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UNITED STATES DEPARTMENT OF LABOR

Randomized multi-site trial of the Job Seekers’ Workshop in patients with substance use disorders (Svikis et al., 2012)

Review Guidelines

Causal Evidence Guidelines

Absence of conflict of interest. 

Citation

Svikis, D. S., Keyser-Marcus, L., Stitzer, M., Rieckmann, T., Safford, L., Loeb, P., Allen, T., Luna-Anderson, C., Back, S. E., Cohen, J., DeBernardi, M. A., Dillard, B., Forcehimes, A., Jaffee, W., Killeen, T., Kolodner, K., Levy, M., Pallas, D., Perl, H. I., Potter, J. S., Provost, S., Reese, K., Sampson, R. R., Sepulveda, A., Snead, N., Wong, C. J., & Zweben., J. (2012). Randomized multi-site trial of the Job Seekers’ Workshop in patients with substance use disorders. Drug and Alcohol Dependence, 120(1-3), 55-64. https://doi.org/10.1016/j.drugalcdep.2011.06.024

Highlights

  • The study's objective was to examine the impact of Job Seekers' Workshop (JSW) on employment outcomes among unemployed or underemployed patients receiving treatment for substance use disorders. 
  • The study was a randomized controlled trial (RCT) that used follow-up assessments to compare the outcomes of eligible individuals randomly assigned to receive JSW to a control group who received standard care. 
  • The study did not find any statistically significant effects of JSW on employment.  
  • The quality of causal evidence presented in this report is high because it is based on a well-implemented RCT with low attrition. This means we would be confident that any estimated effects would be attributable to JSW and not to other factors. However, the study did not find statistically significant effects.  

Intervention Examined

Job Seekers’ Workshop

Features of the Intervention

The Job Seekers' Workshop (JSW) was developed and tested in the late 1970s to promote employment among individuals who are drug-dependent. The goal of the program is to help individuals acquire the necessary skills to find and secure employment. The efficacy of JSW was demonstrated in several small-scale studies in the late 1970s involving different groups of individuals, including heroin-dependent parolees and probationers, and unemployed methadone maintenance patients.  

This study examined JSW in a larger, heterogenous, treatment-based sample of adults with substance use disorders. The study was conducted at eleven treatment programs (six outpatient psychosocial counseling programs and five methadone maintenance programs) that were members of the National Institute on Drug Abuse (NIDA) Clinical Trials Network. JSW consisted of three 4-hour weekly sessions conducted in groups of 1 to 4 participants. The sessions focus on various aspects of job acquisition such as finding available jobs, making "cold calls" to potential employers, and practicing job interview skills. A crucial element of the intervention was the use of individualized videotape feedback, which allows participants to practice and gradually enhance their interview skills. The intervention was designed to serve unemployed or underemployed adults with alcohol and/or drug abuse or dependence who were enrolled in a substance abuse treatment program and interested in obtaining a job. 

Features of the Study

The study was a randomized controlled trial that assigned 628 eligible individuals to the treatment or control group. The randomization process was stratified based on employment history and current employment status. The treatment group included 299 individuals that were offered the JSW. The control group included 329 individuals who received “standard care.” Standard care reflected the existing practices in each treatment program (e.g., if they offered vocational groups or referrals to community resources), plus a “Community Job Resources Brochure” (consistent across all 11 sites) that included information on local job placement and vocational training resources. The authors examined the effects of the JSW program using a follow-up assessment conducted at 4, 12, and 24 weeks after random assignment. The authors used statistical tests to compare average outcomes between individuals randomly assigned to the treatment group (JSW) versus the control group (standard care).  

Findings

Employment

  • The study found no statistically significant impacts on any employment or full time employment (in a new taxable or non-taxed job) by the 12-week or 24-week follow up. 

Considerations for Interpreting the Findings

The study authors estimated multiple related impacts on outcomes related to employment (and outcomes that combine employment and enrollment in training). Performing multiple statistical tests on related outcomes makes it more likely that some impacts will be found statistically significant purely by chance and not because they reflect program effectiveness. However, since the authors do not find any statistically significant results, this “multiple comparisons” problem has not influenced their conclusions.  

For sample members who are not observed at follow up, the authors impute an outcome of zero – that the individual did not gain employment or enter a training program by the given point in time. Because the study loses a slightly higher proportion of sample members from the treatment group than the control group, imputing those outcomes as 0s is a conservative estimate – it decreases the chances that the authors find a positive impact of the program on employment outcomes.  

Causal Evidence Rating

The quality of causal evidence presented in this report is high because the study is based on a well-implemented randomized controlled trial with low attrition. This means we would be confident that any estimated effects would be attributable to JSW and not to other factors. However, the study did not find statistically significant effects. 

Reviewed by CLEAR

September 2024

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