Improving outcomes for homeless people with alcohol disorders: a multi-program community-based approach
Improving outcomes for homeless people with alcohol disorders: a multi-program community-based approach
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DOI：
10.1080/09638237.2017.1340617
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发表时间：
2020-11-01
影响因子：
3.3
通讯作者：
Birchmier, Chelsea
中科院分区：
文献类型：
--
作者：
Morse, Gary A.;York, Mary M.;Birchmier, Chelsea
背景资料：相对较少的社区计划被发现对患有酒精障碍的无家可归者有帮助，即使这个群体代表了一个高风险，易受伤害的人群，结果很差。目的：本研究旨在实施和评估强化社区为基础的计划，为无家可归的人与酒精障碍。方法：该项目与一个无家可归者外展小组密切合作，进行转诊，然后提供两种不同的强化药物滥用治疗方法，以满足两个亚组的需求：无严重精神疾病的酗酒无家可归者接受社区强化方法和个案管理服务，而那些有酒精和严重精神疾病的人被分配到自信的社区治疗和综合双重障碍（ACT/IDDT）服务。该研究招募了322名患有酒精障碍的无家可归者，并在六个月和计划出院时对结果进行了评估。结果如下：在头六个月，参与者在一些成果领域有了显著改善，包括药物滥用、精神健康、住房、就业和健康;在六个月至出院期间，进展一般保持稳定。结论：以社区为基础的方案与移动的外展队协调，然后提供CRA和ACT/IDDT似乎是有希望的方法，帮助个人与酒精障碍的无家可归和恢复。
Background: Relatively few community-based programs have been found to be helpful for homeless people with alcohol disorders, even though this group represents a high-risk, vulnerable population prone to poor outcomes. Aims: This study sought to implement and evaluate intensive community-based programs for homeless people with alcohol disorders. Method: The project worked closely with a homeless outreach team for referrals, and then provided two different, intensive substance abuse treatment approaches matched to the needs of two subgroups: homeless individuals with alcohol disorders without severe mental illness received community reinforcement approach (CRA) and case management services, while those with alcohol and severe mental illness were assigned to assertive community treatment and integrated dual disorders (ACT/IDDT) services. The study enrolled 322 homeless people with alcohol disorders and outcomes were assessed at six months and program discharge. Results: Participants improved significantly over the first six months in a number of outcome areas, including substance abuse, mental health, housing, employment and health; progress generally remained stable between six months and discharge. Conclusions: Community-based programs that coordinate with mobile outreach teams and then provide CRA and ACT/IDDT appear to be promising approaches for helping individuals with alcohol disorders out of homelessness and into recovery.