BACKGROUND: Little is known about the health outcomes of clinician-supervised, performance-based, abstinence-contingent therapeutic work programs on homeless persons with addiction disorders. This study examined the effect of the Department of Veterans Affairs compensated work therapy program (CWT) on nonvocational outcomes. With mandatory urine screenings and adherence to addiction treatment schedules, CWT provided work opportunities (wages, hours, and responsibilities) with jobs created from Veterans Affairs contracts competitively obtained from private industry. METHODS:Homeless, substance-dependent veterans (N = 142) from 4 Department of Veterans Affairs medical centers were randomized, assessed at baseline, and reassessed at 3-month intervals for 1 year. Both CWT and control groups had access to comprehensive rehabilitation, addictions, psychiatric, and medical services. Data were analyzed to determine an immediate CWT effect after treatment and rates of change during 1 year. RESULTS: Compared with control subjects, patients in the CWT program were more likely to (1) initiate outpatient addictions treatment, (2) experience fewer drug and alcohol problems, (3) report fewer physical symptoms related to substance use, (4) avoid further loss of physical functioning, and (5) have fewer episodes of homelessness and incarceration. No effect on psychiatric outcomes was found. CONCLUSION:Work therapy can enhance nonvocational outcomes of addiction treatment for homeless persons, although long-term gains remain unknown.
RCT Entities:
BACKGROUND: Little is known about the health outcomes of clinician-supervised, performance-based, abstinence-contingent therapeutic work programs on homeless persons with addiction disorders. This study examined the effect of the Department of Veterans Affairs compensated work therapy program (CWT) on nonvocational outcomes. With mandatory urine screenings and adherence to addiction treatment schedules, CWT provided work opportunities (wages, hours, and responsibilities) with jobs created from Veterans Affairs contracts competitively obtained from private industry. METHODS: Homeless, substance-dependent veterans (N = 142) from 4 Department of Veterans Affairs medical centers were randomized, assessed at baseline, and reassessed at 3-month intervals for 1 year. Both CWT and control groups had access to comprehensive rehabilitation, addictions, psychiatric, and medical services. Data were analyzed to determine an immediate CWT effect after treatment and rates of change during 1 year. RESULTS: Compared with control subjects, patients in the CWT program were more likely to (1) initiate outpatient addictions treatment, (2) experience fewer drug and alcohol problems, (3) report fewer physical symptoms related to substance use, (4) avoid further loss of physical functioning, and (5) have fewer episodes of homelessness and incarceration. No effect on psychiatric outcomes was found. CONCLUSION: Work therapy can enhance nonvocational outcomes of addiction treatment for homeless persons, although long-term gains remain unknown.
Authors: Charles E Drebing; E Alice Van Ormer; Christopher Krebs; Robert Rosenheck; Bruce Rounsaville; Lawrence Herz; Walter Penk Journal: J Appl Behav Anal Date: 2005
Authors: Lori L Davis; Sandra G Resnick; Kelly P Maieritsch; Kenneth C Weber; Christopher R Erbes; Thad Q Strom; Kimberly P McCall; Tassos C Kyriakides Journal: Psychiatr Rehabil J Date: 2019-04-04
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-03-09 Impact factor: 8.262
Authors: Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell Journal: CMAJ Date: 2020-10-13 Impact factor: 8.262