This grant submission is in response to the National Institute on Drug Abuse's Program Announcement PA-99-113 """"""""Drug Use and Related Adverse Behavioral and Social Consequences."""""""" The proposal involves research outlined on PA-113-99 encompassing """"""""local-level"""""""" prevalence studies to document trends in drug use and/or abuse in the context of community membership. We have the unique opportunity to assess a large group of welfare recipients in Western PA to address issues of substance abuse, mental health and treatment. Our preliminary findings demonstrates a high rate of substance use/abuse (approximately 44 percent) psychiatric symptomatology (approximately 49 percent), and cognitive impairment (up to 50 percent) in WtW clients. In addition, 17 percent spontaneously report a past history of physical or sexual abuse. However, no research, to our knowledge, has investigated the relationship of these factors as barriers from welfare to work. Moreover, there is very little empirical information available on how best to facilitate treatment entry for these individuals following identification of a substance abuse and/or psychiatric disorder. The purpose of this study is twofold: 1) examine the predictors of employment outcome in a large group of WtW recipients (N=425). We hypothesize that substance abuse, psychiatric disorder, cognitive function, and past history of sexual abuse and physical violence will be predictive of employment outcome (e.g., wages, job retention). 2) Operationalize and test a theoretically-based treatment intervention to improve an individual's motivation to change and to facilitate entry into treatment. We expect that 40-50 percent of WtW clients will meet criteria for substance abuse and/or psychiatric impairment. Of those, half (100 Ss) will be randomized into a Motivational Therapy (MT) intervention, and the other half (100 Ss) into treatment-as-usual (TAU). We hypothesize, compared to TAU subjects, MT subjects will show improve treatment acceptance as measured by: a) higher treatment engagement rates as measured by attendance of the initial outpatient session within 30 days of the treatment referral (primary outcome); b) higher attendance rates during the six month course of outpatient treatment (for treatment initiators); c) improved employment outcome (e.g., wages, job retention); and d) improved mental health outcomes (e.g., improved mood). Despite the high prevalence of, and seriousness of the problem of substance abuse and psychiatric disorder among welfare recipients, there is little empirical information available on how these factors impede welfare to work or how best to facilitate treatment entry for these individuals following identification of a problem. The current study will address this omission.
| Gorske, Tad T; Daley, Dennis C; Yenerall, Eric et al. (2006) Neuropsychological function and employment status in a welfare-to-work sample. Appl Neuropsychol 13:141-50 |
