Impact of work therapy on health status among homeless, substance-dependent veterans

A randomized controlled trial

T. Michael Kashner, Robert Rosenheck, Anthony Brian Campinell, Alina Surís, Randy Crandall, Nancy J. Garfield, Paul Lapuc, Karen Pyrcz, Thomas Soyka, Annie Wicker

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)938-944
Number of pages7
JournalArchives of General Psychiatry
Volume59
Issue number10
StatePublished - Oct 1 2002

Fingerprint

Veterans
Health Status
Randomized Controlled Trials
Homeless Persons
Therapeutics
Mandatory Testing
Salaries and Fringe Benefits
Psychiatry
Appointments and Schedules
Industry
Outpatients
Alcohols
Urine
Control Groups
Health

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Kashner, T. M., Rosenheck, R., Campinell, A. B., Surís, A., Crandall, R., Garfield, N. J., ... Wicker, A. (2002). Impact of work therapy on health status among homeless, substance-dependent veterans: A randomized controlled trial. Archives of General Psychiatry, 59(10), 938-944.

Impact of work therapy on health status among homeless, substance-dependent veterans : A randomized controlled trial. / Kashner, T. Michael; Rosenheck, Robert; Campinell, Anthony Brian; Surís, Alina; Crandall, Randy; Garfield, Nancy J.; Lapuc, Paul; Pyrcz, Karen; Soyka, Thomas; Wicker, Annie.

In: Archives of General Psychiatry, Vol. 59, No. 10, 01.10.2002, p. 938-944.

Research output: Contribution to journalArticle

Kashner, TM, Rosenheck, R, Campinell, AB, Surís, A, Crandall, R, Garfield, NJ, Lapuc, P, Pyrcz, K, Soyka, T & Wicker, A 2002, 'Impact of work therapy on health status among homeless, substance-dependent veterans: A randomized controlled trial', Archives of General Psychiatry, vol. 59, no. 10, pp. 938-944.
Kashner, T. Michael ; Rosenheck, Robert ; Campinell, Anthony Brian ; Surís, Alina ; Crandall, Randy ; Garfield, Nancy J. ; Lapuc, Paul ; Pyrcz, Karen ; Soyka, Thomas ; Wicker, Annie. / Impact of work therapy on health status among homeless, substance-dependent veterans : A randomized controlled trial. In: Archives of General Psychiatry. 2002 ; Vol. 59, No. 10. pp. 938-944.
@article{ef66b8fdf21b4fe684390b9152ef4447,
title = "Impact of work therapy on health status among homeless, substance-dependent veterans: A randomized controlled trial",
abstract = "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.",
author = "Kashner, {T. Michael} and Robert Rosenheck and Campinell, {Anthony Brian} and Alina Sur{\'i}s and Randy Crandall and Garfield, {Nancy J.} and Paul Lapuc and Karen Pyrcz and Thomas Soyka and Annie Wicker",
year = "2002",
month = "10",
day = "1",
language = "English (US)",
volume = "59",
pages = "938--944",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "American Medical Association",
number = "10",

}

TY - JOUR

T1 - Impact of work therapy on health status among homeless, substance-dependent veterans

T2 - A randomized controlled trial

AU - Kashner, T. Michael

AU - Rosenheck, Robert

AU - Campinell, Anthony Brian

AU - Surís, Alina

AU - Crandall, Randy

AU - Garfield, Nancy J.

AU - Lapuc, Paul

AU - Pyrcz, Karen

AU - Soyka, Thomas

AU - Wicker, Annie

PY - 2002/10/1

Y1 - 2002/10/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0036792807&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036792807&partnerID=8YFLogxK

M3 - Article

VL - 59

SP - 938

EP - 944

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 10

ER -