Customized Employment Supports (CES, formerly known as Comprehensive Employment Supports) was developed to help methadone treatment patients, who are likely to have irregular work histories, attain rapid placement in paid jobs and increase their legitimate earnings. CES counselors work intensively with a small caseload of unemployed and underemployed patients (15-18 in the initial period) to help them overcome the barriers that hinder their employment. This intervention extends to an addiction population the principles of the Individual Placement and Support (IPS) model of vocational counseling for persons with disabilities. CES has six stages of service delivery: assessment, engagement, enhancement of self-efficacy to reduce barriers, focused employment skills teaching, preparation for interviewing, and job retention. CES is implemented in two settings: first in the program/clinic to practice interviewing and prepare a resume, and then in the community to help the individual secure and retain a job. Sessions in the community involve active engagement techniques to build a therapeutic alliance with the patient. Vocationally relevant learning activities take place in the community on “neutral turf” to promote the development of patient trust and openness. Master’s-level vocational rehabilitation counselors meet with patients individually up to three times per week during an intensive phase of up to 6 months until employment is obtained, followed by continuing job retention support.