Learning from Disappointing Outcomes: An Evaluation of Prevocational Interventions for Methadone Maintenance Patients

Abstract

To increase rates of employment and improve overall rehabilitation in methadone maintenance treatment, three prevocational trainings, Vocational Problem Solving, Job Seekers Workshop, and the two combined, were evaluated as adjunctive services. Between March 1995 and April 1998, subjects in treatment were interviewed at baseline, randomly assigned to one of the trainings, and followed up at 6 and 12 months postbaseline. None of the three models produced significantly greater employment or better overall rehabilitation. Experience from the study suggests that closer integration of prevocational training with treatment, individualizing efforts to meet training needs, and providing support during job-finding and early job-holding might improve program effectiveness.

• Methadone treatment
• Vocational counseling
• Substance use
• Employment outcomes
• Program evaluation

Notes

^aStudy titled “Substance Abuse and the Transition from Welfare to Work,” Grant 1 RO1 DA11521 from the National Institute on Drug Abuse, whose support is gratefully acknowledged.

Additional information

Notes on contributors

Victor Lidz

Victor Lidz, Ph.D., received his doctorate in Sociology from Harvard University in 1976 and has taught sociology at the University of Chicago and the University of Pennsylvania. He is currently Assistant Professor and Acting Director of the Institute for Addictive Disorders, Department of Psychiatry, Drexel University College of Medicine in Philadelphia. He has collaborated on a number of studies evaluating outreach programs, treatment modalities, HIV-risk reduction interventions, and other services for drug abusers since 1989.

Diane M. Sorrentino

Diane Sorrentino, Ph.D., received her doctorate in Clinical Psychology from Drexel University in 1991 and has taught psychology at Montclair State University. She is currently Substitute Assistant Professor at the City University of New York, the College of Staten Island in the Department of Student Services/SEEK Program. Her primary areas of focus are student services, couples counseling, and Thomistic psychology.

Lenore Robison

Lenore Robison, B.A., is currently completing a Doctorate in Anthropology at Temple University in Philadelphia, Pennsylvania. Her doctoral dissertation on factors affecting adherence to HAART medications for HIV/AIDS examines how patients use adherence to retrieve and manipulate power in the patient/medical provider relationship. She is currently developing an HIV/AIDS media education project. Ms. Robison has managed research, outreach programs, and evaluation studies related to substance abuse and HIV/AIDS since 1989.

Scott Bunce

Scott C. Bunce, Ph.D., is Assistant Professor of Psychiatry at Drexel University College of Medicine. He received doctoral degrees in clinical and personality psychology from the University of Michigan. His primary research interest is in affective neuroscience and the effects of trauma on adult personality and capacity to have healthy relationships. Dr. Bunce also employs event-related brain potentials to explore implicit learning and affective responses. He is currently helping to develop an optical brain imaging method that employs near-infrared light to measure hemodynamic responses in the cortex. Dr. Bunce conducts outpatient therapy at the Center City Clinic of the Department of Psychiatry's Institute for Addictive Disorders.