Furthermore, clinical trials do not mirror the reality of usual care in practice, which has a lower rate of treatment adequacy compared with evidence-based clinical trials. To put it simply, treatment can improve work functioning but, at present, these improvements are often not substantial enough to translate into significantly improved labour market outcomes. However, it has been found that the increases in earnings are not sufficient to offset lost transfer payments, nor is employment stable (around 50% of the people placed leave the job in six months) (Frank and Koss, 2005).