Vocational Rehabilitation of Participants with Severe Substance Use Disorders in a VA Veterans Industries Program

Abstract

There are approximately 100 Veterans Industries work therapy programs in the Veterans Health Administration (VHA) throughout the U.S. The majority of participants are veterans with severe substance use disorders and their length of stay ranges from 3 to 12 months. This study examines the Veterans Industries work therapy model at one site where veterans are referred from an addictions partial hospitalization treatment program. The study period was from 1996--97 and includes 80 patients. The characteristics of the participants are described. Barriers to employment are identified including unemployment rates, homelessness, drug of choice, age, and disability status. Outcome rates are reported including employment, abstinence, and housing support.

The Effectiveness of Vocational Services for Substance Users in Treatment

“…Dickinson and Maynard's (1981) results seem fairly definitive, if only because of the randomized controlled design, despite some doubts about the fidelity with which the program was implemented in multiple cities. In one study, the competitive employment rate attenuated considerably by the 3-month postdischarge follow-up (Kerrigan et al, 2004). The initial rate of transition to competitive employment was higher than found by the earlier study, but outcomes were severely attenuated at a 1-year postintervention follow-up-only 25% were still competitively employed.…”

“…Supported work through Veterans' Industries-two studies (Kerrigan et al, 2004;Rosenheck and Siebyl, 1997)-although the interventions are multifaceted in each case. Days paid for working, changes in employment income, changes in motivation for work, and action steps to obtain employment, also were not significant for intervention condition.…”

Effect of job skills training on employment and job seeking behaviors in an American Indian substance abuse treatment sample

“…Likewise, employment problems are also common among individuals receiving substance abuse treatment [7,8]. Several factors contribute to low rates of employment in alcohol/drug dependent individuals including low motivation to work, insufficient skills to obtain a job, a lack of vocational skills necessary to qualify for available work, as well as functional impairment directly related to alcohol/drug use.…”

Effects of experimental Unemployment, Employment and Punishment analogs on opioid seeking and consumption in heroin-dependent volunteers

“…In human studies of drug SA, providing a concurrent response-contingent economic alternative simulates employment. This is informative because, in the naturalistic setting, employment is associated with less substance use (Zanis et al, 2000; Kerrigan et al, 2004; Butzin et al, 2005; Silverman et al, 2005). Greenwald and Steinmiller (2009) showed that providing a $4 vs. $2 alternative could decrease opioid seeking behavior but only when no supplemental drug was available for consumption outside the choice session, suggesting that the individual's drug supply can moderate the impact of employment on drug seeking.…”