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

Abstract

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-hr 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 12 weeks (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.

Twelve-month employment intervention outcomes for drug-involved offenders

“…28) and others reported no intervention effects on key employment outcomes (e.g. 22). These inconsistent findings are further complicated by differences in study design and employment measures.…”

“…Another study examining long-term substance abuse treatment clients and methadone maintenance found that neither group experienced any significant improvement in employment (21). More recently, a multi-site randomized trial of the Job Seekers' Workshop found no difference in 12-week or 24-week employment outcomes, with only modest employment gains overall (22).…”

A therapeutic workplace for the long-term treatment of drug addiction and unemployment: Eight-year outcomes of a social business intervention

“…While the Therapeutic Workplace was in operation the Therapeutic Workplace participants reported significantly more days worked per month, more employment income, more total income, and less money spent on drugs (Table 3). Although much of the employment reported by Therapeutic Workplace participants was employment in the Therapeutic Workplace data entry business, these data show that this population rarely becomes employed in community jobs (Usual Care Control participants), but they will work fairly consistently when given an employment opportunity (Therapeutic Workplace participants) and when common barriers to employment (Svikis et al 2012) are minimized.…”

“…Employment has been extremely difficult to promote in low-income adults with long histories of drug addiction (Magura, Staines, Blankertz, & Madison, 2004; Svikis et al 2012). One fairly large and well-conducted study evaluated the long-term effectiveness of an intensive case management intervention in 302 substance-dependent women receiving Temporary Assistance for Needy Families (Morgenstern et al, 2009).…”

“…Such a long training phase was probably not necessary, although we cannot know from this study how little time would be needed to prepare participants to serve as employees in a business like Hopkins Data Services. Based on our experience to date (Silverman et al, 2012), we expect that participants could be trained and prepared for employment in much less time. Second, because this was a Stage 1 Behavior Therapy Development project, a priority was placed on the development of this novel intervention, and less emphasis was placed on maintaining the most elegant experimental design.…”