12-Step Facilitation for the Dually Diagnosed

为双重诊断患者提供 12 步便利

• 批准号: 6970257
• 负责人: Michael Parks Bogenschutz
• 金额: $ 35.88万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6970257
• 关键词: alcoholism /alcohol abuse therapy; behavior therapy; behavioral /social science research tag; clinical research; comorbidity; drug abuse therapy; human subject; human therapy evaluation; major depression; mental disorders; mental health counseling; outcomes research; patient care management; patient oriented research; self help; social support network; substance abuse related disorder; therapy compliance

DESCRIPTION (provided by applicant): Although there has been relatively little work on 12-step treatment for seriously mentally ill patients, extant literature indicates that dually diagnosed individuals attend traditional 12-step programs such as AA, NA, and CA at rates comparable to singly diagnosed substance abusers, and that participation is associated with decreases in substance use. Specialized 12-step programs for the dually diagnosed, developed over the past 10 years, may offer additional benefits. In order to maximize the effectiveness of specialized and traditional 12-step programs for dually diagnosed individuals, specially adapted 12-step facilitation (TSF) treatment for the dually diagnosed should be developed and tested. Standard TSF should be modified to address the special needs of dually diagnosed individuals, mesh with specialized 12-step programs available in the area, and address barriers to attendance, participation, and engagement experienced by the dually diagnosed. We have developed a modified TSF based on the Project MATCH TSF manual. Modifications to this 12 week individual therapy include: emphasis on specialized 12-step program attendance; readings primarily from specialized 12-step program literature; participation in the second session by a community specialized 12-step program member; case management to assist participants in finding and attending meetings; omission of work on the fourth step; and the addition of topics covering medication compliance and specific social skills needed to negotiate 12-step meetings. In a pilot study with 10 dually diagnosed individuals, participants showed significant decreases in substance use and significant increases in 12-step attendance after receiving the specialized TSF. Building on this pilot study, the proposed study is a larger Stage Ib study of the modified TSF for seriously mentally ill patients engaged in dual diagnosis treatment. Participants with a psychotic or major affective disorder will be randomized to modified TSF (n=90) vs. treatment as usual (n=45). Participants will be followed for a total of 48 weeks. Assessments will include rigorous diagnosis and measures of alcohol and other drug use, consequences, psychiatric symptoms, 12-step behaviors, 12-step specific and non-specific change mechanisms, and social support. Specific Aims of the study include assessment of the integrity of the planned intervention and assessment battery; tests of the effectiveness of the adapted TSF relative to treatment as usual; determination of whether psychiatric diagnosis moderates treatment response; and investigation of causal mechanisms of response to treatment.

描述（由申请人提供）：虽然对严重精神疾病患者的12步治疗的研究相对较少，但现有文献表明，双重诊断的个体参加传统的12步治疗项目（如AA、NA和CA）的比例与单一诊断的药物滥用者相当，而且参与与药物使用的减少有关。在过去的10年里，专门针对双重诊断的12步治疗方案可能会带来额外的好处。为了最大限度地提高对双重诊断个体的专业和传统12步方案的有效性，应该开发和测试专门适用于双重诊断个体的12步促进（TSF）治疗。标准的TSF应进行修改，以满足双重诊断个体的特殊需求，与该地区现有的专业12步计划相结合，并解决双重诊断患者在出席、参与和参与方面遇到的障碍。我们根据Project MATCH TSF手册开发了一个修改后的TSF。