The Effectiveness of Interventions Intended to Improve Employment Outcomes for Persons with Substance Use Disorder: An Updated Systematic Review

Background Employment is one of the strongest predictors of positive outcomes for persons with substance use disorder.Purpose:To conduct a systematic review of interventions intended to improve employment outcomes for persons with substance use disorder (SUD) at any stage of recovery. This is an update of a prior review published in 2004.Methods:Two bibliographic databases, PUBMED and PSYCHINFO, were searched for articles published in the period 2005-2018 that referenced employment, education, or vocational rehabilitation for people with SUD.Results:One hundred thirty-two articles were identified of which 14 met the criteria for inclusion, primarily a minimum of a quasi-experimental evaluation design. Each study was reviewed with the following format: setting (modality); subject characteristics; research procedures; results; limitations/comments.Results:Nine programs or models were represented among the 14 studies, with Individual Placement and Pupport (IPS) and its variant Customized Employment Supports (CES) having the most studies with positive results. But generally, the magnitude of any intervention effects on employment was small for all interventions; one outcome may have shown statistical significance while one or more other outcomes did not, and there was little consistency in how outcomes were measured among the studies.Conclusions/Importance:IPS/CES currently shows the most evidentiary support. But all the studies of interventions with positive outcome data should be replicated with larger samples in diverse settings.