Acceptance and relationship context: a model of substance use disorder treatment outcome
Acceptance and relationship context: a model of substance use disorder treatment outcome
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DOI：
10.1111/j.1360-0443.2006.01506.x
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发表时间：
2006-08-01
期刊：
影响因子：
6
通讯作者：
Moos, Rudolf H.
中科院分区：
文献类型：
--
作者：
Gifford, Elizabeth V.;Ritsher, Jennifer B.;Moos, Rudolf H.
目的 本研究提出并测试了长期药物滥用障碍恢复中的行为改变模型，即接受和关系背景 (ARC) 模型。该模型明确指出，基于接受的行为和建设性的社会关系会导致康复，而具有支持性、参与性关系的治疗计划会促进这些因素的发展。设计本研究采用前瞻性纵向自然主义设计并控制研究变量的基线水平。设置和参与者 该模型在 15 个住宅药物滥用障碍治疗项目的 2549 名患者样本中进行了测试。测量通过访谈和自我报告问卷评估基于接受的反应（ABR）、社会关系质量（SRQ）、治疗计划联盟（TPA）和物质使用相关的损害。结果 TPA 预测了 ABR 和 SRQ，反过来，ABR 预测了更好的 2 年和 5 年治疗结果。基线对照模型解释了 2 年随访结果差异的 41% 和 5 年随访结果差异的 28%。结论 接受具有亲和关系网络的治疗方案的患者更有可能对先前与药物使用相关的内部状态做出适应性反应，发展建设性的社会关系并实现长期治疗益处。
Aims This study presented and tested a model of behavior change in long-term substance use disorder recovery, the acceptance and relationship context ( ARC) model. The model specifies that acceptance-based behavior and constructive social relationships lead to recovery, and that treatment programs with supportive, involved relationships facilitate the development of these factors. Design This study used a prospective longitudinal naturalistic design and controlled for baseline levels of study variables. Setting and participants The model was tested on a sample of 2549 patients in 15 residential substance use disorder treatment programs. Measurements Acceptance-based responding (ABR), social relationship quality (SRQ), treatment program alliance (TPA) and substance use-related impairment were assessed using interviews and self-report questionnaires. Findings TPA predicted ABR and SRQ and, in turn, ABR predicted better 2-year and 5-year treatment outcomes. The baseline-controlled model accounted for 41% of the variance in outcome at 2-year follow-up and 28% of the variance in outcome at 5-year follow-up. Conclusions Patients from treatment programs with an affiliative relationship network are more likely to respond adaptively to internal states associated previously with substance use, develop constructive social relationships and achieve long-term treatment benefits.