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.

清醒的居住房屋（SLH）是试图尝试的人的无酒精和无毒品的生活环境 戒除物质并制定长期恢复计划。研究表明居民 在这些房屋中 戒酒。最强，最一致的复发预测指标之一是较短 保留在房子里。与SLH经理的焦点小组建议同行帮助增强保留率， 对家庭的承诺和对恢复的承诺。建立持续的纵向 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。最初的目标将通过帮助广泛构思， 包括捐赠与接收帮助的比较以及与同龄人相对于其他人的帮助 （即家人和朋友）。我们还将评估捐赠和接收不同的复发如何影响复发 帮助类型，例如工具与情感。然后，该研究将测试一个新型路径模型 暗示，由于SLH的总体文化以及帮助 恢复，在与恢复相关的上下文（即，在住所和12步组中）帮助他人 导致与同龄人的恢复，提高自尊心，更强有力的承诺 禁欲，更多地关注他人，并提高与恢复相关的应对能力。我们认为所有这些 然后，效果将加强帮助者对住所的承诺，从而更长的保留率。 SLH 是拟议研究的理想场所，因为主要的治疗影响涉及同伴支持 在酒精和无毒品的生活环境中。因为当前关于关系的研究 在帮助和恢复恢复性饮酒问题之间，当前的酒精使用障碍将是 纳入标准。该研究将包括定性访谈，以告知研究程序和 确定捐赠和接收帮助的经验，以照亮路径模型。个人进入 患有饮酒障碍的SLH（n = 200）将根据帮助，社交网络， 物质使用和ASI问题的严重程度。因为复发率在不久之后最高 进入房屋，我们将在头三个月内进行基线和每月评估 以及6个月的最后一次采访。研究的意义很高，因为SLH和其他类型的 恢复住宅正在经历快速增长，需要数据，以延展性因素 促进更好的结果。此外，这项研究将增加有关帮助的文献 恢复，将是第一个说明有助于影响SLH结果的途径的途径。 SLH提供者将能够使用研究结果来确定干预点以增强 保留和维持清醒居民的恢复。