Skip to main content

Individual Placement and Support (IPS) for Methadone Maintenance Therapy Patients: A Pilot Randomized Controlled Trial

Administration and Policy in Mental Health and Mental Health Services Research volume 44, pages 359–364 (2017)Cite this article

Abstract

Individual Placement and Support (IPS) is an evidence-based employment model for people with severe mental illness, but it has not been evaluated for clients enrolled in substance abuse treatment programs. This study evaluated the effectiveness of IPS for people with opioid use disorders enrolled in an opioid treatment program. Within a randomized controlled experiment, 45 patients receiving methadone maintenance therapy were assigned to either IPS or a 6-month waitlist. The waitlist group received IPS after 6 months. The primary outcome assessed over 1 year compared the attainment of a job for the IPS condition to the waitlist comparison group. During the first 6 months after enrollment, 11 (50%) active IPS participants gained competitive employment compared to 1 (5%) waitlist participant (Χ 2 = 12.0, p < 0.001). Over 12 months of enrollment, 11 (50%) IPS participants gained competitive employment compared to 5 (22%) waitlist participants (Χ 2 = 3.92, p = 0.07). We conclude that IPS holds promise as an employment intervention for people with opioid use disorders in methadone maintenance treatment, but larger trials with longer follow-up are needed.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-IV (5th ed.). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Becker, D. R., & Drake, R. E. (2003). A working life for people with severe mental illness. New York: Oxford University Press.

    Book  Google Scholar 

  • Bond, G. R., Drake, R. E., & Luciano, A. E. (2015). Employment and educational outcomes in early intervention programmes for early psychosis: A systematic review. Epidemiology and Psychiatric Sciences, 24, 446–457.

    CAS  Article  PubMed  Google Scholar 

  • Bond, G. R., Peterson, A. E., Becker, D. R., & Drake, R. E. (2012). Validating the revised individual placement and support fidelity scale (IPS-25). Psychiatric Services, 63, 758–763.

    Article  PubMed  Google Scholar 

  • Center for Substance Abuse Services. (2000). Integrating substance abuse treatment and vocational services. Treatment improvement protocol (TIP) series 38. DHHS publication no. SMA 00-3470. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Deegan, P. E., & Drake, R. E. (2006). Shared decision making and medication management in the recovery process. Psychiatric Services, 57, 1636–1639.

    Article  PubMed  Google Scholar 

  • Drake, R. E., Bond, G. R., & Becker, D. R. (2012). Individual placement and support: An evidence-based approach to supported employment. New York: Oxford University Press.

    Book  Google Scholar 

  • Drake, R. E., McHugo, G. J., Becker, D. R., Anthony, W. A., & Clark, R. E. (1996). The New Hampshire study of supported employment for people with severe mental illness: Vocational outcomes. Journal of Consulting and Clinical Psychology, 64, 391–399.

    CAS  Article  PubMed  Google Scholar 

  • Eklund, M., Hermansson, A., & Håkansson, C. (2012). Meaning in life for people with schizophrenia: Does it include occupation? Journal of Occupational Science, 19, 93–105.

    Article  Google Scholar 

  • Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. C. (2009). Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377–381.

    Article  PubMed  Google Scholar 

  • IBM Corp. (2015). IBM SPSS statistics for windows (version 23.0). Armonk, NY: IBM.

    Google Scholar 

  • Kampman, K., & Jarvis, M. (2015). American Society of Addiction Medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use. Journal of Addiction Medicine, 9, 358–367.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Luciano, A. E., Bond, G. R., & Drake, R. E. (2014). Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinal research. Schizophrenia Research, 159, 312–321.

    Article  PubMed  Google Scholar 

  • Magura, S., Staines, G. L., Blankertz, L., & Madison, E. M. (2004). The effectiveness of vocational services for substance users in treatment. Substance Use and Misuse, 39, 2165–2213.

    Article  PubMed  Google Scholar 

  • Marshall, T., Goldberg, R. W., Braude, L., Dougherty, R. H., Daniels, A. S., Ghose, S. S., … Delphin-Rittmon, M. E. (2014). Supported employment: Assessing the evidence. Psychiatric Services, 65, 16–23.

    Article  PubMed  Google Scholar 

  • McLellan, A. T., Grissom, G. R., Zanis, D. A., Randall, M., Brill, P., & O’Brien, C. P. (1997). Problem-service ‘matching’ in addiction treatment. A prospective study in 4 programs. Archives of General Psychiatry, 54, 730–735.

    CAS  Article  PubMed  Google Scholar 

  • Modini, M., Tan, L., Brinchmann, B., Wang, M., Killackey, E., Glozier, N., … Harvey, S. B. (2016). Supported employment for people with severe mental illness: A systematic review and meta-analysis of the international evidence. British Journal of Psychiatry, 209, 14–22.

    Article  PubMed  Google Scholar 

  • Noel, V. A., Oulvey, E., Drake, E. E., & Bond, G. R. (2016). Barriers to employment for transition-age youth with developmental and psychiatric disabilities. Administration and Policy in Mental Health and Mental Health Services Research. doi:10.1007/s10488-016-0773-y.

  • Oregon Supported Employment Center for Excellence. (2011). Oregon supported employment center for excellence, 2016. Retrieved from http://osece.org/.

  • Ramsay, C. E., Broussard, B., Goulding, S. M., Cristofaro, S., Hall, D., Kaslow, N. J., … Compton, M. T. (2011). Life and treatment goals of individuals hospitalized for first-episode nonaffective psychosis. Psychiatry Research, 189, 344–348.

    Article  PubMed  PubMed Central  Google Scholar 

  • Richardson, L., Wood, E., Montaner, J., & Kerr, T. (2012). Addiction treatment-related employment barriers: The impact of methadone maintenance. Journal of Substance Abuse Treatment, 43, 276–284.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schuckit, M. A. (2016). Treatment of opioid-use disorders. New England Journal of Medicine, 375, 357–368.

    Article  PubMed  Google Scholar 

  • Staines, G. L., Blankertz, L., Magura, S., Cleland, C. M., & Bali, P. (2005). Evaluating vocational rehabilitation programs for substance users: Issues in designing and implementing randomized studies. Evaluation and Program Planning, 28, 61–68.

    Article  Google Scholar 

  • StataCorp. (2011). Stata statistical software: Release 12. College Station, TX: StataCorp LP.

    Google Scholar 

  • Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies: Tackling the opioid-overdose epidemic. New England Journal of Medicine, 370, 2063–2066.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

For this unfunded pilot project, we gratefully acknowledge the in-kind support from the CODA, Inc. administration. We thank the CODA Research Department for their implementation and conduct of the trial. A special thanks to the patients and study participants.

Author information

Affiliations

  1. CODA, Inc., Portland, OR, USA

    Carrie E. Lones, Kathryn Carr, Teresa Leckron-Myers & Tim Hartnett

  2. 1027 E. Burnside St., Portland, OR, 97214, USA

    Carrie E. Lones

  3. IPS Employment Center, Westat, Lebanon, NH, USA

    Gary R. Bond & Deborah R. Becker

  4. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA

    Mark P. McGovern

Authors
  1. Carrie E. Lones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gary R. Bond
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark P. McGovern
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kathryn Carr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Teresa Leckron-Myers
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tim Hartnett
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Deborah R. Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carrie E. Lones.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lones, C.E., Bond, G.R., McGovern, M.P. et al. Individual Placement and Support (IPS) for Methadone Maintenance Therapy Patients: A Pilot Randomized Controlled Trial. Adm Policy Ment Health 44, 359–364 (2017). https://doi.org/10.1007/s10488-017-0793-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-017-0793-2

Keywords

  • Supported employment
  • Methadone
  • Opioid use disorder