Dissertation
Referral source, employment, and the recovery of underserved substance use treatment clients
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Summer 2019
DOI: 10.17077/etd.b66u-mejo
Abstract
<p>Substance use disorders (SUDs) are a serious public health concern contributing to health risks for individuals and communities. Recovery capital are client strengths associated with SUD recovery. Employment represents recovery capital associated with positive SUD treatment outcomes. However, the relationship between employment mechanisms and SUDs are not well understood. The present study investigates how specific employment variables at SUD treatment intake predict (a) successful treatment completion, (b) abstinence at six-month treatment follow-up, (c) reduced use at six-month treatment follow-up. Additionally, employment variable change is explored. A retrospective, cross-sectional investigation with logistic regression modeling to predict substance use at six-months post SUD treatment follow-up was used. Clients in the study period (1999-2016, N = 8,925) were a mean age of 31.7 (SD=11.8), mostly male (67.2%), and primarily White (86.6%). Results demonstrated that employment variables at intake predicted greater successful treatment completion, Wald χ2[36]=185.3, p<0.0001. However, greater employment strengths were predictive of maintained use at six-month follow-up rather than abstinence or reduced use. Further investigation showed, the best predictors of post-treatment recovery were months employed change (AOR=1.53, 95% CI=1.34-1.75) and days missed from work change (AOR=2.43, 95% CI=2.00-2.96). Counseling psychologists can help to improve substance use outcomes and the quality of life for those in SUD treatment by becoming involved in intervention design, consultation, and policy making that focuses on increasing employment length and reducing absenteeism due to substance use. Employment is one route to engagement that can help to improve the lives for those involved.</p>
Details
- Title: Subtitle
- Referral source, employment, and the recovery of underserved substance use treatment clients
- Creators
- Ethan Sahker - University of Iowa
- Contributors
- Saba Rasheed Ali (Advisor)Stephan Arndt (Advisor)Stewart Ehly (Committee Member)Charles Bermingham (Committee Member)William M. Liu (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Psychological and Quantitative Foundations
- Date degree season
- Summer 2019
- DOI
- 10.17077/etd.b66u-mejo
- Publisher
- University of Iowa
- Number of pages
- vi, 35 pages
- Copyright
- Copyright © 2019 Ethan Sahker
- Language
- English
- Description illustrations
- illustrations
- Description bibliographic
- Includes bibliographical references (pages 30-35).
- Public Abstract (ETD)
Addiction affects many people, families, and communities. Treating addiction tends to be coercive, such as criminal justice mandates or family ultimatums. Therefore, completing treatment and staying abstinent is often motivated by avoiding punishment. Alternatively, treatment can focus on people’s strengths for motivation to change. Employment is one strength associated with treatment success. However, the specific factors of employment in relation to recovery after treatment is still not well understood.
This research investigates specific some factors of employment that are associated with improved recovery after treatment is completed. A total of 8,925 people who went to addictions treatment in Iowa were surveyed six-months after they completed treatment. This study tested, Current Employment, Occupation, Primary Support Source, Months Employed, Days of Work Missed due to substances use, and Gross Income to see what is associated with recovery.
Results from the study showed that more employment strengths for every category (i.e. full-time employment, greater income) was associated with successful treatment completion. However, these same strengths were surprisingly also associated with greater relapse at six-months post-treatment. Alternatively, an improvement in employment strengths in Months Employed and Days of Work Missed was associated with greater recovery, regardless of what people had at treatment admission.
This means that treatment interventions may be more successful when focused on developing improvements in employment retention and reducing work absenteeism. This may be due to greater internalized or intrinsic motivation, or improvements in self-esteem and self-determination.
- Academic Unit
- Psychological and Quantitative Foundations
- Record Identifier
- 9983776869202771
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