Impact of work therapy on health status among homeless, substance-dependent veterans: a randomized controlled trial.
نویسندگان
چکیده
BACKGROUND Little is known about the health outcomes of clinician-supervised, performance-based, abstinence-contingent therapeutic work programs on homeless persons with addiction disorders. This study examined the effect of the Department of Veterans Affairs compensated work therapy program (CWT) on nonvocational outcomes. With mandatory urine screenings and adherence to addiction treatment schedules, CWT provided work opportunities (wages, hours, and responsibilities) with jobs created from Veterans Affairs contracts competitively obtained from private industry. METHODS Homeless, substance-dependent veterans (N = 142) from 4 Department of Veterans Affairs medical centers were randomized, assessed at baseline, and reassessed at 3-month intervals for 1 year. Both CWT and control groups had access to comprehensive rehabilitation, addictions, psychiatric, and medical services. Data were analyzed to determine an immediate CWT effect after treatment and rates of change during 1 year. RESULTS Compared with control subjects, patients in the CWT program were more likely to (1) initiate outpatient addictions treatment, (2) experience fewer drug and alcohol problems, (3) report fewer physical symptoms related to substance use, (4) avoid further loss of physical functioning, and (5) have fewer episodes of homelessness and incarceration. No effect on psychiatric outcomes was found. CONCLUSION Work therapy can enhance nonvocational outcomes of addiction treatment for homeless persons, although long-term gains remain unknown.
منابع مشابه
Counseling Therapy with Hatha Yoga on Adherence Level, Nutritional Status, and Quality of Life Among HIV-Infected Adolescents: A Randomized Controlled Trial
متن کامل
Psychotherapy and Addiction; Examining the Effectiveness of Well-being group therapy on Craving Index in Methamphetamine-dependent Men under Short-term residential treatment, a controlled randomized trial
Positive psychology is a branch of psychology that instead of focusing solely on psychopathology, emphasizing on the psychological potential is considered. Well-Being Therapy is one of the approaches derived from positive psychology. The present study was conducted with the aim of examining the effectiveness of well-being-therapy on Craving Index in substance –dependent (Methamphetamine) men. T...
متن کاملSetting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia
BACKGROUND It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study...
متن کاملPopulation-Tailored Care for Homeless Veterans and Acute Care Use, Cost, and Satisfaction: A Prospective Quasi-Experimental Trial
INTRODUCTION Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nont...
متن کاملHealth status, service use, and costs among veterans receiving outreach services in jail or community settings.
OBJECTIVE This study compared client characteristics, service use, and health care costs of two groups of veterans who were contacted by outreach workers: a group of veterans who were contacted while incarcerated at the Los Angeles jail and a group of homeless veterans who were contacted in community settings. METHODS Between May 1, 1997, and October 1, 1999, a total of 1,676 veterans who wer...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Archives of general psychiatry
دوره 59 10 شماره
صفحات -
تاریخ انتشار 2002