Stress Reduction in Therapeutic Community Treatment

治疗性社区治疗中的减压

• 批准号: 6761331
• 负责人: MARIANNE T. MARCUS
• 金额: $ 34.66万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-20 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6761331
• 关键词: behavior therapy; behavioral /social science research tag; clinical research; cortisol; curriculum; drug abuse therapy; human subject; human therapy evaluation; nursing research; stress management; stressor; therapy design /development

DESCRIPTION (provided by applicant): Effective treatment for substance use disorders is a national priority. Therapeutic communities (TCs), an important treatment modality, provide a highly structured social learning environment to encourage positive changes in behavior, attitudes, and self-image. Successful outcomes for TC treatment are correlated with time in treatment; yet, attrition from TCs is disturbingly high. We believe that stress mediates progress and retention in TCs and that stress reduction strategies are needed to assist clients to manage the inherently stressful environment of the TC. A number of studies document the promise of Mindfulness-Based Stress Reduction (MBSR) in reducing stress in a variety of clinical and non-clinical populations. We have preliminary data to demonstrate that MBSR decreases stress in TC clients as evidenced by a decrease in awakening salivary cortisol measurements. This study is designed to translate our MBSR findings into behavioral treatment for TCs to enhance engagement and retention of clients. The proposed Stage 1 Behavioral Development research will refine and test the first MBSR program based on a manual, as an adjunct to TC treatment. The study will: 1) operationally define and standardize principles and techniques of MBSR; 2) pilot test and refine MBSR in TC treatment; and 3) test hypotheses evaluating the potential of MBSR to influence stress, which is proposed as the mediator of progress and retention. Stress will be measured with salivary cortisol and the Perceived Stress Scale. Progress is conceptualized as progression toward re-entry to society, global self-change and internalized self-change. These outcomes will be measured with a facility point system, standard TC measures and linguistic analysis of stress descriptions, respectively. Retention will be measured with facility admission and dropout records. Data will be analyzed using general linear mixed models to address change over time and a standard analysis approach for examining mediation effects.

描述（由申请人提供）： 有效治疗药物使用障碍是国家优先事项。治疗社区是一种重要的治疗模式，它提供了一个高度结构化的社会学习环境，以鼓励行为、态度和自我形象的积极变化。TC治疗的成功结果与治疗时间相关;然而，TC的损耗高得令人不安。我们认为，压力介导的进步和保留在TC和减压策略是必要的，以帮助客户管理TC固有的压力环境。许多研究记录了基于正念的减压（MBSR）在各种临床和非临床人群中减轻压力的承诺。我们有初步的数据表明，正念减压疗法可以降低TC患者的压力，这可以从清醒时唾液皮质醇测量值的降低得到证明。本研究旨在将我们的MBSR研究结果转化为TC的行为治疗，以提高客户的参与度和保留率。拟议的第一阶段行为发展研究将完善和测试基于手册的第一个MBSR计划，作为TC治疗的辅助手段。该研究将：1）操作性地定义和标准化MBSR的原则和技术; 2）在TC治疗中对MBSR进行试点测试和改进; 3）测试评估MBSR影响压力的潜力的假设，这被认为是进步和保持的中介。将使用唾液皮质醇和感知压力量表测量压力。进步的概念是重新进入社会、全球自我改变和内化自我改变的进步。这些结果将分别用设施点系统、标准TC措施和压力描述的语言分析来衡量。保留将衡量与设施入院和辍学记录。将使用一般线性混合模型分析数据，以解决随时间的变化和标准分析方法检查中介效应。