A randomized controlled trial of the therapeutic workplace for community methadone patients: A partial failure to engage

Todd W. Knealing, Conrad J. Wong, Karly N. Diemer, Jacqueline Hampton, Kenneth Silverman

Research output: Contribution to journalArticle

Abstract

The Therapeutic Workplace is an employment-based treatment for drug addiction that uses wages for work to reinforce drug abstinence. The Therapeutic Workplace has promoted abstinence from heroin and cocaine in treatment-resistant mothers in methadone treatment. This study attempted to replicate that effect in crack cocaine users recruited from community-based methadone programs. Participants were randomly assigned to a Therapeutic Workplace (n = 22) or usual care control (n = 25) group. Therapeutic Workplace participants were invited to work in the workplace and earn vouchers every weekday for 9 months contingent on documented opiate and cocaine abstinence. The two groups did not differ significantly on measures of cocaine or opiate use collected during study participation. Daily attendance and urinalysis results of the Therapeutic Workplace group were analyzed, and only 7 of the 22 participants initiated consistent periods of abstinence and workplace attendance. Two individuals gained access to the workplace on a few days, and 9 participants attempted to gain access to the workplace but never provided a drug-negative urine sample. Possible reasons for differences between the current study and the previous Therapeutic Workplace study are considered. Procedures that increase participant contact with the Therapeutic Workplace and its reinforcement contingencies might increase the likelihood of these individuals being successful in the treatment program.

Original languageEnglish (US)
Pages (from-to)350-360
Number of pages11
JournalExperimental and clinical psychopharmacology
Volume14
Issue number3
DOIs
StatePublished - Aug 1 2006

Keywords

  • Abstinence
  • Cocaine
  • Contingency management
  • Employment
  • Methadone maintenance

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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