Vocational Rehabilitation Outcomes of Veterans With Substance Use Disorders in a Partial Hospitalization Program

Kerrigan, Anthony J.; Kaough, Judith E.; Wilson, Bill; Wilson, Josephine; Boeringa, J. Alexander; Monga, Trilok N.

doi:10.1176/appi.ps.51.12.1570

Cited by 13 publications

(10 citation statements)

References 8 publications

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“…Finally, vocational and employment training can positively impact client outcomes,48–49 particularly when services are well-matched to need50 or are a key component of a case management approach 51–52. However, there is no generally accepted vocational rehabilitation or employment assistance model for use with criminal offenders,8,53–54 particularly for those who are also substance abusers whose use histories present significant employer concerns.…”

Section: Implications For Behavioral Healthmentioning

confidence: 99%

Employment Services Utilization and Outcomes among Substance Abusing Offenders Participating in California’s Proposition 36 Drug Treatment Initiative

Evans¹,

Hser²,

Huang³

2009

J Behav Health Serv Res

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California drug treatment programs may use funds to address barriers to work faced by Proposition 36 offenders, most of whom are not working at treatment entry, but employment services utilization and related behavioral outcomes have never been studied. This study examined primary data collected on 1,453 offenders by 30 programs during 2004 to explore the characteristics, employment services utilization, and outcomes of those who did and did not receive employment services while in drug treatment. One-year outcomes were mostly similar across groups, however, increases in the proportion of offenders employed, receiving income from employment and family or friends, and being paid for work were significantly greater among the received-employment-services group, and a greater proportion of this group also completed drug treatment. Employment services utilization was less likely for persons recruited from outpatient settings and more likely with greater severity of family/social problems and desire for services. Odds of employment one-year post-treatment entry were higher for those of Hispanic race/ethnicity (vs. White) and for those with treatment completion/longer retention but lower for those who were older, lived in specific counties, had greater employment problem severity at intake, and received other income-related services. Strategies for improving employment services utilization and outcomes among Proposition 36 offenders are discussed.

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Section: Implications For Behavioral Healthmentioning

confidence: 99%

Employment Services Utilization and Outcomes among Substance Abusing Offenders Participating in California’s Proposition 36 Drug Treatment Initiative

Evans¹,

Hser²,

Huang³

2009

J Behav Health Serv Res

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“…In addition, the social and economic contingencies are likely to promote continued abstinence. Alternatively, some posit a job provides a mechanism for reintroducing and reintegrating an individual back into his/her community (Kerrigan et al, 2000; Platt, 1995). Still others note that vocational services, delivered in concert with drug treatment, often strengthen self-esteem and contribute to self-efficacy, while enhancing problem solving and decision making skills (Shepard and Reif, 2004).…”

Section: Introductionmentioning

confidence: 99%

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

Svikis

Stitzer

Rieckmann

et al. 2012

Drug and Alcohol Dependence

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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.

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“…For clients enrolled in methadone maintenance treatment (MMT), Magura and colleagues tested an innovative supported employment intervention, whose service processes resembled those of both ACT and IPS (Blankertz et al, 2003;Magura et al, in press). The Department of Veterans' Affairs integrates 3-month long ''Compensated Work Therapy'' programs nationwide with substance dependence treatment and supported housing (Kashner et al, 2002;Kerrigan et al, 2000;Milby et al, 1996;Rosenheck and Seibyl, 1997). Other recent innovative employment interventions include Kidorf's (Kidorf et al, 1998, in press) and Silverman's (Silverman et al, 2001(Silverman et al, , 2002 contingency management strategies; Siegal's (Siegal et al, 1996) adaptation of Rapp's strengthsbased case management model for persons with mental illness (Rapp et al, 1993); and social model residential programs (Room, 1998).…”

Section: Act Demonstration In Context Of Formal Studies Of Other Emplmentioning

confidence: 99%

Employment Outcomes for Hard-to-Reach Persons with Chronic and Severe Substance Use Disorders Receiving Assertive Community Treatment

Gold

Meisler

DuRoss³

et al. 2004

Substance Use & Misuse

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Many persons with chronic and severe substance use disorders (SUDs) enter and exit public substance dependence treatment systems with limited benefit, but continue overuse of high-cost health and human services. Less than a third holds jobs, earning income below U.S. federal poverty levels. Long-term integrated substance dependency treatment, rehabilitation, and support services will be essential to resolve substance dependence and employment problems. This single-group program evaluation reports adaptation of Assertive Community Treatment (ACT), a multi-component, team-based service model originally designed for persons with severe mental illnesses and multiple disabilities, for effectiveness with persons with severe SUDs. The ACT model delivers an integrated package of treatment, rehabilitation, and support to reduce substance misuse and increase employment. Of the 35 clients admitted 12 months prior to conclusion of this 2-year service demonstration, only one left treatment prematurely. Generally, clients modestly reduced substance misuse and increased employment. However, the evaluation design and small sample limit inferences of causation and generalizability of these promising outcomes. Persuading states to adopt expensive team-based approaches for this population will require firm evidence of favorable cost-benefit ratios.

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Vocational Rehabilitation Outcomes of Veterans With Substance Use Disorders in a Partial Hospitalization Program

Cited by 13 publications

References 8 publications

Employment Services Utilization and Outcomes among Substance Abusing Offenders Participating in California’s Proposition 36 Drug Treatment Initiative

Employment Services Utilization and Outcomes among Substance Abusing Offenders Participating in California’s Proposition 36 Drug Treatment Initiative

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

Employment Outcomes for Hard-to-Reach Persons with Chronic and Severe Substance Use Disorders Receiving Assertive Community Treatment

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