This guide provides information about best practices in providing employment assistance to people experiencing difficulties with drug or alcohol use. It is a starting point for understanding some of the important issues involved when providing employment assistance to job seekers with substance related disorders.
Understanding substance abuse and its impact on job performance
People with disability are usually experts in their own needs and will understand the impact of their disability on work performance and what workplace adjustments they may need at interviews, while training or on the job. However, some people experiencing substance abuse may not necessarily have a great level of self awareness in these areas, and may need additional assistance in determining appropriate goals especially employment related goals.
Substance related disorders affect many people in society and many people experiencing difficulties with substances will also have other mental health problems such as depression, schizophrenia and bipolar disorder. People experiencing both mental health and drug or alcohol problems are often described as experiencing complex co-existing disorder.
Other people use drugs and alcohol as a coping mechanism for the traumas they are experiencing or have experienced.
Whatever the cause, people experiencing substance abuse often (but not always) also experience other difficulties which impact on the ability to seek and maintain employment. Drugs and alcohol may:
- impact on daily functioning
- affect health either directly as a result of blood-borne disease or indirectly through poor nourishment
- be associated with difficult family relationships
- be impacted upon by the need to fund the drugs or alcohol, or by withdrawal symptoms when unable to maintain sufficient levels of intake.
A substance related disorder is diagnosed when there is a significant level of distress or impairment in social, occupational or other important areas of functioning associated with the substance use.
People may experience some associated impairment of brain functioning as a result of drug or alcohol abuse, usually due to overdose or repeated high levels of usage. This is known as an acquired brain injury. If present, an acquired brain injury will have long term impacts on a person’s functioning, which will not recover with withdrawal from use of the drug or alcohol.
While people are actively using drugs and alcohol, areas of functioning important to employment that may be affected include motivation and energy, maintaining focus and concentration, appropriate behaviour and social interaction, productivity levels, ability to handle stressful situations, planning and organisational skills.
It is important to consider whether employment strategies are valid to pursue while a person is an active user of substances and has no desire for change. Strategies for employment have greater success following a commitment to reduce or cease drug use and then appropriate interventions to allow for drug withdrawal and support onto maintenance or replacement prescribed medication. This may be associated with other appropriate treatment or counselling support.
Effective practices are those that lead to engagement of the person in the employment program and develop trust over time, even though the person with the substance abuse disorder may not be consistent or reliable in explaining their situation (Dartmouth Evidence-based Practices Center 2007).
What types of substances are abused?
The common substances abused fall into one of three main categories:
- stimulants
- depressants
- hallucinogens.
Prescribed medication may be another source of drug use or abuse.
Stimulants include drugs such as tobacco, cocaine, amphetamines or MDMA (ecstasy). Depressants include alcohol, opoids such as heroin or codeine, cannabis (marijuana) and inhalants such as petrol or glue. Hallucinogens include drugs such as LSD and magic mushrooms.
Put the person first
When developing a job search plan or offering post-employment support, it is necessary to be flexible and treat each person with stabilised substance abuse difficulties individually. Tailor your approach to their individual needs and capacities and focus clearly on each person’s goals and abilities. This should also entail reassessing and adapting plans and support as necessary, and linking people with relevant specialist services if that has not already occurred.
Tapping into their existing support networks to assist the realisation of vocational ambitions can be important. Use current and valid assessments and reports (school, work experience, medical, rehabilitation or work capacity) to help you gain a full understanding of the person’s strengths, barriers and any assistance they will require along the road to employment.
Flexibility is especially important when working with people with drug or alcohol difficulties as momentary or significant relapse may occur at any stage along the road to recovery. Timeframes for job search may need to be extended due to periods where the person is unable to focus on employment goals, and a good working relationship with the job seekers’ professional supports is vital.
Pre-employment strategies
You may wish to review the myths about substance abuse and employment to gain a greater understanding of the readiness for employment of this group of job seekers.
Assisting job seekers with stabilised drug and alcohol difficulties find suitable and durable employment, demands that you consultatively develop an individualised pre-employment plan that incorporates a discussion of the following:
- avoiding workplaces that serve alcohol, even for those people who have been successful in recovery from substance abuse
- an assessment of the possible benefits and risks of occupations that have a high incidence of substance use on the job, for example, construction
- the job seeker's pattern of use of substances, which may involve a discussion with the job seeker and their treatment team—for instance, if someone is not interested in reducing substance use and tends to use in the evenings, then you may try to help the person identify afternoon jobs
Other pre-employment strategies include:
- supporting job seeker choice in regard to applying for jobs that test for substance
- use failed tests as an opportunity to develop discussions with the person about discrepancy between intended and actual behaviour
- involving all stakeholders (treating health professionals, family) in discussion about what can be done and allowing the job seeker to make the final decisions about services provided
- providing linkages to support services that can assist the job seeker in managing potential earnings, for example, shopping on payday, use of a trustee, auto credits and debits, and use of the income for goals that reduce the availability of cash for substances.
Job search
Sometimes people with drug or alcohol difficulties may have unrealistic ideas about jobs in which they could succeed. These ideas may have been fostered by memories of capabilities and skills gained prior to their substance abuse or are symptomatic of a lack of readiness for employment. Whatever the cause it is crucial to carefully explore each job seeker’s work skills and interests through personal discussion, checking any previous employment references or talking frankly to teachers or former employers.
For those with limited or no recent work experience, it may be beneficial to arrange work experience or voluntary work, where associated with a likelihood of employment, to assist with the selection of appropriate future job choice.
This process of exploration may also help determine whether a person may need to access the Supported Wage System and be paid productivity based sub-minimum wages. This is only likely in circumstances where the person has other impacts on their abilities such as associated acquired brain injury or concurrent mental health impacts.
Most job seekers will undoubtedly benefit from personal involvement in preparing suitable resumes, and using a range of job search methods to look for work. However, many people who have experienced drug or alcohol abuse may need considerable encouragement or even direct assistance with actually contacting employers and setting up interviews due to low self esteem and difficulties with social interaction.
Job interviews
Below are some tips for supporting people with drug or alcohol with interviews:
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develop strategies to handle stress and nervousness at an interview by exploring what aspects of interviews concern the person and how to stay relaxed and calm in an interview situation
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if the job seeker has problems with communication and social interaction, consider acting as a support person at the interview to give the person confidence or to encourage them to sell themselves to the employer
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complete some interview practice and preparation with the job seeker, so that they can anticipate questions, prepare answers and develop their own line of questions about the job and company
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encourage interviewers to provide positive feedback during and after the interview process
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make sure the job seeker has a good understanding of what are acceptable and legally permissible interview questions in relation to their disability
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work out an approach to the question of disclosure.
Disclosure issues
There is no one answer to the question of disability disclosure for people with substance abuse difficulties. Drug or alcohol abuse is by and large an invisible condition. Consequently it is absolutely essential that the pros and cons of disclosure be thoroughly discussed with this group of job seekers.
People with substance abuse difficulties will often not want to disclose their condition. Disclosure of substance abuse to you and to employers can be challenging for the person concerned because of fears of legal consequences as well as fears around stigma and unfair discrimination. This can in turn provide a challenge when marketing the job seeker as you need to consider the employer’s obligations to provide a safe and productive workplace.
It is important to canvass with job seekers the benefits of disclosure in terms of workplace integration and job maintenance. For example, if someone needs particular adjustments to working hours or routines to function effectively in the workplace and/or flexibility with leave. Similarly if someone needs modifications to physical workspace to make a less distracting environment or support strategies (such as time out if anxious, or being able to phone someone external to work if they are feeling stressed) then disclosure is beneficial. There is also the questions of timing (when to disclose) and selectivity (who needs to know).
Post-placement strategies
Job commencement
Starting a job can be an anxious experience for any new employee. For a new employee with substance abuse difficulties, concerns about previous job failures and acceptance by co-workers can make starting a new job an especially testing and stressful time. Such employees will need reassurance that such feelings are normal.
Indeed for these reasons new employees with substance abuse difficulties are more likely to need confidence boosting and anxiety reducing moral reassurance during the initial settling in period and the development of support strategies rather than actual assistance with skills training. This could involve:
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periodic presence of a support worker on site
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behind the scenes counselling or the availability of time to phone an external person to debrief
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temporary flexibility, such as changing starting or finishing times, reducing hours, time off for necessary health appointments, and individualised use of break time
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employer and co-worker education on the impact of any other possible conditions (mental health issues or acquired brain injury) on performance and behaviour to break down possible misunderstandings on the job, involving full or partial disclosure.
Ongoing support
Once an employee with drug and alcohol abuse difficulties has commenced work and been given all the necessary initial assistance, you can increase their chances of maintaining this employment by providing ongoing support as it is required. The way this support is delivered will vary and may include:
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using an integrated team approach to problem solving and to celebrate success—the team may include employment specialists, mental health professionals, drug and alcohol counsellors and medical practitioners
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assisting job seekers to prepare for possible triggers for substance use in the workplace, for example, practice responses to co-workers going out for a beer
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developing contingency plans for mental health deterioration such as temporary replacements, additional unpaid leave and gradual return to work
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viewing job problems related to substance abuse as opportunities to improve work performance and worker reliability—discuss best approaches to providing ongoing assistance
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asking rehabilitation specialists and treatment professionals to help address work performance issues and to identify the forms of assistance that may be required to improve work performance
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pointing out the person's accomplishments along the way
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viewing setbacks as learning experiences and offering ongoing assistance with employment goals
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talking to employees about long term goals including career development plans.
More information
For information and step by step instructions on the financial help available to employers of people with disability, including the application process, visit:
The following fact sheets, developed for service providers, are also a useful resource:
References
Becker D.R, Drake R.E and Naughton W.J 2005, ‘Supported employment for people with co-occurring disorders’, Psychiatric Rehabilitation Journal, vol.28, no.4, pp.332-336.
Dartmouth Evidence-based Practices Center 2007, Information sheet: Employment supports for clients with co-occurring mental illness and substance abuse, Psychiatric Research Center, New Hampshire.