Let`em Work Let`em Live

Employment poses one of the major challenges for addiction clients. Clients oftentimes have criminal histories or have experienced lapses between jobs and have difficulty knowing how best to fill out a job application or speak with a potential employer during an interview. Assisting addiction clients with vocational needs is critical, as research indicates that employed clients typically have better drug treatment outcomes than unemployed clients do.

The Job Seekers' Workshop was developed by Sharon Hall and colleagues1 to address these exact kinds of problems. The JSW demonstrated efficacy across several studies^1-4 and was included as an intervention in the National Institute on Drug Abuse's Clinical Trials Network (see https://www.nida.nih.gov/CTN/index.htm for more information). In this article, we describe the objectives, activities, and challenges that can arise in implementing the JSW intervention.

The JSW's main goal is to improve clients' job seeking and interviewing skills. The program consists of three four-hour group workshops delivered weekly, with an ideal number of approximately five participants. There are several things that the JSW is not. It is not designed to motivate clients to gain employment, nor to sell clients on doing something they don't want to do. It is not therapy and does not get into deep discussions about clients' past or their substance abuse history. Rather, the JSW seeks to provide clients with the skills necessary to increase the probability of gainful employment.

In this respect, the JSW is grounded in behavioral theory, as it is focused on helping individuals learn behaviors involved in the process of securing employment—especially performing well in a job interview. “Facilitators” or leaders of the JSW workshops are most often treatment program professionals who have been trained to deliver the intervention. This training usually takes place in one of two ways: 1) the developers or senior trainers of the JSW train professionals to deliver the workshops directly; or 2) professionals who already have been trained by JSW senior trainers then train other professionals in their treatment programs to deliver the intervention, in a “train the trainer” model.

Components of the workshops

Becoming employed is a function of one's ability to seek out opportunities, complete a job application, and present well during the job interview process. Tables 1 and 2 display the JSW daily activities and equipment used to help clients achieve these skills.

As can be seen in Table 1, the workshops are experiential as opposed to didactic. Each workshop builds on the previous one. During the first workshop, the purpose, ground rules, and activities are discussed, and clients are given an opportunity to vent about past work experiences and difficulties encountered with employment. The video interaction sequence, discussed in more detail below, is introduced with the intent of getting clients comfortable with the idea of seeing themselves on camera. Sample job applications are reviewed and clients complete an application “as if” they were applying for a job. The completed applications are reviewed and edited, and then are used as the basis of the final role-play in the video interaction sequence.


Sudie E. Back, PhD

Table 1. Job Seekers' Workshop daily activities

Workshop #1

Workshop #1

Workshop #1

1. Set up the video camera. Have it on when participants enter the room so they can get accustomed to it and to seeing themselves on camera.

2. Welcome and introductions.

3. Review the purpose of the JSW.

4. Review the activities to be covered in the three workshops.

5. Review any ground rules (e.g., turn off cell phones) and answer any questions.

6. Break (10-15 minutes).

7. Let participants vent briefly about past work experiences.

8. Initial role-play using the video interaction sequence. This first role-play is conversational and not a job interview, but more a chance for clients to get used to the VIS and see how they present themselves.

1. Welcome and answer any questions from Workshop #1.

2. First job interview role-play using the VIS. This role-play is structured as a job interview, and problem areas and concerns are discussed.

3. Break (10-15 minutes).

4. Job applications are completed.

5. Break (10-15 minutes).

6. Review job leads.
   

1. Answer any questions from Workshop #2.

2. Finish completing job applications if necessary.

3. Final job interview role-play using the VIS. Completed job applications are the basis for this role-play. Make it as realistic as possible and be sure to cover problem areas.

4. Break (10-15 minutes).

5. Practice making phone calls to potential employers.

6. Break (10-15 minutes).

7. Résumés are reviewed if necessary.

8. Summarize the three days of workshops and what clients have learned and accomplished.

9. Hand out certificates of completion and congratulate clients for their successes.

Clients also learn techniques for seeking out employment, pursuing job leads, and finding resources for potential job opportunities. This is done primarily through Web-based searches, newspaper classified ads, and practice phone calls to potential employers. Assistance in writing a résumé is offered during the workshops as well.

Table 3 lists the steps of the video interaction sequence. The VIS is one of the most important and powerful components of the workshop. It involves videotaped role-plays that are played back to the group for feedback and then repeated. With each role-play, the interview becomes more and more realistic.

For many clients, the VIS can feel intimidating, particularly at first. However, at the end of the program, participants often remark on how helpful the VIS has been and how much they have learned from participating in the videotaped role-plays. Clients also are reassured at the outset that the role-plays are brief (five minutes or less) and are erased at the end of each workshop. The VIS allows clients to see themselves improving right before their eyes. This can serve as a powerful source of reinforcement—so much more than what a group facilitator or members could provide alone.

On the first day of the JSW, the video camera is turned on so that clients can be exposed to the camera as they first enter the room. The first role-play is not a job interview, but rather an opportunity for clients to get more comfortable being videotaped and to see how they present themselves. This role-play is conversational, involving neutral questions about personal interests or job history (e.g., “What are your hobbies?” or “What has been your favorite job?”). This segment is immediately played back, and usually clients will make spontaneous remarks such as, “I didn't know my hair looked like that” or “I don't like seeing myself on video.” The group leader's input at this early stage should be limited to supportive comments such as, “You make good eye contact” or simply “It took a lot of courage to do that.” Following this feedback, each client decides on one or two things he/she would like to focus on or do differently in the next role-play, and then the sequence is repeated.

During the second workshop, the VIS is repeated and this time the role-play is structured as a job interview. Clients practice entering, shaking hands firmly, sitting down and getting comfortable, taking a breath or two, and then presenting themselves. When the video is played back, each client has an opportunity to see how various statements, attitudes, and explanations come across. Following the first replay, each client is offered feedback from the leader and other group members. Identifying weak areas and suggesting concrete alternatives can be helpful at this time, but it is important that any negative feedback be kept as specific as possible and be offered in a constructive, non-confrontational manner, and that more positive than negative feedback is provided.

Table 2. Equipment and materials needed

• Daily workshop agendas for participants

• Video camera/Camcorder, tripod, television

• Refreshments and light snacks

• Copies of blank job applications

• Pencils and black pens

• Most recent classified ads from local newspaper

• Telephone books

• Access to a telephone or cell phone

• Access to the Internet

• Graduation certificates

The interviews gradually become more difficult, with greater focus and practice on problematic areas. In the third workshop, the leader uses the completed job application as the basis for the interviews. This final interview should be as realistic as possible, allowing clients a chance to respond to difficult questions that may arise in a typical interview (e.g., “Do you currently have a problem with drugs?” “Are you in treatment?” “When will you get your driver's license back?”). This will allow confidence in clients' self-presentation to develop.

Table 3. Steps to the Video Interaction Sequence

1. Set up the role-play. Make sure the client knows what is going to happen and what he/she is supposed to do.

2. Start the video recording.

3. Interview the client in role-play (five minutes or less).

4. Rewind and immediately replay the video.

5. Ask for the participant's initial, brief reaction.

6. Group leader and members provide several points of positive reinforcement for effective behaviors.

7. Plan with the client what to do to improve in the re-practice (what one or two things to focus on).

8. Rewind the videotape and start recording again.

9. Interview the client in role-play again (five minutes or less).

10. Rewind and immediately replay the new video.

11. Positively reinforce improvements.

In dealing with negative or difficult information, clients are instructed to try to turn the discussion around and emphasize a positive attitude and information. If the interviewer is dwelling on a prison record, for example, the client might emphasize recent efforts at rehabilitation with remarks such as, “The past is behind me and I'm interested in making a future for myself.” Clients practice explaining the circumstances briefly (one or two sentences) and in a relaxed tone of voice.

In discussing criminal records, participants are advised to reveal only their convictions (not arrests) and to avoid loaded words or phrases such as “narcotics” or “armed robbery.” Other ideas for saying the same thing are tried until each person has some alternative ways to describe past experiences. For example, “using narcotics” may become “I had some past involvement with drugs, but that is no longer a problem for me.” Again, the client is coached to present a positive attitude and to try to put the addiction in the past and return the interview's focus to the present.

Common issues arising in workshops

Several issues typically arise during the JSW program. For many clients, the question of whether to lie or tell the truth about their addiction history and background is a central one. Clients may be considering either fabricating a more positive job history or being completely open and not concealing any details, no matter how negative or damaging they may be in an interview. One effective approach in the workshop is to ask the interviewee to try the interview first one way and then the other. The weaknesses of the fabricated interview usually become quite apparent through the video feedback.

Clients are never encouraged to lie, but it is emphasized that full disclosure of negative information also might not be necessary. Clients are helped to differentiate therapy from the job interview. Clearly, the goals of each are quite different, and thus the amount of disclosure needed is different. The theme of total candor typically gives rise to rationalizations about one's inability to get a job (such as “I can't get a job because of my jail time” or “I can't get a job because I'm on methadone”), culminating in a general atmosphere of hopelessness. The leader can acknowledge the reality of some of these concerns, but also counter with three main points:

• An employer is not interested in a victim but rather in someone who presents him/herself in a positive, motivated way.

• The workshop cannot change one's background or wider social conditions, but can teach some skills to help counteract such disadvantages.

• A prospective employer is not likely to be able to identify an applicant as someone who had an addiction, and decisions about hiring are based primarily on a positive presentation of oneself.

In the view of many addiction clients, asking them to give a positive representation of themselves on job interviews is equivalent to asking them to lie. Since they often view themselves in a negative light, it can be difficult for them to think of qualities they possess that would be desirable to a prospective employer. Perhaps the most important and difficult concept that the leaders must communicate is that everyone in the working world tries to present him/herself in the best possible light during a job interview, and that it is not a fundamentally different problem for addiction clients.

Clients are never encouraged to lie or falsify information; rather, the emphasis is on identifying strong points or skills that would be attractive to a potential employer and avoiding discussion of negative information, just as any other job applicant would do. Building self-confidence and helping clients develop a positive presentation is one of the most fundamental tasks of the workshops. In helping clients gain employment, we can help them stay on the road to recovery.

Sudie E. Back, PhD, is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina and has served as a Job Seekers' Workshop group facilitator and trainer. Her e-mail address is backs@musc.edu.
A'delle Chellis, MEd, is Director of Research and Community Relations at the Dorchester Alcohol and Drug Commission in South Carolina and has served as a JSW group facilitator.
Dace S. Svikis, PhD, is a Professor in the Dep-artment of Psychology at Virginia Common-wealth University and is Principal Investigator of a national clinical trial of the JSW.
Kathleen T. Brady, MD, PhD, is a Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina and is Principal Investigator and Director of the Southern Consortium of the NIDA Clinical Trials Network.

References

1. Hall SM, Loeb P, Norton J, et al. Improving vocational placement in drug treatment clients: a pilot study. Addictive Behaviors 1977; 2:227–34.
2. Hall SM, Loeb P, Coyne K, et al. Increasing employment in ex-heroin addicts I: criminal justice sample. Behav Ther 1981; 12:443–52.
3. Hall SM, Loeb P, LeVois M, et al. Increasing employment in ex-heroin addicts II: methadone maintenance sample. Behav Ther 1981; 12:453–60.
4. Sorensen JL, Hall SM, Loeb P, et al. Dissemination of a job seekers' workshop to drug treatment programs. Behav Ther 1988; 19:143–55.