The major long-term objective of the project is to increase the rate and stability of methadone client employment utilizing a vocational problem- solving training intervention with booster/refresher sessions. The relationship between these interventions and employment, relapse to drug use, hopelessness and depression indices, and AIDS-risk behaviors also will be evaluated. Previous research by members of the study team (Platt and Metzger) demonstrated that a vocational job readiness problem-solving intervention increased the employment rate of methadone clients by 100% at six months post-intervention; however, these gains had diminished by 12 months post- intervention. the focus of this study is on maintaining and extending employment gains beyond six months by adding a booster/refresher intervention. It is hypothesized that the booster intervention will act synergistically with the problem-solving intervention to produce a more powerful and lasting effect on methadone client employment by reinforcing the new skills and demonstrating their application in clients' real-life situations, thereby preventing their extinction. It also is hypothesized that enhanced employment status will reduce hopelessness and depression in methadone clients and will reduce the incidence of relapse and AIDS high- risk behaviors as well. Additional foci of this research include: a) investigating why black methadone clients appear to benefit more than white clients from a vocational problem-solving intervention; b) increasing understanding of the reasons for client job loss, change, or retention; and c) examining the relationships between vocational problem-solving training, employment status, and depression and hopelessness on drug use, psychiatric symptomatology, and AIDS high-risk behaviors. Approximately 288 unemployed clients will be recruited from new admissions to the participating methadone facility over a 12 month period. Three groups will be created using random assignment procedures: (E1) vocational problem-solving training + a booster intervention six months following the training; (E2) vocational problem-solving training only; and the control group (C) the standard care offered at the participating clinic, which includes group and individual counseling. Employment status will be monitored on a biweekly basis and verified through pay stubs. Drug use will be monitored on a weekly basis through random urine testing, and symptomatology will be assessed at baseline, 6, 12 and 18 month follow-ups using standardized psychological instruments.
