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All intervention participants were recruited from a federal health care center in Birmingham, AL, from November 2001 to June 2004. To qualify for program enrollment, applicants had to meet the following criteria: (1) be experiencing homelessness; (2) have a cocaine dependence (with reported cocaine use over the past 2 weeks serving as the proxy); (3) be experiencing psychological distress (as measured by the Brief Symptom Inventory); (4) participate voluntarily; and (5) plan to stay in Birmingham, AL, for the next 18 months. Two hundred and six applicants met these criteria, and 103 were subsequently assigned each to the intervention condition and the comparison condition. Individuals were randomly assigned to the two intervention conditions with equal probabilities.
Researchers followed study participants for 18 months after random assignment.
University of Alabama at Birmingham, Department of Psychology; Birmingham Healthcare
The intervention condition provided paid employment training up to $5.25 an hour, daily cognitive behavioral treatment, and six months of abstinence-contingent housing to people experiencing homelessness and cocaine dependence in Birmingham, AL. Participants were transported from study-provided housing to job training, job interviews, and work sites. Participants who failed a drug or alcohol test (administered three times weekly) were relocated to a shelter or other housing and lost their program stipend; they could return to abstinence-contingent housing and had a chance to re-earn their stipend after three consecutive negative urine tests. Throughout the intervention, participants received cognitive behavioral therapy focused on completing behavioral assessments, setting treatment goals, and reviewing and revising those goals throughout the intervention period. During the six-month active treatment phase, participants received an initial job-readiness assessment and computer and office training in a computer training lab, followed by training focused on job search, interviewing, and job retention skills. Participants received an additional 12 months of aftercare treatment and post-treatment follow-up after the 6-month active treatment phase.
The comparison condition also provided 6 months of abstinence-contingent housing and paid employment training up to $5.25 an hour to people experiencing homelessness and cocaine dependence in Birmingham, AL. This was followed by up to 12 months of aftercare treatment and post-treatment follow-up. However, comparison group participants did not receive the extensive cognitive behavioral treatment received by participants in the intervention group.
None
The study took place in Birmingham, AL.