Authors: Blankertz, Laura | Staines, Graham L. | Magura, Stephen | Madison, Elizabeth M. | Horowitz, Emily | Spinelli, Michael | McKenzie, Anita | Bali, Priti | Guarino, Honoria | Grandy, Audrey | Young, Rebecca | Fong, Chunki
Article Type:
Research Article
Abstract:
Few methadone-maintained patients are employed, due to personal barriers and limited vocational services. With federal and state policy reforms compelling substance users to obtain work or risk losing public benefits, it is imperative to develop and test innovative vocational rehabilitation models. Designed for methadone patients, the Customized Employment Supports (CES) model integrates components of traditional vocational counseling in treatment, innovative vocational programs for the severely mentally ill, and case management techniques. This
…paper describes CES, its principles, essential elements, and stages of service delivery. The model features a small caseload [16], long service duration (up to 18 months), frequent counselor-patient contacts, fieldwork with patients, and rapid job search. Although the primary goal of CES is competitive employment, incremental and intermediate steps involving any productive activity are also valued. After establishing a working alliance, the CES counselor helps patients increase their self-efficacy, and addresses both vocational and non-vocational barriers to employment. The CES model may also contribute to non-vocational improvements, especially reductions in illicit drug use, excessive alcohol consumption, and criminality. The CES model has been implemented at two urban methadone-maintenance clinics as part of a five-year randomized clinical trial to test the model's efficacy by comparing it with standard vocational services.
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Keywords: vocational rehabilitation, substance abuse, methadone treatment, employment barriers, welfare-to-work, self-efficacy, randomized clinical trial, intensive counseling
Citation: Journal of Vocational Rehabilitation,
vol. 19, no. 3, pp. 143-155, 2003
Price: EUR 27.50