The effect of concurrent alcohol, drug, psychiatric and vocational treatment on consumer issues, treatment participation, and employment

Abstract

Despite high rates of unemployment among individuals with substance use disorders (SUDs) with psychiatric issues, little is known about a substance abuse intensive outpatient program (SAIOP) based on vocational counseling services. Further, limited research exists on relationships between five critical variables (baseline alcohol use, drug use, and psychiatric issue severity; treatment participation rate; and employment status at 210 days). The purpose of this study was two-fold: (1) to assess the effectiveness of SAIOP based on vocational counseling services for unemployed or underemployed individuals with SUDs by comparing baseline and 210-day post-baseline rates of employment and levels of alcohol use, drug use, and psychiatric issue severity as measured by the addiction severity index 5 (ASI-5); and (2) to determine the direct and indirect effects between five critical variables, and specifically whether treatment participation rate mediates the relationship between baseline levels of consumers' issues and employment at 210 days. For the first research question, t-test and two-by three tables were conducted. For the second research question, structural equation modeling was used to examine two theoretical models (initial and revised models). This study used archival data from Project Working Recovery (PWR) with 106 participants who completed both the baseline and 210-day post-baseline PWR evaluation survey. Based on the outcomes of consumers attending an SAIOP based on vocational counseling services tended to have less severe alcohol, drug, psychiatric issues, and improved percentages of employment at 210 days. Additionally, this study found that treatment participation rate mediated the relationship between alcohol use, drug use, and psychiatric issue severity and 210-day employment status. Findings highlight the effectiveness of SAIOP based on vocational counseling services in order to reduce consumers' alcohol, drug, and psychiatric issue severities and improve percentages of employment. Moreover, the mediating effect of treatment participation rate is powerful in order to improve treatment outcomes although consumers have severe issues, which influence their treatment participation rates negatively.