Employment has been identified as an important element in the rehabilitation of drug abusers and, together with abstinence from illicit drugs and criminal involvement, is frequently used as a criterion of treatment outcome. The research literature for the last 20 years on variables affecting employment and the vocational rehabilitation of drug abusers is reviewed with an emphasis on (a) the identification of variables influencing the employment of drug abusers and (b) the evaluation results of interventions that have been developed for this purpose. It is concluded that a number of programs have been demonstrated to have had some success in the vocational rehabilitation of drug abusers. Specific recommendations are made concerning both the direction of further research in this area and the application of existing knowledge in current practice.

PROBLEMThe Means-Ends Problem-Solving Procedure'') (MEPS) is a measure of the ability to conceptualize, in interpersonal problem situations, appropriate and effective means to reach a specified goal in order to satisfy an aroused need. The MEPS consists of nine stories scored according to criteria presented in the manual") and has been used to assess real-life problem-solving ability in adult psychiatric patientsc3* 4 * 5*fi), adolescent psychiatric patients(', a), youthful heroin offenders(2), as well as various normal groups"' g ) .This stydy reports the results of factor analyses of scores on the stories that comprise this instrument in samples of male and female psychiatric patients and male delinquents. The purpose of these factor analyses was to confirm the impression gained from story intercorrelations and other analyses obtained in previous studies(3* ') that the MEPS measures a single underlying dimension. METHODThe psychiatric patient sample consisted of 72 males and 66 females who were on either the short-term hospitalization or extended care services of an urban community mental health center. The majority of Ss had a primary or secondary diagnosis of schizophrenia, and all cases that involved a diagnosis of primary or secondary organicity were screened out. The male delinquent sample consisted of 476 adolescent reformatory inmates.By means of the orthogonal varimax rotation method, factor analyses of the male and female patient and delinquent adolescent data were carried out separately on individual story scores obtained from the nine stories that comprise the MEPS. All nine stories were used for the psychiatric patient samples, while a shorter form that omitted stories 1 and 5 was used for the delinquent sample. The factor analyses were based upon an intercorrelation matrix in which the communality estimates were squared multiple correlations and the criterion for the number of factors extracted was the number of eigenvalues that exceeded unity. RESULTS AND DISCUSSIONIn the case of both male and female patients and the delinquents, the results of the factor analyses indicated the existence of only one factor, which accounted for 37.1y0 of the variance in the case of male patients, 31.2% in the case of female patients, and 24.3% in the case of the delinquents. Rotated factor loadings on the nine stories ranged from .49 to .77 for male patients, from .31 to .70 for female patients, and .36 to .54 for the delinquents. This factor, labeled "means-ends cognition," can be described as the ability t o articulate (when presented with an aroused need and the satisfaction of that need in interpersonal situations) step-bystep means to reach the stated goal.This study provides content validity for the MEPS in that it demonstrates the factorial unidimensionality of the stories Ohat comprise it. Previous studies have demonstrated that means-ends cognition may be the most important of a number of elements that comprise the overall cognitive ability to deal with real-life interpersonal situations(5). One implicatio...

This study tests the hypotheses that psychiatric patients are less able than normal controls to address themselves to hypothetical real-life problematic situations and to provide solutions to such problems. Using a means-ends story-completion technique, differences were found between the performances of short-term psychiatric inpatients (N = 53) and hospital employee controls (N = 61) that supported both hypotheses. The results of this study are discussed in terms of other problem-solving approaches to the understanding of psychopathology.

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This study examined whether voucher delivery arrangements affect treatment outcome. First, 90 cocaine-dependent adults were randomly assigned to behavioral counseling or counseling plus vouchers for cocaine-free urine samples. The value of each voucher was low at the beginning but increased as the patient progressed (Voucher Schedule 1). Voucher Schedule 1 produced no improvements relative to counseling only. Next, 23 patients received vouchers on either Voucher Schedule 1 or Voucher Schedule 2. Voucher Schedule 2 began with high voucher values, but requirements for earning vouchers increased as the patient progressed. Average durations of cocaine abstinence were 6.9 weeks on Voucher Schedule 2 versus 2.0 weeks on Voucher Schedule 1 (p = .02). This confirms that vouchers can assist in initiating abstinence and that voucher delivery arrangements are critical.