The role of vocational behaviors preceding and during 12-step oriented treatment

Correlates of employment among men in substance use recovery: The influence of discrimination and social support

The purpose of the present study was to identify correlates of employment among men in substance use recovery, including recovery-related discrimination and social support. A cross-sectional sample of men (N = 164) who lived in sober living homes located across the United States participated in the present study. Data were collected online and through mailed surveys. No socio-demographic variables were associated with employment status. Discriminant Analysis (DA) was conducted to understand how recovery-related discrimination and social support contributed to group separation (employed vs. not employed). Results from this analysis suggested that recovery-related discrimination was the driving force in classification, as men who were not employed had much higher recovery-related discrimination than men who were employed. Men who were not employed also had lower social support scores than men who were employed. Stigma and discrimination may play a large role in employment among former and current substance users. Treatment providers should discuss the impact of stigma on individuals while they are in treatment. However, additional research is needed to more fully understand the relations among discrimination, social support, and employment.

Randomized multi-site trial of the Job Seekers' Workshop in patients with substance use disorders

BACKGROUND

Unemployment is associated with negative outcomes both during and after drug abuse treatment. Interventions designed to increase rates of employment may also improve drug abuse treatment outcomes. The purpose of this multi-site clinical trial was to evaluate the Job Seekers' Workshop (JSW), a three session, manualized program designed to train patients in the skills needed to find and secure a job.

METHOD

Study participants were recruited through the NIDA Clinical Trials Network (CTN) from six psychosocial counseling (n=327) and five methadone maintenance (n=301) drug treatment programs. Participants were randomly assigned to either standard care (program-specific services plus brochure with local employment resources) (SC) or standard care plus JSW. Three 4-h small group JSW sessions were offered weekly by trained JSW facilitators with ongoing fidelity monitoring.

RESULTS

JSW and SC participants had similar 12- and 24-week results for the primary outcome measure (i.e., obtaining a new taxed job or enrollment in a training program). Specifically, one-fifth of participants at 12weeks (20.1-24.3%) and nearly one-third at 24 weeks (31.4-31.9%) had positive outcomes, with "obtaining a new taxed job" accounting for the majority of cases.

CONCLUSION

JSW group participants did not have higher rates of employment/training than SC controls. Rates of job acquisition were modest for both groups, suggesting more intensive interventions may be needed. Alternate targets (e.g., enhancing patient motivation, training in job-specific skills) warrant further study as well.

Measuring employment among substance-using offenders

Employment has been identified as an important predictor of drug abuse treatment outcome; however, employment has been measured in a variety of different ways in the drug abuse literature and typically with community samples. The present IRB-approved study used factor analysis to identify commonalities among several employment measures collected from a sample of drug court offenders who entered one of two Kentucky drug courts between March 2000 and November 2002. Measures included demographics, employment, substance use, and criminality. The factor analysis produced four employment factors: status, earnings, duration, and stability. These factors had different correlation patterns with substance use and criminality. Study limitations are noted.

The value of vocational rehabilitation in substance user treatment: a cost-effectiveness framework

Vocational rehabilitation (VR) programs within addiction treatment traditionally consider employment as the desired outcome. This singular focus ignores other benefits, such as.reduced substance use. A framework for evaluating the cost-effectiveness of VR within addiction treatment is presented and illustrated with data from the Alcohol and Drug Services Study (ADSS, 1996--1999). VR was associated with a 2.5% increase in probability of abstinence at an $883 increase in cost per admission. Thus, the estimated cost-effectiveness of VR in promoting abstinence is $35,000 per additional abstinent client ($883/0.025), indicating that VR is a cost-effective contributor to other goals of addiction treatment.