Background: The evidence-based Therapeutic Workplace (TWP) is a promising employment-based treatment where access to work is contingent on objective evidence of abstinence from drugs. TWP is sometimes criticized for requiring individuals who use drugs to voluntarily enroll in a program requiring urine drug testing.
Objective: This experiment was conducted to assess whether urine drug testing as a condition of employment decreases the value of employment opportunities and to what degree.
Methods: Participants were unemployed, DSM-IV opioid-dependent, and enrolled in TWP. Participants completed discounting tasks assessing preference for a hypothetical job paying a constant wage that did not require urine drug testing and a job that paid a variable wage but required drug testing. The primary outcome was 'job value' operationalized as percentage wage difference to accept a job requiring urine drug testing.
Results: Percent wage difference to accept a job that required urine testing was analyzed using GEE. Results revealed a significant main effect of recent drug use (χ2(1) = 10.07, p < .01).
Conclusion: Most participants were willing to accept a urine drug-testing job across wages similar non-drug testing jobs. Participants reporting recent cocaine or heroin use were less likely to choose urine drug-testing employment.
Background: An important factor embedded within Vocational Rehabilitation (VR) delivery capacity relates to geography, such as distance from the VR office and availability of service providers or community rehabilitation programs.
Objective: We explored receipt of VR job search and placement services based on distance to an urban center, demographic, and disability variables after controlling for local employment conditions.
Methods: Using 2015 RSA-911 case services data, we used probit to produce estimates for each combination of service and service source (agency and purchased), and Ordinary Least Squares (OLS) and semi-parametric regression to estimate log expenditures for each service category.
Results: Being Black or living at a long distance from a metro area increased the probability of receiving agency-based services but lowered the probability of receiving purchased services. Conversely, being older and having less education lowered the probability of receiving agency services but increased the probability of receiving purchased services. Females, Blacks, and those living at a distance greater than 50 miles from a metro area received significantly lower expenditures.
Conclusions: Systematic differences in the types of services provided call for more in-depth analysis to ensure that policies and procedures are in place to minimize sociodemographic disparities in service delivery and outcomes.
Background: There is an urgent need for services that support a successful transition to postsecondary education and employment for young adults with neurodevelopmental and cognitive disabilities (e.g. autism spectrum disorder, attention-deficit/hyperactivity disorder, traumatic brain injury).
Objective: The purpose of this expository article is to describe the Cognitive Skills Enhancement Program (CSEP), a comprehensive clinical program designed for young adults with neurodevelopmental and cognitive disabilities transitioning to postsecondary education.
Methods: CSEP was developed through a community-academic partnership between a university and a state vocational rehabilitation program. Young adult participants complete programming that addresses four primary clinical targets: (1) emotion regulation, (2) social skills, (3) work readiness, and (4) community participation with the overall goal to increase awareness and promote successful employment outcomes while they transition to post-secondary education.
Results: To date, CSEP has supported 18 years of sustained programming and clinical services to 621 young adults with neurodevelopmental and cognitive disabilities.
Conclusion: This partnership model allows for flexible responses to participant needs, implementation barriers, and advances in evidence-based practices. CSEP meets the needs of diverse stakeholders (e.g. state vocational rehabilitation, postsecondary training facilities, participants, universities) while providing high-quality and sustainable programming. Future directions include examining the clinical efficacy of current CSEP programming.