Rehabilitation Research and Training Center on Substance Abuse, Disability and Employment

1
Rehabilitation Research and Training Center on
Substance Abuse, Disability and Employment

• Department of Community Health
• Boonshoft School of Medicine
• Wright State University
• Dayton Ohio

2
Wright State University
WSU serves 16,000 students with programs leading
to more than 100 undergraduate and 50 Ph.D.,
graduate and professional degrees. Student
Disability Services sees 800 students/yr Boonsho
ft School of Medicine has Family Practice
specialty, with community placements for all
students. Med Student instruction and
experience in Alcohol and Drug interventions
required in curriculum
3
Overview of RRTC

• Rehabilitation Research and Training Center on
  Substance Abuse, Disability, and Employment
• Funded by the National Institute on Disability
  and Rehabilitation Research

4
Faculty - active

• Debra Becker, Ph.D., Dartmouth University
• John Corrigan, Ph.D., Ohio State University
• Robert Drake, M.D., Dartmouth University
• Colette Duggan, Ph.D., Rehabilitation Institute
  of Michigan
• Jo Ann Ford, MRC, Wright State University
• Margaret Glenn, Ed.D., West Virginia University
• Debra Guthman, Ed.D., California School for the
  Deaf
• Allen Heinemann, Ph.D., Rehabilitation Institute
  of Chicago
• David Hollar, Ph.D., University of North Carolina
• Joseph Keferl, Rh.D., Wright State University
• Linda Lazowski, Ph.D., SASSI Institute
• Mary McAweeney, Ph.D., Wright State University
• Dennis Moore, Ed.D., Wright State University

5
R1 Promoting Substance Use Assessment by
Vocational Rehabilitation Agencies

• Goal To create, validate, and evaluate the
  efficacy for wide-spread adoption of substance
  use disorder screening among state-federal VR
  programs

6
Why Conduct This Study?

• Rate of SUD in VR
• Apparent high level of undetected SUD
• No screener for VR or sensitive to persons with
  disabilities (e.g., alternative formats,
  prescription drug abuse)

7
Phases of Project

• Instrument and item selection
• Validation of instrument (N 1,000)
• Evaluation of system-wide use (6 states target
  15,000 administrations)

8
Outcomes

• Validated SAVR-S screener in alternate formats
• Online resources toolkits for VR professionals
• Efficacy study of SAVR-S use in VR systems
• Wide dissemination of findings

9
R2 Efficacy of the Individual Placement and
Support (IPS) Model for Consumers with Disability
and Substance Use Disorders

• Goal To investigate the efficacy of IPS among
  persons with traumatic brain injury or other
  severe disabilities with coexisting substance use
  disorders (SUD). The two clinical trial sites
  affiliated with Wright State and Ohio State
  medical schools.

10
Why Conduct This Study?

• Substance use disorders occur frequently among
  persons with disabilities
• VR beginning to implement IPS with MI consumers
• Substance dependence has been identified as a
  major causative factor in secondary disability
• Dartmouth and many other sites validated success
  of the IPS model

11
Randomized Control Study

• Participants have substance use disorder TBI or
  other significant disability
• Cohorts at WSU OSU clinics (N200)
• Model fidelity enhanced by IPS originator as
  co-PI (Robert Drake)
• Baseline employment rates lower than many other
  IPS study populations

12
Outcomes

• First study of IPS with this population
• Policy and Procedures manuals
• Training components and dissemination

13
R3 State level policy analyses and the provision
of rehabilitation services to consumers with
substance abuse problems

• Goal Determine and elaborate on policy-related
  factors at state VR levels that promote or
  inhibit effective service delivery to persons
  with disabilities who experience substance use
  disorders

14
Why Conduct This Study?

• Need to understand contexts of VR service
  provision regarding persons with SUD
• Some risk that screening for SUD in VR can have
  detrimental effect for consumers
• Wide variability in official prevalence of SUD
  diagnosed among state-based VR programs
• Policies and practices appear to impact rate of
  SUD identification

15
Project Components

• Literature and Policy review
• National surveys of state VR and alcohol/drug
  agency directors
• Survey of VR counselors
• In depth case studies six states

16
Outcomes

• Identify barriers and promising practices based
  on policy and respondent data
• Use case studies to identify critical areas of
  policy and practice for VR programs
• Publications, briefs, and training materials

17
R4 An investigation of factors that contribute
to unsuccessful case closure among consumers of
vocational rehabilitation services

• Goals
• Determine factors that contribute to unsuccessful
  case closure within the state-federal VR system

18
Why Conduct This Study?

• Over 50 of VR cases are closed unsuccessfully
• High cost of unsuccessful closures to VR
• SUD may have significant bearing on the above
  statistics

19

Sample

• 200 unsuccessful VR closures nationwide
• Stratified random sample from eight recruited
  state VR programs
• Over-sampling for minorities and SUD balanced
  for gender, race, and functional impairments

20

Outcomes

• Nationally representative, qualitative-
  quantitative study of consumer and counselor
  perspectives on unsuccessful VR closures
• Publications, briefs, and input into RRTC online
  training materials

21
RRTC Training Products

• www.myvrtraining.com free CEU, self-guided
  courses on VR and substance abuse
• SAVR-S substance abuse screener, with automated
  scoring
• Web-based tools for VR and substance abuse issues
  (e.g., Toolkit for VR Professionals)

22
Tool kits

• Facilitating self determination in SUD assessment
• Advocating for accessible SUD services
• The VR Counselors role in facilitating recovery
  through effective recovery plans

23

• Validation of a substance use disorder screening
  instrument for use in vocational rehabilitation
  settings.
• A substance abuse screening tool for
  rehabilitation counselors working in vocational
  rehabilitation agencies.
• Utilization of substance abuse screening across
  state vocational rehabilitation agencies.
• Factors that contribute to unsuccessful case
  closures among consumers of vocational
  rehabilitation services.
• Predictors of successful closure in the
  state/federal vocational rehabilitation system
  Findings from a sample of persons with disability
  and substance use disorders.
• Utilizing supported employment for persons with
  SUD and co-existing disabilities.
• Policy issues in VR related to consumers with
  substance use disorders.

24

• Demographics, rates and progress of goals during
  substance abuse treatment for persons who are
  deaf or hard of hearing.
• The substance abuse in vocational rehabilitation
  - screener in American sign language (SAVR-S-ASL)
  for persons who are deaf.
• Psychosocial aspects related to the
  dual-diagnosis of substance use disorder and
  disability.
• Relationship of substance use by students with
  disabilities to long-term educational,
  employment, and social outcomes.
• Intention to quit tobacco use among clients in
  substance use disorder treatment settings.
• Clinical characteristics and staff training needs
  of two substance use disorder treatment programs
  specialized for persons with disabilities.
• Substance abuse and women with disabilities.