Integrating Employment Services with Substance Use Treatment and Recovery

The Experiences of Five Programs

By Hannah Betesh, Deena Schwartz, Shelley Rappaport, Karin Martinson

This report documents the experiences of five programs that integrate employment services into treatment and recovery programs for people with substance use disorder (SUD). (Treatment services treat SUD directly, and recovery services support success in the recovery process, during or after treatment.) It describes the experiences of programs in relation to three critical aspects of program design and implementation:

  • Structuring programs to integrate employment services with treatment and recovery services
  • Designing employment services to address the specific needs of people with SUD
  • Providing support services and connecting people with SUD with jobs appropriate for them

The report is based on interviews with managers and direct service staff members at five programs integrating SUD treatment and recovery services with employment services, conducted virtually during the summer of 2020. Those interviews revealed that:

  • Programs made different decisions regarding the nature and content of employment services and when in the treatment and recovery process those services were offered. Some programs in this study began employment services early in the recovery process, while others began them after participants had been in recovery longer. Moreover, some programs offered participants more leeway in deciding which types of employment services to use and when, while others required participants to follow a specific timeline, participate in specific services, or both. Finally, for some programs, participation in employment services was a condition of program enrollment, while for others it was optional.
  • Organizational partnerships are important for providing the range of employment and treatment and recovery services participants need. People in recovery from SUD navigate complex barriers to employment that often require services from multiple systems. Organizations can offer these services (treatment, occupational training, and support services) in different ways. Several types of organizations led the programs in this study, and those organizations had varying abilities to provide the array of services needed. All the programs relied to some extent on organizational partners for some program services.
  • Programs offering employment services—including job-placement services—must adapt them to accommodate people in recovery from SUD. While the study found variation in the types of adaptations programs made to employment services, the programs did consistently design those services to reflect the needs of people in recovery from SUD: They adjusted the timing and intensity of employment services to align with treatment and recovery service needs, provided job-readiness services (to prepare people for workplace expectations of behavior and communication) to ease the transition to employment, identified occupational training programs of interest to and appropriate for this population, found appropriate work environments and provided continuing support once participants had jobs, and cultivated relationships with employers to support the hiring of people in recovery.

Program Profile: Avivo, Minnesota

Program Profile: Ikron, Ohio

Program Profile: Access to Recovery in Massachusetts

Program Profile: Community Recovery Program, Virginia

Program Profile: Women in Recovery, Oklahoma

Betesh, Hannah, Deena Schwartz, Shelley Rappaport, and Karin Martinson. 2022. Integrating Employment Services with Substance Use Treatment and Recovery. New York: MDRC.