Recruiting

Purposeful Pathways & TW

Sponsor:

VA Office of Research and Development

Code:

NCT07097376

Conditions

Unemployment

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Purposeful Pathways

Transitional Work

Study Details

Brief summary:

Veterans living with mental health and substance use conditions are at risk of unemployment, which leads to significant health-related consequences. Though the Veterans Health Administration offers numerous vocational rehabilitation programs to address unemployment, they are not uniformly effective for everyone who participates. This project will test a new model for addressing Veteran unemployment. This new model adds career development services (a vocational counseling program called Purposeful Pathways) to a standard model of vocational rehabilitation (a program called Transitional Work \[TW\]). The investigators will test if adding Purposeful Pathways to TW leads to more Veterans working in quality jobs as well as better quality of life, reduced mental health symptoms, and reduced substance use. This project fills a critical need in advancing research and practice aimed at reducing Veteran unemployment; thereby preventing consequences to Veteran's economic, social, and health related functioning and well-being.

The investigators will conduct a phase II, multi-site, RCT comparing Purposeful Pathways + TW (n=127) to TW alone (n=127) among Veterans participating in TW at VA Bedford, VA Hines, and VA North Texas. Aim 1: Evaluate the efficacy of Purposeful Pathways for improving occupational functioning (primary outcome). Hypothesis: Purposeful Pathways + TW, compared to TW only, will improve occupational functioning. Aim 2: Evaluate the efficacy of Purposeful Pathways for improving quality of life, and reducing mental health symptoms and substance use (secondary outcomes). Hypothesis: Purposeful Pathways + TW, compared to TW only, will improve quality of life, and reduce mental health symptoms and substance use. Aim 3 (Exploratory): Explore whether occupational functioning (competitive employment attainment) in the Purposeful Pathways + TW group is mediated by vocational identity, work hope, self-regulation, and/or employment motivation, key factors central to the Purposeful Pathways intervention.

Conditions

Unemployment

Study ID

NCT07097376

Start date

Sep 1, 2026

Status verified date

Sep, 2026

Completion date

Mar 31, 2031

Anticipated

Primary completion date

Oct 1, 2030

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • enrolled in VHA TW at one of the three VA recruitment sites
  • be unemployed
  • report interest/intention to return to paid work within the upcoming three years
  • presence of a psychiatric disorder as indicated by documented ICD-10 diagnosis (mental health disorder and/or substance use disorder) addressed in an encounter at VHA within the 24 months preceding study enrollment
  • willing to participate in weekly vocational counseling sessions

Exclusion Criteria:

  • report a plan to remain unemployed during the upcoming 12 months
  • report plans to retire within the next 12 months
  • be currently retired
  • be a full-time student
  • enrolled in Supported Employment
  • experiencing significantly elevated mental health symptoms as indicated by a score greater than 26 on the Symptom Checklist-6 (SCL-648)
  • have a guardian or conservator

Study Design

Enrollment

254 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Purposeful Pathways

Participants in this arm will receive treatment as usual, which is the transitional work intervention, as well as the Purposeful Pathways intervention

active comparator: Treatment as usual

Participants in this arm will receive treatment as usual, which is the transitional work intervention.

Interventions

Purposeful Pathways

Purposeful Pathways is a manualized intervention to assist Veterans in aspiring and pursuing meaningful employment. Purposeful Pathways is an individual counseling protocol delivered weekly for up to 12 sessions (50 minutes per session) focused on career exploration, goal clarity, job-searching, and self-regulation.

Transitional Work

Provides individuals with immediate access to a non-competitive, paid job contracted by the VA. Positions are typically housed within a VA hospital (e.g., housekeeping, grounds, kitchens, and construction), but are sometimes located in the community. TW is time-limited. TW is staffed by vocational rehabilitation specialists (VRS).

Primary outcome measure

  • Number of Participants with Competitive Employment [ Time Frame: through study completion, an average of 15 months ]
  • Number of days worked [ Time Frame: through study completion, an average of 15 months ]
  • Total hours worked [ Time Frame: through study completion, an average of 15 months ]
  • Income earned [ Time Frame: through study completion, an average of 15 months ]
  • Career Adapt-Ability Scale [ Time Frame: through study completion, an average of 15 months ]
  • Positive Meaning Scale of the Work as Meaning Inventory [ Time Frame: through study completion, an average of 15 months ]

Central Contacts and Locations

Central contacts

Brian J Stevenson, PhD

(718) 687-3919Brian.Stevenson4@va.gov

Locations

Edward Hines Jr. VA Hospital, Hines, IL

Recruiting

Hines, Illinois, United States, 60141-3030

Contacts

Matthew Sprong, PhD

815-993-8724matthew.sprong@va.gov

More Information

Sponsor

VA Office of Research and Development

Last update posted

Sep 9, 2026

Last verified

Sep, 2026

Keywords

  • rehabilitation, vocational

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by VA Office of Research and Development on 2026-09-09.