Assertive outreach and motivational techniques can enhance methadone patients' participation in vocational counseling and increase subsequent employment. In a study of 211 unemployed methadone patients at two facilities in New York City, Dr. Stephen Magura and colleagues at the National Development and Research Institutes found that 47 percent of participants assigned to the Customized Employment Supports (CES) intervention attended five or more vocational counseling sessions within 6 months of beginning the study. In contrast, only 12 percent of those in the clinic's standard vocational programs were as assiduous. CES counselors engaged patients in the program with tactics such as checking their clinic schedules and arranging impromptu visits; spent more time with patients in counseling sessions than counselors in the standard program; responded promptly to requests for help; accompanied patients in their job searches; and helped patients overcome barriers to employment. Among 168 participants interviewed 6 and 12 months after beginning the study, 41 percent in the CES group, compared with 26 percent of those who received standard counseling, reported paid employment at both followup assessments.