Finding a job is difficult for veterans with posttraumatic stress disorder (PTSD) and individuals with severe mental illness, who have high unemployment rates even though many want to work.

The job interview - especially hard for those with mental illness - can be a major hurdle.

A virtual human - based on software originally used to train FBI agents - helped vets with PTSD and individuals with severe mental illness build their job interview skills and snag significantly more job offers, reports a new Northwestern Medicine study.

Participants in the training practiced repeatedly with the virtual character, a human resources staff member named Molly Porter. They spoke their responses to Molly’s questions using voice recognition software. A job coach in the program gave them immediate on-screen feedback as to whether their responses helped or hurt their rapport with Molly. The interviews got tougher as they progressed.

Vets with PTSD and individuals with severe mental illness who took the training were nine times more likely than non-trainees to get job offers in a six-month follow-up after training. The more training interviews participants completed, the greater the likelihood of receiving a job offer and in a shorter amount of time.

“Veterans with PTSD and people with mental illness such as bipolar disorder, major depression and schizophrenia are prone to anxiety, which can escalate during stressful social encounters such as the job interview,” said Matthew J. Smith, assistant professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “The training was a big confidence builder for them.”

The study will be published July 1 in the journal Psychiatric Services.

The commercially available training from SIMmersion LLC is computer-based and can be accessed over the Internet at http://www.jobinterviewtraining.net or installed from a DVD. It fills an important need, Smith said. Evidence-based employment services are not widely available to individuals with severe mental illness at a national level.

Closed-door interviews may trigger feeling trapped

The job interview can be an emotional land mine for individuals with severe mental illness.

Vets with PTSD may have trouble concentrating and following a conversation. A closed-door job interview may trigger a sense of being trapped. These former soldiers also may feel detached from others, which makes it hard for them to connect socially with the interviewer.

Tricky conversations about time off for therapy

The vets and individuals with severe mental illness may need structured time off from work to attend their mental health services and need to know how to discuss this in an interview. These individuals may also have an extended period of unemployment, and the training gives them tools to discuss gaps in their work history. Practicing with the training program also helped participants become more comfortable in a job interview environment.

The interviews with Molly Porter taught participants how to emphasize their strong work ethic and ability to work well with others. The program also showed them how to share their prior work experiences in a positive way (rather than complaining about past experiences), sound interested in the position and speak professionally.

Trainees receive a score at the end of each interview with scores of 90 or better informing them that, “You’ve got the job!”

When an individual accesses Molly, the program has certain features so a person can identify a disability. The program takes that into account when it asks questions in the job interview.

Study participants included 70 individuals with severe mental illness (bipolar disorder, major depressive disorder, schizophrenia or schizoaffective disorder) or U.S. military veterans who had a diagnosis of PTSD and a mood or psychotic disorder.

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The program was a collaborative effort between Northwestern, SIMmersion LLC and Morris Bell, a professor of psychiatry at Yale School of Medicine to develop and test the training program.

Other Northwestern authors on the study include Dr. Michael Fleming and Neil Jordan.

The research was supported in part by grant R44 MH080496 from the National Institute of Mental Health of the National Institutes of Health.

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