Impact of work therapy on health status among homeless, substance-dependent veterans: A randomized controlled trial

T. Michael Kashner, Robert Rosenheck, Anthony Brian Campinell, Alina Surís, Randy Crandall, Nancy J. Garfield, Paul Lapuc, Karen Pyrcz, Thomas Soyka, Annie Wicker

Research output: Contribution to journalArticlepeer-review

84 Scopus citations


Background: Little is known about the health outcomes of clinician-supervised, performance-based, abstinence-contingent therapeutic work programs on homeless persons with addiction disorders. This study examined the effect of the Department of Veterans Affairs compensated work therapy program (CWT) on nonvocational outcomes. With mandatory urine screenings and adherence to addiction treatment schedules, CWT provided work opportunities (wages, hours, and responsibilities) with jobs created from Veterans Affairs contracts competitively obtained from private industry. Methods: Homeless, substance-dependent veterans (N = 142) from 4 Department of Veterans Affairs medical centers were randomized, assessed at baseline, and reassessed at 3-month intervals for 1 year. Both CWT and control groups had access to comprehensive rehabilitation, addictions, psychiatric, and medical services. Data were analyzed to determine an immediate CWT effect after treatment and rates of change during 1 year. Results: Compared with control subjects, patients in the CWT program were more likely to (1) initiate outpatient addictions treatment, (2) experience fewer drug and alcohol problems, (3) report fewer physical symptoms related to substance use, (4) avoid further loss of physical functioning, and (5) have fewer episodes of homelessness and incarceration. No effect on psychiatric outcomes was found. Conclusion: Work therapy can enhance nonvocational outcomes of addiction treatment for homeless persons, although long-term gains remain unknown.

Original languageEnglish (US)
Pages (from-to)938-944
Number of pages7
JournalArchives of General Psychiatry
Issue number10
StatePublished - Oct 1 2002

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health


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