Blankertz Laura, Magura Stephen, Staines Graham L, Madison Elizabeth M, Spinelli Michael, Horowitz Emily, Bali Priti, Guarino Honoria, Grandy Audrey, Young Rebecca
Institute for Treatment and Services Research at National Development and Research Institutes, New York, New York 10010, USA.
Subst Use Misuse. 2004;39(13-14):2239-60. doi: 10.1081/ja-200034600.
Traditionally, methadone-maintained patients have made only limited progress in vocational rehabilitation programs, largely because they encounter multiple individual-level barriers to their employment. The Customized Employment Supports (CES) model is designed to help patients overcome these employment barriers and attain paid work as soon as possible. To facilitate this transition, the model assigns CES counselors small caseloads so that, using intensive interventions, they can engage patients in a working alliance and enhance patients' self-efficacy. Methods used to help patients increase their self-efficacy are derived from social psychological literature and include role modeling, persuasion, and minimizing emotional arousal. Because the transition to competitive work is a major change, many patients initially take smaller steps such as entering training programs and accepting informal employment. The CES model is being evaluated in a randomized clinical trial.
传统上，接受美沙酮维持治疗的患者在职业康复项目中取得的进展有限，这主要是因为他们在就业方面面临多种个人层面的障碍。定制就业支持（CES）模式旨在帮助患者克服这些就业障碍，并尽快获得有偿工作。为便于实现这种转变，该模式为CES顾问分配少量的个案量，以便他们通过强化干预，与患者建立工作联盟并增强患者的自我效能感。用于帮助患者提高自我效能感的方法源自社会心理学文献，包括榜样示范、说服以及尽量减少情绪唤起。由于向竞争性工作的转变是一项重大变化，许多患者最初会采取较小的步骤，例如参加培训项目和接受非正式工作。CES模式正在一项随机临床试验中接受评估。
