Peer Helping, Retention, and Relapse in Sober Living Houses

清醒生活之家中的同伴帮助、保留和旧病复发

• 批准号: 10118052
• 负责人: DOUGLAS L POLCIN
• 金额: $ 54.5万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10118052
• 关键词: Abstinence; Affect; Age; Alcohol abuse; Alcohol or Other Drugs use; Alcohols; Area; Characteristics; Coping Skills; Data; Development; Emotional; Environment; Family; Feedback; Focus Groups; Friends; Gender; Helping Behavior; Home environment; Household; Individual; Inpatients; Intervention; Interview; Legal; Length; Length of Stay; Literature; Longitudinal Studies; Measures; Medical; Modeling; Neighborhoods; Outcome; Pathway interactions; Persons; Pharmaceutical Preparations; Procedures; Provider; Public Health; Race; Randomized Clinical Trials; Recovery; Relapse; Research; Sampling; Services; Severities; Site; Social Environment; Social Network; Socioeconomic Status; Source; Testing; Therapeutic; Time; Woman; Work; acute care; alcohol abstinence; alcohol use disorder; drinking; enhancing factor; experience; improved; inclusion criteria; men; novel; outcome prediction; outpatient programs; parent grant; peer; peer support; primary outcome; programs; rapid growth; recruit; relapse prediction; residence; secondary outcome; self esteem; sobriety; social model; treatment services

Sober living houses (SLHs) are alcohol- and drug-free living environments for persons attempting to abstain from substances and develop a long-term program of recovery. Studies have shown residents in these homes make significant, sustained improvements in multiple areas of functioning, including abstinence from alcohol. One of the strongest and most consistent predictors of relapse is shorter retention in the house. Focus groups with SLH managers suggest peer helping enhances retention, commitment to the household, and commitment to recovery. Building upon an ongoing longitudinal study of SLHs, the proposed study will assess the relative impact of helping behaviors on retention, and in turn, on relapse. Initial aims will assess how relapse is affected by helping broadly conceived, including comparisons of giving versus receiving help and helping in relation to peers versus others (i.e., family and friends). We will also assess how relapse is affected by giving and receiving different types of help, such as instrumental versus emotional. The study will then test a novel path model suggesting that, because of the overarching culture of SLHs and the innate benefits of helping in recovery, helping others in recovery-related contexts (i.e., in the residence and in 12-step groups) will lead to stronger relationships with peers in recovery, improved self-esteem, a stronger commitment to abstinence, more focus on others, and improved recovery-related coping skills. We posit all of these effects will then reinforce helpers' commitment to the residence, resulting in longer retention. SLHs are ideal sites for the proposed study because the primary therapeutic influence involves peer support within an alcohol- and drug-free living environment. Because the current research on the relationship between helping and recovery focusses on alcohol problems, a current alcohol use disorder will be an inclusion criterion. The study will include qualitative interviews to inform study procedures and identify experiences of giving and receiving help that illuminate the path model. Individuals entering SLHs with alcohol use disorders (N=200) will be assessed on measures of helping, social networks, substance use, and severity of problems on the ASI. Because the rates of relapse are highest soon after entering the houses, we will conduct baseline and monthly assessments during the first three months and a final interview at 6 months. Significance of the study is high because SLHs and other types of recovery residences are experiencing rapid growth and data are needed on malleable factors that promote better outcomes. Further, this study will add to the narrowly focused literature on helping in recovery and will be the first to illustrate the pathways by which helping influences outcomes in SLHs. SLH providers will be able to use study findings to determine intervention points for enhancing retention and sustaining recovery among sober living residents.

清醒生活之家 (SLH) 是为那些试图戒酒的人提供的无酒精和无毒品的生活环境。 戒除药物并制定长期康复计划。研究表明居民 在这些家庭中，在多个功能领域取得重大、持续的改进，包括 戒酒。复发最有力、最一致的预测因素之一是较短 保留在房子里。 SLH 经理的焦点小组建议同伴帮助可以提高保留率， 对家庭的承诺和对康复的承诺。建立在持续的纵向 对 SLH 的研究，拟议的研究将评估帮助行为对保留的相对影响， 反过来，复发时。初步目标将评估如何通过广泛的帮助来影响复发， 包括给予与接受帮助的比较，以及与同伴和其他人的帮助相关的比较 （即家人和朋友）。我们还将评估给予和接受不同药物对复发的影响 帮助的类型，例如工具性帮助和情感性帮助。然后该研究将测试一种新颖的路径模型 这表明，由于 SLH 的总体文化以及帮助他人的先天优势 恢复，在与恢复相关的环境中（即在住所和 12 步小组中）帮助他人将 导致在康复过程中与同伴建立更牢固的关系，提高自尊，更有力地致力于 禁欲、更多地关注他人以及提高与康复相关的应对技能。我们假设所有这些 效果将增强帮助者对住所的承诺，从而导致更长时间的保留。 SLH 是拟议研究的理想地点，因为主要的治疗影响涉及同伴支持 在无酒精和无毒品的生活环境中。因为目前关于关系的研究 在帮助和康复之间重点关注酒精问题，当前的酒精使用障碍将是一个 纳入标准。该研究将包括定性访谈，以告知研究程序和 确定给予和接受帮助的经历来阐明路径模型。个人进入 将根据帮助、社交网络、 物质使用情况以及 ASI 上问题的严重程度。因为术后不久复发率最高 进入房屋后，我们将在前三个月进行基线和月度评估 并在 6 个月时进行最终面试。这项研究的意义很高，因为 SLH 和其他类型的 康复住宅正在快速增长，需要有关可塑性因素的数据 促进更好的结果。此外，这项研究将补充有关帮助的狭隘文献 恢复，并将第一个说明帮助影响 SLH 结果的途径。 SLH 提供者将能够利用研究结果来确定干预点，以增强 清醒生活的居民的保留和持续恢复。