Objective: Limited research exists on how employment interventions contribute to employment outcomes for homeless youth. This study examines the comparative efficacy of 2 interventions—Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS)—provided to homeless youth with mental illness in a randomized controlled trial. Method: Participants were recruited from 1 homeless youth agency in Los Angeles, CA, and randomized to the SEI (n = 36) or IPS (n = 36) conditions. Over 20 months, SEI participants received 4 SEI components, and IPS participants received IPS services based on 8 principles. Data were collected at baseline and follow-up for the primary employment outcome (paid employment) and 5 secondary employment outcomes. Results: Over 20 months, 39% of SEI participants and 32% of IPS participants reported any paid employment. Across both groups, participants who reported working at baseline had nearly 8 times the odds of working at follow-up (OR = 7.91, p < 0.05). No stati...

Summary: Due to the focus of micro-practice interventions on clinical outcomes and macro-practice interventions on structural outcomes, limited research exists on the clinical benefits resulting from clients’ involvement in macro therapeutic interventions (i.e. structural interventions that target community, organizational, systems, and/or policy-level change and which also have clinical benefits to clients or consumers). In response to this knowledge gap, the authors present four case studies of macro therapeutic interventions in the areas of social enterprise creation, community-based participatory research, transformative organizing, and community-based partnerships. Findings: Collectively, these interventions draw from community, economic, and social development theory, empowerment theory, feminist theory, and critical theory. The authors synthesize the key intervention components across case studies that contribute to clinical and collective empowerment outcomes. Applications: The authors then offer recommendations to the social work profession for developing, implementing, and evaluating macro therapeutic interventions within clinical practice settings.