Vocational rehabilitation of participants with severe substance use disorders in a VA Veterans Industries Program

Authors: Walker, W. C., Marwitz, J. H, Kreutzer, J. S., Hart, T., & Novack, T. A.
Year Published 2004
Publication Substance Use and Misuse
Volume 39
Number 13
Pages 2513-2523
Publisher Marcel Dekker

The VA Veterans Industries programs have been established across the country to provide a therapeutic gateway to gainful employment for veterans who have physical and mental disabilities or addictive disorders. Eighty percent of patients referred to vocational rehabilitation programs have a history of severe substance use disorders. Despite the interest in the vocational rehabilitation of substance users (Hawkins and Catalano, 1985), little empirical evidence exists about which specific vocational rehabilitation services promote successful employment outcomes.


The purpose of this study was to evaluate the effectiveness of the Veterans Industries program, a component of the Addictions Partial Hospitalization Program (APHP) at the Houston Veterans Affairs Medical Center (VAMC). Outcome rates are reported including employment, abstinence, and housing support.


The study was conducted at the Houston, TX VAMC within the APHP, an addiction treatment program.


The study sample consisted of 80 veterans who were out-patients of the APHP and who were referred for vocational rehabilitation. The mean age of patients was 45 (range 29–59). Participants were predominantly male (98%) and African-American (62%). Most (68%) were Vietnam era veterans. At enrollment, 100% were unemployed, 73% were homeless, and 15% were receiving a disability pension.

Data Collection

Data were collected at intake for age, education, military history, training, employment history, earnings, disability, disability compensation, substance use, and living situation. Employment data were collected following program exit and at three-month follow-up.


The study used a pre/post intervention design, without a control or comparison group.


Of 80 patients, 72 (90%) successfully completed APHP and received a regular discharge. This means that they completed 4 weeks of partial hospital treatment and graduated to outpatient treatment consisting of group therapy twice a week. Fifty-nine percent of the homeless veterans received supportive housing. All veterans who remained abstinent and continued to participate in work therapy received supportive housing. The average length of service was 3 months. Forty-three of the 80 veterans (54%) obtained competitive employment. The majority of jobs were in entry-level service positions including housekeeping, building maintenance, security, shipping, and receiving. A follow-up conducted 3 months after discharge from Veterans Industries indicated that 60% maintained competitive employment.


The study findings support the conclusion that vocational services improve the employment rates of clients leaving treatment. The existence of job counseling, job placement, and job development services in clinics is positively correlated with the difference between admission and discharge employment rates.

URL http://www.tandfonline.com/doi/abs/10.1081/JA-200034695?journalCode=isum20
Populations Male & Female | Hispanic or Latino | Black / African American | White / Caucasian | Homeless | Veterans
Outcomes Employment acquisition
NIDILRR Funded Not Reported
Research Design Single group, Quasi-experimental
Peer Reviewed Yes