychiatric disabilities (n=52) |
SEd staff (Onsite) | Open Trial | Develop skills for career plan | 42% employed or enrolled in education program | *4 semesters *Not specified *USA |
|
| Davis, et al., 2022 | Peer Academic Supports for Success (PASS) | Young adult college students w/ MHCs (n=12) | Peers with or without MHCs (Onsite) | Open Trial | Peer coaching, Identifying academic challenges | Attracts & retains students, Promising support for students w/ MHCs | *Two academic semesters *At least once/week; at least 50-min session *USA |
|
| Ellison et al., 2015 | Supported Employment & Supported Education (SE & SEd) for Emerging Adults | Early-emerging adults w/ serious mental health conditions (n=35) | SEd specialist & Peer mentors (Onsite) | Open Trial | Peer mentorship, Vocational support groups | 49% started job/education program in 12 months | *12 months *SEd service – 1x/mth *Peer mentorship – 1x/mth *USA |
|
| Kinney et al., 2020 | New Start for Student Veterans Supported Education (NSSV SEd) services |
Veterans in SEd services (n=94) | Trained veteran peers | Open Trial | Multifaceted educational services, Individualized supports | Apply trauma-informed care, Promote academic self-efficacy | *N/A *Not specified *USA |
|
| Kidd et al., 2012 | Redirection Through Education (RTE) (w/ Cognitive Remediation) | Students with psychosis (enrolled in cognitive remediation) (n=16) | SEd specialists/
Clinical Psychologist (Onsite) |
Open Trial | CR integrated into RTE, Assessments | Feasible integration of CR into SEd, Enjoyable with improvements | *10 weeks (CR intervention + Supported Ed.) *2x/wk for computer- based cognitive exercise sessions; 50- min session *Weekly group discussion sessions; 50 min *Canada |
|
| Schindler & Kientz, 2013 | Bridge Program | Individuals w/ MHCs (n=48) | Occupational therapy graduate students | Open Trial | Self-contained classrooms, One-to-one mentoring | Customized approach efficient in reaching goals | *Not specified *Weekly *USA |
|
| Ponizovsky et al., 2004 | Supported Education Program (SEP) | Service-user students (SUS) w/ schizophrenia (n=70) | Social worker/ Occupational therapist (Offsite/mobile) |
Quasi- experimental | Courses, Small groups | SUS participants utilized emotion & avoidance coping | *3-6 months *1-2x/wk; 3-4hr sessions *Israel |
Note. Articles are organized based on program type Combined SEd and Supported Employment, blue; Traditional SEd, Green; Self-contained classroom, Orange; Peer-delivered SEd, yellow; Enhanced SEd (i.e. cognitive remediation), purple; Occupational therapy-based SEd, gray. SEd=Supported Education, SMHCs= serious mental health conditions, MHCs= Mental Health Conditions; IPS = Individual Placement & Support; SE = Supported Employment; QOL = Quality of Life; TAY = Transition-age youth; IPS-WFM = Individual Placement & Support-Workplace Fundamentals Model, StAB = Start in education and employment, CAP = Consumer as Provider, CAR = Career Advancement Resources, ACES = Academic Coaching for Educational Success, MHA = Mental Health Association NCT = Non-Cognitive Therapy, ADA = Americans with Disabilities Act SEP = Supported Education Program, RTE = Redirection Through Education, SEER = Supported Education Enhancing Rehabilitation.
Table 3. Impactful Components, Implementation Barriers, and Outcomes in 15 Supported Education Implementation Studies
| Author, Year | Program Name | Participants | Staff/Modality | Design | Focus | Components | Barriers | Outcomes |
| Cohen et al., 2020 | IPS & SE | TAY, mental health conditions | CMHP (Offsite) | Case study, Pilot | Adaptations for TAY | Flexibility, family involvement, goal development | Engagement challenges, funding gaps | Advocacy for TAY-specific policies |
| McDiarmid et al., 2005 | Consumer as provider (CAP) Training | Individuals, severe mental illness (n=47) | CAP staff (Onsite) | Longitudinal | Consumer employment prep | Basic helping skills, recovery principles, executive skill development, accommodations | None | 63% employed at 6 months |
| Russell and Strauss, 2004 | Consumer as provider (CAP) | Adults, psychiatric disabilities (n=1077) | CAR staff (Mobile) | Implementation | CAR as SEE program | Skills training, peer mentor program, goal development | Stigma, fear of return to school/work | Fear addressed through support plans |
| Cooper, 1993 | ACES Program | Students, psychiatric diagnoses (n=22) | MHA staff (Mobile) | Implementation | ACES mobile SEd | 2-phase program, education coach, executive skill development, peer & academic support, goal development | Lack of college status for mobile support | All students utilized services |
| Isenwater et al., 2002 | College Link Program | Individuals, long-term mental health issues (n=37) | Psychology grad student (Onsite) | Mixed-method/ Implementation |
Outcome evaluation of SEd | Peer support, skill development, QOL improvement | None | Improved self-esteem, social functioning |
| Biebel et al., 2018 | Three sites with SEd initiatives | Individuals, received SEd services (n=20) | SEd staff (2 offsite; 1 onsite) | Focus groups/ Implementation |
Experiences of individuals with psychiatric disabilities | Specialist access, wellness, executive skill development, accommodations, QOL improvement | None | Students value supports for education |
| Thompson, 2013 | Supported Education Program | Students, mental illness/substance abuse (n unknown) | Peer support instructor (Onsite) | Implementation | Emotional well-being benefits | Peer support course, QOL improvement | Issues in rural provision of SEd | Improved emotional well-being |
| Pettella et al., 1996 | Kennedy Center’s S.E.P. | Individuals, psychiatric disabilities (n=15) | S.E.P. staff/Consultant Psychologist (Mobile/Onsite) | Implementation/ Case study |
Functional techniques for SEd | Career exploration, peer support, executive & academic skills development, goal development | None | Techniques facilitate academic success |
| Cook, & Solomon, 1993 | CSP | Students, severe mental illness (n=125) | CSP staff (Offsite/mobile) | Implementation/ Outcome |
Changes & accomplishments for PSE & trade schools | Career counseling, peer support, executive skill development | None | Improvements in academic/vocational achievements |
| Liberman et al., 1998 | SBPC SEP | Individuals, major psychiatric diagnoses (n=30) | SBPC staff (Offsite/mobile) | Implementation | Hybrid mobile-type SEP & counseling | Individual support, college info, academic supports, goal development | Cautious clinician referrals | 26.6% attended college |
| Parten, 1993 | Supported Education (Systems Approach) | Enrolled students, psychological disabilities (n=209) | College/SEd staff (Onsite) | Implementation/ 18-month pilot |
Efficacy of accommodation provisions | Systems approach, accommodations, peer support | None | Encouragement/support |
| Gilbert et al., 2004 | RTE | Adult consumers/survivors (n unknown) | Program staff (Onsite) | Implementation/ history |
History, challenges, outcomes of RTE | Various phases, vocational skills, executive skill development | Funding barriers, lack of therapeutic supports | RTE adapts over the years |
| Hain and Gioia, 2004 | SEER | Individuals, recovering from psychiatric disabilities (n unknown) | SEER staff (Onsite/mobile) | Implementation | Unique components of SEER | Support, normalization, flexibility, peer support, academic supports, QOL improvement | Ongoing funding issues, attrition | ~10% go on to PSE within 6 months |
| Dougherty et al., 1992 | SEd Program (Clubhouse Model) | Laurel House members (n=27) | SEd staff (Onsite/Offsite) | Implementation/ integration |
Integration of SEd into clubhouse model | Assessments, coordination, academic supports, goal development | None | 75% enrolled in community colleges |
| Bateman, 1997 | Statewide SEd Program | Individuals, psychiatric disabilities (n=42); parents (n=18) | Research team | Implementation/ Focus groups |
Phase 1 development of statewide SEd | Consumer/parent interviews, QOL improvement | None | Consideration of family input |
Note. Articles are organized based on program type Combined SEd and Supported Employment, blue; Traditional SEd, Green; Self-contained classroom, Orange; Peer-delivered SEd, yellow; Enhanced SEd (i.e. cognitive remediation), purple; Occupational therapy-based SEd, gray. SEd=Supported Education, SMHCs= serious mental health conditions, MHCs= Mental Health Conditions; IPS = Individual Placement & Support; SE = Supported Employment; QOL = Quality of Life; TAY = Transition-age youth; IPS-WFM = Individual Placement & Support-Workplace Fundamentals Model, StAB = Start in education and employment, CAP = Consumer as Provider, CAR = Career Advancement Resources, ACES = Academic Coaching for Educational Success, MHA = Mental Health Association NCT = Non-Cognitive Therapy, ADA = Americans with Disabilities Act SEP = Supported Education Program, RTE = Redirection Through Education, SEER = Supported Education Enhancing Rehabilitation.