Cognitive Behavioral Therapy to Improve Work and Wellness in Veterans With Mental Illness
WORKWELL
Work as a Determinant of Health: A Pragmatic Trial of Enhanced Cognitive Behavioral Therapy to Bolster Competitive Work and Wellness in Veterans With Serious Mental Illness (WORKWELL)
1 other identifier
interventional
294
1 country
3
Brief Summary
Vocational instability in Veterans with serious mental illness (SMI) is pervasive, costly, and harmful. Over 75% of Veterans with SMI are unemployed, resulting in economic difficulties and trouble meeting basic needs. Overall, among adults with depression, work dysfunction results in a 36 to 51 billion dollar loss annually. Unemployed Veterans with SMI also suffer major health consequences, including a more severe course of illness and poor recovery over time, leading to increased inpatient and emergency service use. The WORKWELL study will synergistically address these deficits in health, recovery, and work functioning by testing the Cognitive Behavioral Therapy for Work Success (CBTw) intervention. Using a pragmatic design, this project will address work as a major social determinant of health and close the health disparity gap among people with SMI. Further, through promotion of work and healthy thinking, CBTw holds promise to reduce risk of suicide among vulnerable veterans with SMI.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jan 2021
Longer than P75 for not_applicable
3 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
August 4, 2020
CompletedFirst Posted
Study publicly available on registry
August 7, 2020
CompletedStudy Start
First participant enrolled
January 1, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 30, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
September 30, 2024
CompletedResults Posted
Study results publicly available
April 1, 2026
CompletedApril 1, 2026
March 1, 2026
3.7 years
August 4, 2020
January 23, 2026
March 11, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (3)
Total Weeks Worked in Competitive Jobs
Mean number of weeks worked in competitive jobs. Competitive jobs are regular jobs open to all that pay at least minimum wage. More total weeks worked in competitive jobs is indicative of a positive outcome.
Baseline to 3 months
Total Weeks Worked in Competitive Jobs
Mean number of weeks worked in competitive jobs.
3 to 6 Months
Total Weeks Worked in Competitive Jobs
Mean number of weeks worked in competitive jobs.
6 to 9 months
Secondary Outcomes (4)
Short Employment Hope Scale (EHS-14)
baseline to 9 months
Recovery Assessment Scale (RAS)
baseline to 9 months
Scale for Suicidal Ideation Change
baseline to 9 months
Cognitive Behavioral Therapy for Work Success (CBTw) Fidelity
12 weeks (during the CBTw intervention period)
Study Arms (2)
Cognitive Behavioral Therapy For Work Success (CBTw)
EXPERIMENTALVeterans will participate in 12 weekly group sessions to discuss thoughts, feelings, and behaviors that promote work success in the community
Psychoeducation
ACTIVE COMPARATORVeterans in the control group will participate in 12 weekly group sessions in which they will learn more about their mental health conditions.
Interventions
Veterans will go to 12 weekly group sessions and will learn more information about their mental health conditions. Psychoeducation modules are from the Illness Management and Recovery program.
Veterans will go to 12 weekly group sessions and will learn healthy thinking about work, positive behavioral coping related to work, and will form a work success plan based on their work goals.
Eligibility Criteria
You may qualify if:
- Unemployment, defined as no current participation in a competitive job
- A competitive work goal, which denotes a goal of a regular job in the community that pays at least minimum wage
- Presence of a serious mental illness including one or more of the following conditions:
- major depression
- bipolar disorders
- schizophrenia
- schizoaffective disorder
- posttraumatic stress disorder (PTSD)
- Currently enrolled in and receiving VA vocational rehabilitation services
You may not qualify if:
- Previous participation in cognitive behavioral therapy intervention geared toward work
- Presence of a severe medical or cognitive impairment that will prevent participation in the study
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (3)
Edward Hines Jr. VA Hospital, Hines, IL
Hines, Illinois, 60141-5000, United States
Richard L. Roudebush VA Medical Center, Indianapolis, IN
Indianapolis, Indiana, 46202-2884, United States
St. Louis VA Medical Center John Cochran Division, St. Louis, MO
St Louis, Missouri, 63106, United States
Related Publications (2)
Kukla M, McGuire AB, Weber KC, Hatfield J, Henry N, Kulesza E, Rollins AL. An Investigation of Employment Hope as a Key Factor Influencing Perceptions of Subjective Recovery among Adults with Serious Mental Illness Seeking Community Work. Behav Sci (Basel). 2024 Mar 19;14(3):246. doi: 10.3390/bs14030246.
PMID: 38540549RESULTKukla ME, Rollins AL, Weber K, Hatfield J, Wu W, Faith L. A., Carter J. L., Wiesepape C, Connors MJ, Wahle SS, Pashka NJ, McGuire AB. A Pragmatic Randomized Controlled Trial Investigating Work Enhanced Cognitive Behavioral Therapy for People with Serious Mental Illness (WORKWELL): Background, Design, and Baseline Outcomes. Journal of Vocational Rehabilitation. 2025 Nov 1; 63(3):299-311, DOI: 10.1177/10522263251376530
RESULT
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Limitations and Caveats
There are no limitations to this study.
Results Point of Contact
- Title
- Dr. Marina Kukla
- Organization
- Department of Veterans Affairs
Study Officials
- PRINCIPAL INVESTIGATOR
Marina Elizabeth Kukla, PhD MS BS
Richard L. Roudebush VA Medical Center, Indianapolis, IN
Publication Agreements
- PI is Sponsor Employee
- No
- Restrictive Agreement
- No
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Masking Details
- Research personnel conducting outcomes assessments will be blinded to condition assignment
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- FED
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
August 4, 2020
First Posted
August 7, 2020
Study Start
January 1, 2021
Primary Completion
September 30, 2024
Study Completion
September 30, 2024
Last Updated
April 1, 2026
Results First Posted
April 1, 2026
Record last verified: 2026-03
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, ICF
- Time Frame
- The data will become available once the study team completes all analyses.
- Access Criteria
- The Research Service will evaluate individual requests.
Upon request, the Research Service will consider requests for the final data sets underlying the publications to be provided to the public. The limited dataset will include de-identified data relevant to the specific request. Independent research groups can view relevant data to evaluate the extent that data sources support conclusions made by authors in published studies as well as observe additional emergent themes and view supplemental details that might not be included in publications.