Abstract: Unpacking Diverse Vocational Trajectories Among Youth and Young Adults with Early Psychosis in Order to Transform Policy and Practice (Society for Social Work and Research 30th Annual Conference Anniversary)

Schedule:

Friday, January 16, 2026

Marquis BR 8, ML 2 (Marriott Marquis Washington DC)

* noted as presenting author

Nev Jones, PhD, Associate Professor, University of Pittsburgh, Pittsburgh, PA

Christina Babusci, MSS, PhD Student, University of Pittsburgh, Pittsburgh, PA

Callie Bennet, MSW, Research Coordinator, University of Pittsburgh, PA

Sara McNemar, BA, Research Coordinator, University of Pittsburgh, PA

Shannon Pagdon, BA, PhD Student, University of Pittsburgh, PA

Yasmine Boumaiz, BA, Research Assistant, University of Maryland at Baltimore, MD

Aruna Saravana, BA, Research Assistant, University of Maryland at Baltimore, MD

Anastasia Fetisova, BA, Research Assistant, University of Maryland at Baltimore, MD

Adaeze Anokwuru, BA, Research Assistant, University of Maryland at Baltimore, MD

Peter Phalen, PsyD, Assistant Professor, University of Maryland at Baltimore, MD

Background: Estimated rates of un- and underemployment among adults with schizophrenia range from 75-90%, among the highest of any disability group in the United States. While specialized early intervention in psychosis services (EPS) were designed to substantially improve functional recovery, actual rates of vocational engagement remain disappointingly low: in the NIMH RAISE multisite EPS trial, for example, actual rates of employment and education did not differ between EPS recipients and controls. The goal of the current research is thus to document limitations of current intervention models and barriers that even those youth/young adults with access to EPS continue to experience.

Methods: We present qualitative data (client N = 60, family N = 15, provider N = 15) collected to date as part of a large, 5-year NIMH funded study of vocational trajectories in early psychosis. Our qualitative approach integrated techniques from grounded theory (e.g. theoretical sampling) with a realist emphasis on context-mechanism-outcomes (CMO), aiming to unpack how and why different pathways emerge and what supports work for whom and under what circumstances, including components of EPS.

Results: We identified four core mechanisms underlying diverse trajectories: self-efficacy, identity transformation (non-illness-centered identity), family and social network support, and financial capacitation. Each mechanism was in turn shaped by key contextual themes including cultural and class background, family political views on work and social welfare, and policies and practices relevant to work and school in participant’s EPS programs.

Discussion: Our discussion of project findings will focus on policy- and practice-relevant learning generated by the study, including modifiable factors at the level of EPS service delivery and at the level of broader policy, and our team’s operational strategies for translating our research into real-world impact. Key takeaways include the need to diversify interventions beyond the Individual Placement and Support (IPS) model of supported employment in the context of EPS, to build supports outside of clinical services in work and school settings, and to recenter funding streams and services that address underlying socioeconomic inequality, including preparation and sociostructural support for higher education among first generation and low SES young adults.