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.
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U2 - 10.1001/archpsyc.59.10.938
DO - 10.1001/archpsyc.59.10.938
M3 - Article
C2 - 12365881
AN - SCOPUS:0036792807
SN - 0003-990X
VL - 59
SP - 938
EP - 944
JO - Archives of General Psychiatry
JF - Archives of General Psychiatry
IS - 10
ER -