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IPS and Cognitive Deficits — MRCPsych Paper B MCQ

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ModerateRehabilitationIPS and Cognitive DeficitsMRCPsych Paper B

A 34-year-old man with schizophrenia has clinically significant deficits in attention and working memory. He clearly wishes to obtain competitive paid employment and is able to engage with an employment specialist. Which vocational approach is most consistent with the Individual Placement and Support model?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Begin a rapid competitive job search with individualised support, addressing cognitive needs alongside employment

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · C = shown as D

The correct answer is B. IPS follows a rapid “place then train” approach: a person who wants competitive employment is helped to search for a suitable job without first having to demonstrate work readiness or normal cognitive performance. Support is individualised and continues after placement; cognitive remediation may be offered alongside vocational rehabilitation. Option A incorrectly makes cognitive remediation a prerequisite. Sheltered or transitional employment (C) may be considered when someone does not currently wish or feel ready to pursue paid employment, but it is not the IPS approach for this patient. Cognitive deficits do not themselves contraindicate employment (D), and IPS eligibility is not determined by an IQ threshold (E).

Reference: NHS England. Individual placement and support for severe mental illness: developing local service specifications and approach. 2023. https://www.england.nhs.uk/long-read/individual-%20placement-and-support-for-severe-mental-illness/