Effective adaptations in Individual Placement and Support delivery: lessons from the drug and alcohol treatment context.

Objectives: Guided by the Model for Adaptation Design and Impact (MADI), this paper explores how the Individual Placement and Support (IPS) model has been adapted for delivery in drug and alcohol treatment services in England. Methods: Interviews, focus groups and surveys with IPS practitioners, commissioners of drug and alcohol services, treatment service managers and experts. Results: Efforts to publicize the IPS service and sharing client 'success stories' with treatment staff are perceived to facilitate effective integration as a key implementation outcome. These adaptations also strengthen referrals to the IPS service, alongside changes to the referral process and schemes to incentivize referrals. Employer engagement is supported by careful framing of IPS and sharing client experiences and outcomes. Flexible and supportive communication with clients, adjusting the pace and taking breaks where needed, is perceived as crucial to achieving employment outcomes. Adaptations are shaped by the local and national context, including the scale of IPS delivery across England, which enables peer-to-peer networking and information sharing. Conclusion: Effective adaptations in IPS are those that strengthen integration, tackle stigma, tailor support, and enable learning networks.