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Background The very long-term unemployed (i.e. those unemployed for more than 2 years) face serious mental health problems and social difficulties in regaining employment.

Aims To assess the effectiveness of a pilot vocationally oriented cognitive behaviour therapy (CBT) programme on mental health and vocational outcomes among a group of very long-term unemployed.

Methods A pre-test–post-test design with follow-up assessment at 12 weeks was used to assess the effects of CBT group training on mental health, self-esteem, optimism and attitudes to work. Participants were recruited through employment agencies in Sydney, Australia.

Results Twelve weeks following CBT training, the 21 participants reported increased optimism and attitudes to work, and more than half of them had participated in some kind of paid employment.

Conclusions While this study is small and non-generalizable, the findings suggest the value of vocationally oriented CBT approaches in assisting the very long-term unemployed to get back into the workforce.