title: Veterans Health Administration Transitional work experience vs. job placement in veterans with co-morbid substance use and non-psychotic psychiatric disorders.
abstract: OBJECTIVE
  This study seeks to compare the effectiveness of Veterans Health Administration's (VHA) transitional work experience (TWE) services and a minimal but common intervention-job placement (JP) services, for veterans with co-morbid substance and psychiatric disorders.
  
  
  METHODS
  We conducted a random clinical trial comparing work outcomes for 89 veterans with co-morbid psychiatric and substance use disorders (SUD) who were randomly assigned to participate in VHA TWE services with those assigned to simple JP services provided by state vocational rehabilitation professionals. Participants were enrolled at the time of application to VHA TWE services and then randomly assigned to the two treatment groups and followed for 12 months.
  
  
  RESULTS
  VHA TWE participants were more likely to engage in paid activity, to work more total hours, to work more weeks and to earn more in total wages. The groups were not significantly different with respect to competitive employment, in terms of the percentage acquiring competitive jobs, the number of hours worked, or wages earned.
  
  
  CONCLUSIONS
  These data suggest that the primary benefit of VHA TWE services is in rapidly engaging participants in paid activity and that these services are not effective at helping dually diagnosed veterans obtain competitive employment.
authors.affiliation: Bedford VA Medical Center, Bedford, MA 01730, USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Penk
authors.forename: Charles E
authors.initials: CE
authors.lastname: Drebing
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
authors.forename: Christopher
authors.initials: C
authors.lastname: Krebs
authors.forename: Alice
authors.initials: A
authors.lastname: Van Ormer
authors.forename: Lisa
authors.initials: L
authors.lastname: Mueller
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D003156:Community Mental Health Services; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D012050:Rehabilitation, Vocational; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*