This presentation will describe research on the therapeutic workplace, an employment-based intervention to address the interrelated problems of poverty, unemployment and drug addiction. Abstinence reinforcement, in which patients receive desirable consequences contingent on providing objective evidence of abstinence, can promote abstinence from abused drugs, but they must employ high magnitude reinforcement to promote abstinence in treatment-refractory patients and they must be maintainedin time to prevent relapse. The therapeutic workplace was developed to provide a practical way to arrange high magnitude and long duration abstinence reinforcement. Under the therapeutic workplace intervention, individuals are hired and paid to work. To reinforce abstinence, participants are required to provide objective evidence of drug abstinence to maintain workplace access. Because many poor individuals lack job skills, the therapeutic workplace offers a training phase before formal employment, and incentives are strategically used to promote engagement in computer-based vocational training on-site. Controlled studies have shown that the therapeutic workplace can retain low-income unemployed adults in training and in employment, promote the development of job skills, initiate and maintain abstinence from heroin and cocaine, and promote adherence to addiction medications in chronically unemployed adults.
Review Kenneth Silverman’s biographical statement.