Research and Publications
ORS strongly believes in the benefits of research and the need to use evidence-based services within all of our allied health and employment related services. ORS also believes in the need to evaluate service delivery across all service areas and programs.
ORS are currently engaging in a research project where we are reviewing the impact of emotion regulation training on NDIS funded behaviour support clients who engage in physical aggression toward others.
This research is being headed up by Anthea Smith, General Manager of Psychological Services and Behaviour Support in consultation with Dr Vanessa Parletta, CEO and Dr Geoff Waghorn, Senior Innovation and Research Consultant. The findings from this study will be submitted for publication and will form the basis of a PhD. ORS are keen to employ research focussed individuals with a passion for using research to improve the service delivery of allied health services across industries.
Previous research studies conducted within ORS have evaluated the influence of wage subsidies on open employment for people with a disability, the effectiveness of evidence based supported employment for people with psychiatric disabilities in Australia, the applicability of evidence based supported employment to adults with participation obligations as a condition of receiving welfare benefits and the financial viability of Individual Placement and Support within Disability Employment Services. The details and abstracts of these peer reviewed journal articles are outlined below.
These services can be funded by the NDIS, Employment/Disability Services Providers, My Aged Care, and privately.
We believe in the need to evaluate service delivery across all service areas and programs.
The influence of wage subsidies on the open employment of people with disabilities
Parletta, V., Waghorn, G. & Dias, S. (in press). The influence of wage subsidies on the open employment of people with disabilities. Journal of Rehabilitation.
The aim of this investigation was to explore in more detail whether, and how, wage subsidy schemes in Australia designed for people with disabilities facilitate employment in the open labour market. The cohort consisted of participants who commenced employment within 18 months of receiving employment assistance from a single large provider of disability employment services (N = 4,516). Among those 3,286 (72.8%) commenced employment in jobs not linked to wage subsidies, and 1,230 (27.2%) had at least one job linked to the actual payment of wage subsidies. The results indicate that both Australian Government and service provider funded wage subsidy schemes had complementary and beneficial effects. Jobs linked to any type of wage subsidy commenced sooner and were more likely to reach both 13-week and 26-week employment milestones, than jobs not linked to wage subsidies. These particular subsidy schemes appear to facilitate the employment of people with disabilities in the Australian open labour market. Although selection bias cannot be eliminated as an alternative explanation, the use of wage subsidies by one large service provider in Australia is associated with enhanced outcomes measured by time to commencing employment and attainment of both 13-week and 26-week employment duration milestones.
Individual Placement and Support (IPS) in Australia: Progress in the past 15 years
Waghorn, G., Killackey, E., Dickson, P., Brock, L., & Skate, C. (2019, June 17). Evidence-Based Supported Employment for People With Psychiatric Disabilities in Australia: Progress in the Past 15 Years. Psychiatric Rehabilitation Journal. Advance online publication. http://dx.doi.org/10.1037/prj0000370
Objective: This report summarizes the major developments in Australia since the first introduction of Individual Placement and Support (IPS) in 2005 in order to outline the current situation and discuss future challenges and opportunities.
Method: Using an informal snowball sampling method, all those known to be involved in IPS implementations in Australia in the last 5 years were contacted.
Results: The program has expanded from 2 full-time employment specialists in 2005 to 87.6 in 2018. The expansion has been most promising in youth mental health where an initial national 14-site trial of IPS was recently expanded to 24
sites. If the trial is successful, IPS may become a core component of a national youth mental health initiative. Expansion in the adult community mental health sector has been constrained by several factors including the low priority for rehabilitation in the public mental health system. On the positive side, the availability of independent technical support from Western Australia means that all new IPS sites can receive expert technical support for program implementation, continuing high-fidelity delivery, external fidelity assessment, outcome evaluation, and cohort-based outcome reporting.
Conclusion and Implications for Practice: The expansion of IPS in the public funded adult mental health sector has not kept pace with progress in the youth mental health sector. There is an urgent need for adult mental health services to cease excluding vocational rehabilitation from treatment, care, and recovery plans. Disability Employment Service contract managers could increase disincentives for providers to adopt high caseloads and low intensity services, at the expense
of more intensive evidence-based practices.
The applicability of supported employment to adults with participation obligations as a condition for receiving welfare benefits
Parletta, V., Waghorn, G. & Dias, S. (2017). The applicability of supported employment to adults with participation obligations as a condition for receiving welfare benefits. American Journal of Psychiatric Rehabilitation, 20:2, 106-125, DOI:
Individual Placement and Support (IPS) is an evidence-based approach to supported employment designed specifically for people with severe mental illness or psychiatric disabilities. It is unclear whether this approach generalizes to adults with less severe mental illnesses. In addition, because IPS is intended for motivated volunteers, it remains unclear whether it is also applicable to individuals with mental illness who have government-imposed obligations to participate in supported employment programs. This study evaluated an IPS enhancement intervention on the Central Coast of New South Wales, Australia, involving 68 adults with a range of different mental illnesses. Thirty-seven of 68 participants had participation obligations as a condition of receiving welfare benefits, and 31 of 68 participants had no such obligations. All participants were tracked for 18 months following program commencement to assess job commencements and 13- and 26-week employment milestones. Usual services enhanced by IPS achieved significantly more job commencements than pre-IPS services. However, those with participation obligations were not less motivated and benefitted as much from the program as those with no participation obligations. The results support the application of evidence-based practices in supported employment to job seekers with more diverse forms of mental illness than the severe mental illnesses. These preliminary results support the generalization of evidence-based practices to policy settings where participation in supported employment is conditional on receiving welfare benefit payments.
The financial viability of evidence-based supported employment for people with mental illnesses in Disability Employment Services
Parletta, V., Waghorn, G. & Dias, S. (2016). The financial viability of evidence-based supported employment for people with mental illnesses in a blended funding system. Journal of Vocational Rehabilitation, 44, 227-241, DOI: 10.3233/JVR-150793
BACKGROUND: Although the Individual Placement and Support (IPS) approach to supported employment has been shown to be more effective than other approaches, it is not clear whether IPS is financially viable within a blended funding system.
OBJECTIVE: This study aimed to compare the financial viability of two approaches (pre-IPS and IPS enhanced) to supported employment for people with mental illnesses in a context where fee for service funding is blended with results based funding.
METHODS: An Australian disability employment service at three locations on the central coast of New South Wales (n = 107) assessed their pre-IPS service results over an 18 month period in terms of job commencements and the attainment of 13 and 26 week employment milestones. Services were then enhanced with IPS practices and a new cohort (n = 68) was tracked for the same outcome variables over the same time period. Both results were compared to the national cohort of disability employment service participants with the same primary psychological or psychiatric disability type (n = 15,496).
RESULTS: Supported employment services enhanced by IPS practices achieved significantly more job commencements (67.6%) than pre-IPS services (56.1%) and the national average for DES providers (39.9%). IPS enhancements were most cost effective per person and per 26 week employment milestone, for those with greater assistance needs.
CONCLUSIONS: IPS enhanced employment services were most financially beneficial when applied to participants with more severe psychiatric disabilities. Providers assisting people with psychological or psychiatric disabilities could benefit from developing a capability to deliver more intensive evidence-based practices such as IPS. The financial advantage of IPS enhancements increases with both the extent of clients’ assistance needs and with the funding system’s emphasis on results-based funding.
Staff Publications (Staff members name highlighted in bold)
Akram, U., Barclay, N. L., & Milkins, B. (2018). Sleep-Related Attentional Bias in Insomnia: Time to Examine Moderating Factors? Frontiers in Psychology, 9(December). https://doi.org/10.3389/fpsyg.2018.02573
Courtauld, H., Notebaert, L., Milkins, B., Kyle, S. D. and Clarke, P. J. F. (2017). Individuals with clinically significant insomnia symptoms are characterised by a negative sleep-related expectancy bias: Results from a cognitive-experimental assessment. Behaviour Research and Therapy, 95: 71-78. https://doi.org/10.1016/j.brat.2017.05.010
Clarke, P. J. F., Bedford, K., Notebaert, L., Bucks, R., Rudaizky, D., Milkins, B., & MacLeod, C. (2016). Assessing the therapeutic potential of targeted attentional bias modification for insomnia using smartphone delivery. Psychotherapy and Psychosomatics, 85(3): 187-189. https://doi.org/10.1159/000442025
Dias, S., Waghorn, G., et al. (2018). Identifying rehabilitation priorities among ex-prisoners vulnerable to mental illnesses and substance abuse. Journal of Rehabilitation MS JoR-2017-126.
Gladman B., Waghorn, G. (2016). The employment experiences of people with severe mental illness. Work: a Journal of Prevention, Assessment, and Rehabilitation, 53, 835-843.
Gladman, B, Waghorn, G., Wishart, L., Dias, S. (2015). Reliability of a measure of health professionals’ perceptions of integrated employment services for people with psychiatric disabilities. Journal of Rehabilitation, 81(1), 3-8.
King, J., Waghorn, G. How higher performing employment specialists help job-seekers with psychiatric disabilities to obtain competitive employment. Submitted 6 Feb 2018 to Journal of Rehabilitation. Enquiry sent April 2019. Original lost by editor. Resubmitted June 2019. Last paper in the series.
Hielscher, E. Waghorn, G. (2017). Self-stigma and fear of employment among adults with psychiatric disabilities. Published as online first by British Journal of Occupational Therapy.
Hielscher, E. Waghorn, G. (2016). The thematic congruence of a plan for helping people with severe mental illness manage their personal information in supported employment. Journal of Rehabilitation, 82(1), 12-26.
Hielscher, E., Waghorn, G. (2015). Managing disclosure of personal information: An opportunity to enhance Supported Employment. Psychiatric Rehabilitation Journal, 38(4), 306-313.
Jonsdottir, A., Waghorn, G. Psychiatric disorders and labour force activity. (2015). Mental Health Review, 20(1), 13-27.
King, J., Waghorn, G. (2018). How high performing employment specialists help people with psychiatric disabilities to retain employment. Journal of Rehabilitation. MS JoR-2017-158.
King, J., Waghorn, G. (2018). How high performing employment specialists engage and support job-seekers with psychiatric disabilities. Journal of Rehabilitation.
Lockett, H., Waghorn, G., Kidd, R. (2018). How program implementation science can inform the development of evidence-based practices in vocational rehabilitation. Accepted 11 August 2017 by Journal of Vocational Rehabilitation.
Lockett, H., Waghorn, G., Kidd, R. (2018). Policy barriers to evidence-based practices in vocational rehabilitation for people with psychiatric disabilities in New Zealand. Work: a Journal of Prevention, Assessment, and Rehabilitation.
Lockett, H., Waghorn, G., Kidd, R., Chant, D. (2017). Predictive validity of evidence-based practices in supported employment. A systematic review and meta-analysis. Mental Health Review, 21(4), 261-281.
McGahey, E., Waghorn, G., Lloyd, C., Morrissey S., & Williams PL. (2016). A formal plan for self-disclosure enhances employment outcomes for young people with severe mental illness. Early Intervention in Psychiatry, 10, 178-185.
Milkins, B., Notebaert, L., Clarke, P. J. F., & MacLeod, C. (2016). The potential benefits of targeted attentional bias modification on cognitive arousal and sleep quality in worry-related sleep disturbance. Clinical Psychological Science, 4(6): 1015-1027. https://doi.org/10.1177/2167702615626898
Morgan, V., Waterreus, A., Carr, V., …, Waghorn, G., et al. (2017). Responding to challenges for people with psychotic illness: Updated evidence from the Survey of High Impact Psychosis. Australian and New Zealand Journal of Psychiatry, 51(2),
Van Veggel, R., Waghorn, G. Dias, S. (2015). Implementing evidence-based supported employment in Sussex. British Journal of Occupational Therapy, 78(5), 286-294.
Waghorn, G., Van Veggel, R., Lockett, H., Chant, D. (2018). The utility of item level fidelity scores for developing evidence based practices in supported employment. Accepted by Journal of Vocational Rehabilitation, 48, 387-391.
Waghorn, G., Hielscher, E., Logan, J., Dias, S. (2017). Vocational functioning among people with psychiatric disabilities five to seven years after receiving supported employment services. Journal of Rehabilitation, 83(2), 36-42.
Waghorn, G., Hielscher, E., Saha, S., McGrath, J.J. (2016). Cognitive and clinical indicators of employment assistance needs in a national survey of psychosis. Psychiatric Rehabilitation Journal, 39(2), 112-119.
Waghorn, G. (2016). Special issue: Vocational rehabilitation (II). British Journal of Occupational Therapy, 79(11), 641-642.
Waghorn, G. (2016). Special issue: Vocational rehabilitation (I). British Journal of Occupational Therapy, 79(5), 255-256.
Waghorn, G., Hielscher, E., Atyeo, J., Saha, S. (2016). The impact of psychotic disorders and comorbid substance abuse on vocational rehabilitation: Results from a national survey of psychosis. British Journal of Occupational Therapy, 79, 290-298.
Waghorn, G., Hielscher, E., & Shields, J. (2015). Planning post-employment support for people with psychiatric disabilities. Journal of Rehabilitation, 81(3), 21-33.
Waghorn, G., Dias, S. Gladman, B., Harris, M. (2015). Measuring what matters: Effectiveness of implementing new evidence-based supported employment for adults with severe mental illness. International Journal of Therapy and Rehabilitation, 22(9),
Waghorn, G. (2015). FactCheck: Is a job a prescription for a young person with mental health issues? The Conversation, 1 July. http://theconversation.com/factcheck-is-a-job-a-prescription-for-a-young-person-with-mental-health-issues-43992.
Westcott C, Waghorn G., McLean, D., Strathan, D., Mowry, B. (2017). Correlates of employment interest and actual employment among adults with schizophrenia. International Journal of Therapy and Rehabilitation, 24(12), 510-519.
Westcott C, Waghorn G., McLean, D., Strathan, D., Mowry, B. (2015). Interest in employment among people with schizophrenia. American Journal of Psychiatric Rehabilitation, 18(2), 187-207.
Westcott C, Waghorn G., McLean, D., Strathan, D., Mowry, B. (2015). Role functioning among adults with schizophrenia. British Journal of Occupational Therapy, 78(3), 158-165.
Williams PW, Lloyd C, Waghorn G, Machingura T. (2015). Implementing evidence-based practices in supported employment on the Gold Coast for people with severe mental illness. Australian Journal of Occupational Therapy, 62(5), 316-325.