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Original

The Effectiveness of Vocational Services for Substance Users in Treatment

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Pages 2165-2213 | Published online: 03 Jul 2009
 

Abstract

Employment appears frequently in the literature as an outcome criterion for substance users in treatment, and most clinicians subscribe to the belief that work plays an important role in recovery from addiction. Despite the importance attached to employment, the major standard treatment modalities have not been shown as effective in increasing client employment after treatment. The article presents a critical review and synthesis of three decades of research on the effectiveness of specialized vocational intervention for addiction treatment clients.

Notes

aSubstance dependency treatment, a common designation in the literature, is a misnomer and is misleading. Substance users/misusers—whatever criteria used to categorize them—represent a heterogeneous range of people using a myriad of types of substances (both legal and illegal ones) in various ways and patterns that are bounded (by culture, place, time, age, gender, ethnicity, etc.). There are no unique treatment modalities used with or for substance users—of whatever types—that aren't also used with nonsubstance users. The traditional five categories for substance user treatment, which is based upon place, time, and the use or nonuse of medication, may be more usefully categorized into: professional models, cultural and or tradition-based models, mutual aid models (AA, NA, GA, OA, etc.) and self-help (“natural recovery”). Editor's note.

Additional information

Notes on contributors

Stephen Magura

Stephen Magura, Ph.D., C.S.W., is Acting Executive Director of NDRI and has been the Principal Investigator of many studies sponsored by the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Child Health and Development. These studies have included drug abuse clinical trials, treatment outcome evaluations, health services research, social epidemiology studies, HIV prevention research, and policy analysis. Dr. Magura has authored or edited several books and special journal issues, including Outcome Measures for Child Welfare Services (1986), Experimental Therapeutics in Addiction Medicine (1994), a special issue of Health and Social Work on “Chemical Dependency” (1994), and a special issue of Substance Use & Misuse on “Program Quality in Substance Dependency Treatment” (2000). He serves on the Editorial Boards of five professional journals, is an elected member of the College on Problems of Drug Dependence (CPDD) and the Research Society on Alcoholism (RSA), serves on federal advisory committees, and is a faculty member of the Middle Eastern-Mediterranean Summer Institute on Drug Use.

Graham L. Staines

Graham L. Staines, Ph.D., is a Senior Project Director at NDRI where he has directed projects on modified therapeutic communities for both methadone patients and mentally ill chemical abusers (MICAs), treatment matching on levels of care among alcoholics, and new models of vocational rehabilitation for methadone clients. Prior to coming to NDRI, he was a Study Director at the Institute for Social Research at the University of Michigan. Funded by the Department of Labor, his research, which focused on the quality of work life, included three national Quality of Employment Surveys of representative samples of workers. In addition to journal articles, his publications on the relationship between work and family life include The Impact of Work Schedules on the Family (co-authored with Joseph H. Pleck in 1983).

Laura Blankertz

Laura Blankertz, Ph.D., is a research associate at Bryn Mawr College and a consultant. She has been a principal investigator on studies sponsored by the Center for Mental Health Services, the National Institute on Alcohol Abuse and Alcoholism, and the Department of Education. These studies have included mental health services research, treatment outcomes for individuals with comorbidities of serious mental illness and substance abuse, and vocational rehabilitation programs for individuals with serious mental illness and for youth with serious emotional disorders. Dr. Blankertz is the past president of the Eastern Evaluation and Research Society, has served on national research steering committees, is on the editorial boards of two professional journals, and is a recipient of the International Association of Psychosocial Rehabilitation Services research award.

Elizabeth M. Madison

Elizabeth M. Madison holds an M.A. in Vocational Rehabilitation from New York University, a B.S. in Forensic Psychology, and is a Certified Rehabilitation Counselor (CRC) and Certified Workforce Development Professional (CWDP). She is a professional in the field of career and workforce development, specializing in vocational rehabilitation for chemically dependent individuals and the welfare-to-work population. She has developed innovative and creative programs to help these populations achieve self-sufficiency and economic independence. She is the Director for NADAP/Project ACE and the owner and president of Potential Unlimited, which develops career and workforce development programs and training for nonprofit organizations, school systems, and individuals. Ms. Madison facilitates training on vocational rehabilitation and substance abuse at various academic institutions and nonprofit organizations such as Lehman College at the City University of New York and Local 1199. She is a Fellow with the Join Together Program at Boston University and a member of the National Association of Workforce Development Professionals (NAWDP) and the Advocates for Vocational Rehabilitation and Substance Abuse (AVRASA).

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