Work and recovery from substance use disorder in Veterans Affairs: Characteristics of veterans seeking work therapy and vocational rehabilitation

Abstract

Objective: Substance use disorders are prevalent in Veterans and associated with a wide range of deleterious effects. Helping Veterans with substance use disorders identify and engage in meaningful and constructive goal-directed activities may be key to promoting recovery. Work, particularly, has been identified as beneficial. Despite the effects of therapeutic work activities, we still do not have a good understanding of who is enrolling in these services.

Methods: This study provides an in-depth descriptive look at psychiatric diagnoses, internal factors, disability level, and demographic characteristics of Veterans (N = 78) early in the course of recovery from substance use disorder who expressed an interest in engaging in work services as part of their recovery.

Results: Compared to normative scores, our sample exhibited deficits in multiple areas of functioning, including global disability, physical health, social relationships, physical safety, self-esteem, and substance use. Of the 78 Veterans, 17 (22%) chose competitive employment, and 61 (78%) chose therapeutic work activity. Compared to Veterans who chose competitive employment, Veterans in the therapeutic work activity branch reported higher rates of medical disabilities that impair the ability to work, were more likely to be retired from employment, had more previous treatment program participation, and had longer periods of abstinence from alcohol.

Conclusions and implications for practice: These findings, though descriptive and preliminary, help us better understand Veterans who are interested in engaging in work activities to promote their recovery, their preference for work therapy versus vocational rehabilitation services, and what additional services they may find most appealing based on their characteristics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).