Correctional Service Canada
Symbol of the Government of Canada

Common menu bar links

Substance Abuse Treatment Modalities: Literature Review

Warning This Web page has been archived on the Web.

Employment Training

The purpose of employment training for substance abusers, either as a single program or as a component of a multi-faceted program, is to develop or enhance the skills necessary to secure and maintain employment upon treatment completion. The rationale for offering occupational upgrading derives from studies which have documented that individuals who present serious drug and alcohol problems also experience difficulties in securing and maintaining employment (Capone et al., 1986; Malla, 1988; Schmidt, 1992). Malla (1988) examined the outcome of refusers and acceptors of treatment for alcoholism and found that although the two groups showed equal amounts of change on employment measures, a higher percentage of the refusers reported drinking at work. Capone et al. (1986) examined retention and outcome in a narcotic antagonist treatment program and showed that patients who dropped out of the program early were found to have less stable employment records compared to those who remained longer. Moreover, the later group also appeared more successful at termination, evidencing better vocational stability.

Schmidt (1992) divided a sample of 406 clients entering public mental health services into two groupings based on scores on the Addiction Severity Index (ASI): problem drinkers and nonproblem drinkers. In a number of demographic comparisons, it was found that problem drinkers were significantly less likely to have full-time employment and were significantly more likely to claim welfare entitlements as their source of income. In addition, a significantly higher proportion of the problem drinkers entered treatment for the purpose of requesting assistance to enhance their employability.

The previous studies have highlighted that individuals who present serious drug and alcohol problems also experience employment problems. This situation is particularly relevant for offenders where, in addition to substance abuse difficulties, the impact of incarceration also plays an integral role in post-release employability. For example, over 20 years ago, some researchers (e.g., Miller, 1972; Taggart, 1972) had concluded that one of the greatest obstacles for the former offender seeking employment is that he cannot provide the skills and qualities the marketplace demands. A recent study by Motiuk and Porporino (1989) confirmed these conclusions by identifying, from a sample of 221 federal offenders, that the majority (123 offenders) presented employment skills as a need to be developed prior to release.

Although poor employment skills are common among drug and alcohol abusers, offenders and non-offenders alike, there are only a few studies that have investigated post-substance-abuse-treatment employability. In a review of substance abuse treatment effectiveness, McLellan et al. (1982) concluded that alcohol and drug abuse treatments can produce significant, pervasive and substantial positive changes, not only in the target problems of drug and alcohol use, but also in important ancillary problems of employment and criminal behaviour. Kosten et al. (1987) examined treatment outcome in opiate addicts over a 2.5 year follow-up. The analyses focused on identifying the relationship of drug abstinence to other outcome indicators of family, social, psychological, medical, employment and legal functioning. Results showed that for participants who remained abstinent over the follow-up period, a significant lessening of problems were identified in all of the outcome indicators, including employment.

Hoffman and Miller (1993) compared pre-treatment characteristics and post-treatment functioning of 9199 inpatients and 1042 outpatients from the Comprehensive Assessment and Treatment Outcome Research (CATOR) evaluation service. Pre-treatment comparisons showed that inpatients (who evidenced higher drug and alcohol severity levels) were more likely to report vocational problems such as being late and missing work altogether. Inpatients were also more than twice as likely as outpatients to report working under the influence almost every day, and more also report being impaired at work at least once a week. Post-treatment employment showed improvement in a number of areas. Results showed reductions in difficulties with a boss or supervisor, number of mistakes made at work, being absent or late, on-the-job injury, and problems encountered in completing work.

There appears to be only one study that has evaluated post-treatment employment for substance-abusing offenders. Funderburk et al. (1993) evaluated a treatment program for violent criminal offenders with alcohol abuse problems. A major component of program was to mobilize community resources to improve the job finding skills of the offenders. A one year follow-up showed an overall significant improvement in life adjustment and employment compared to intake levels. Specifically, more than twice as many had improved their employment situation than had deteriorated.

Although not specific to substance abusers, there is evidence to suggest that securing employment is a determinant of post-release success for offenders. Myers (1984) examined a sample of male inmates released from prison who had low financial resources, were repeat property offenders, had no known history of drug and alcohol abuse, and had not been on work release for more than three months. Results showed that after a one year follow-up, better wages and employment significantly reduced individual recidivism rates. The author concluded that improved employment opportunities allowed the sample of repeat property offenders to avoid engaging in future criminality.

In summary, it has been found that individuals who present serious drug and alcohol problems also experience employment difficulties. Employment training is offered to enhance the prospects of securing a job after treatment completion. Although the specific vocational techniques employed in treatment were not delineated, a number of studies have shown improvements in employability at post-treatment. Follow-ups of offenders, including substance and nonsubstance abusers, have shown that securing and maintaining employment after incarceration has a positive impact on recidivism rates. Given that the majority of offenders also evidence drug and alcohol problems, the need for employment training as a treatment component is especially relevant.

References for Employment Training:

Capone, T., Brahen, L., Condren, R., Kordal, N., Melchionda, R., & Peterson, M. (1986), “Retention and outcome in a narcotic antagonistic treatment program”, Journal of Clinical Psychology, 42(5), 825-833.

Funderburk, F. R., Mackenzie, A., DeHaven, G. P., Stefan, R., & Allen, R. P. (1993), “Evaluation of the multiple offender alcoholism project: Quasiexperimental evaluation strategy with a focus on individual change and quality of life”, Evaluation and Program Planning, 16, 181-191.

Hoffman, N. G., & Miller, N. S. (1993), “Perspectives of effective treatment for alcohol and drug disorders”, Recent Advances in Addictive Disorders, 16(1), 127-140.

Kosten, T. R., Rounsaville, B. J., & Kleber, H. D. (1987), “Multidimensionality and prediction of treatment outcome in opioid addicts: 2.5-year follow-up”, Comprehensive Psychiatry, 28(1), 3-13.

Malla, A. (1988), “An outcome study comparing refusers and acceptors of treatment for alcoholism”, Canadian Journal of Psychiatry, 33, 183-187.

Miller, M. (1972), “Vocational training in prisons: Some social policy implications”, Abstracts on Criminology and Penology, (July - December), 220.

McLellan, A. T. et al. (1982), “Is treatment for substance abuse effective”, Journal of the American Medical Association, 247, 1423-1427.

McLellan, A. T., Luborsky, L., O'Brien, C. P., Barr, H. L., & Evans, F. (1986), “Alcohol and drug abuse treatment in three different populations: Is there improvement and is it predictable?”, American Journal of Drug and Alcohol Abuse, 12 (1 & 2), 101-120.

Motiuk, L. L., & Porporino, F. J. (1989), Offender Risk/Needs Assessment: A Study of Conditional Releases, Research Report # 1, Research and Statistics Branch. Ottawa: CSC.

Myers, S. L. (1984), ‘Do better wages reduce crime?”, American Journal of Economics and Sociology, 43(2), 191-196.

Schmidt, L. (1992), “A profile of problem drinkers in public mental health services”, Hospital and Community Psychiatry, 43(3), 245-250.

Taggart, R. (1972), The Prison of Unemployment, Baltimore: John Hopkins University Press.