The power of the employment specialist: Skills that impact outcomes

Purpose – The purpose of this paper is to provide the personal accounts of the journey back to work from the perspective of both the person entering employment and the Employment Specialist who assisted them. Design/methodology/approach – Two people with mental health problems who received help into employment from an employment service in a London Mental Health Trust were asked to give write their accounts of their journey. The Employment Specialists who assisted them in this journey were also asked to write their accounts. Findings – Reflective accounts – no findings presented. Originality/value – Much has been written about the effectiveness of Individual Placement and Support evidence-based supported employment, but little has been published about the lived experience of this approach from the perspective of both the person endeavouring to return to work and the employment specialists who support them. This paper presents two such accounts.

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Abstinence-contingent wage supplements to promote drug abstinence and employment: a randomised controlled trial

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-213761 ◽

2020 ◽

Vol 74 (5) ◽

pp. 445-452 ◽

Cited By ~ 2

Author(s):

August F Holtyn ◽

Forrest Toegel ◽

Shrinidhi Subramaniam ◽

Brantley P Jarvis ◽

Jeannie-Marie Leoutsakos ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Urine Samples ◽

Control Group ◽

Opioid Use ◽

Employment Services ◽

Employment Specialist ◽

Drug Abstinence ◽

Randomised Controlled

BackgroundPoverty, unemployment and substance abuse are inter-related problems. This study evaluated the effectiveness of abstinence-contingent wage supplements in promoting drug abstinence and employment in unemployed adults in outpatient treatment for opioid use disorder.MethodsA randomised controlled trial was conducted in Baltimore, MD, from 2014 to 2019. After a 3-month abstinence initiation and training period, participants (n=91) were randomly assigned to a usual care control group that received employment services or to an abstinence-contingent wage supplement group that received employment services plus abstinence-contingent wage supplements. All participants were invited to work with an employment specialist to seek employment in a community job for 12 months. Abstinence-contingent wage supplement participants could earn training stipends for working with the employment specialist and wage supplements for working in a community job, but had to provide opiate and cocaine-negative urine samples to maximise pay.ResultsAbstinence-contingent wage supplement participants provided significantly more opiate and cocaine-negative urine samples than usual care control participants (65% vs 45%; OR=2.29, 95% CI 1.22 to 4.30, p=0.01) during the 12-month intervention. Abstinence-contingent wage supplement participants were significantly more likely to have obtained employment (59% vs 28%; OR=3.88, 95% CI 1.60 to 9.41, p=0.004) and lived out of poverty (61% vs 30%; OR=3.77, 95% CI 1.57 to 9.04, p=0.004) by the end of the 12-month intervention than usual care control participants.ConclusionAbstinence-contingent wage supplements can promote drug abstinence and employment.Trial registration numberClinicalTrials.gov NCT02487745.

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