title: A community-based trial of vocational problem-solving to increase employment among methadone patients.
abstract: Unemployment remains a common problem among methadone patients. This study examined the effectiveness of the Vocational Problem-Solving Skills (VPSS) intervention to help unemployed methadone patients obtain employment.
  
  
  METHODS
  109 patients were randomly assigned to receive 10 sessions of either VPSS (n=62) or Interpersonal Problem-Solving (IPS) (n=47). Fourteen counselors from two methadone programs were trained to deliver both the VPSS and IPS counseling sessions.
  
  
  RESULTS
  Overall, 93% (101/109) of the patients completed a 6-month follow-up assessment which revealed that 58.6% (34/58) of patients in the VPSS condition were employed, whereas 37.2% (16/43) in the comparison condition worked (chi-square=4.53, 1 df, p<0.05). However, a multinomial regression equation found that the VPSS intervention did not significantly contribute to the prediction of employment. Other factors such as longer length of previous work experience, 40 years of age or older, treatment site, and baseline patient motivation to work emerged as significant predictors.
  
  
  CONCLUSIONS
  Although VPSS alone was not a strong independent predictor of improved employment functioning, improvements in employment functioning were detected at one of the two sites as a function of VPSS.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. zanis@ac.marywood.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Zanis
authors.forename: D
authors.initials: D
authors.lastname: Coviello
authors.forename: A I
authors.initials: AI
authors.lastname: Alterman
authors.forename: S E
authors.initials: SE
authors.lastname: Appling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004521:Educational Measurement / Q000592:standards; D004651:Employment / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000534:rehabilitation*; D014830:Vocational Guidance / Q000191:economics*
chemical_list: D009294:Narcotics; D008691:Methadone