Four Models of Telephone Support for Stimulant Recovery

兴奋剂恢复电话支持的四种模式

• 批准号: 6928285
• 负责人: DAVID J FARABEE
• 金额: $ 51万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-15 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6928285
• 关键词: behavioral /social science research tag; clinical research; cocaine; drug /alcohol abstinence; drug abuse therapy; drug addiction; health care model; health services research tag; human subject; human therapy evaluation; mental health counseling; methamphetamine; patient oriented research; relapse /recurrence; social support network; telemedicine

DESCRIPTION (provided by applicant): The continuing development and refinement of empirically supported interventions to increase participation in post-treatment aftercare and promote sustained abstinence from illicit drug use is a priority for the addictions field. Typical models of drug abuse intervention have intensive periods of "treatment" followed by a less intensive, poorly defined "aftercare" period. Frequently, patients involved in the intensive phase of treatment show a reduction in, or complete abstinence from, the target and other drug use. However, when the treatment intensity is decreased during the aftercare period, relapse and readdiction are common. For drug abuse treatment to provide the desired result of long-term abstinence, it is important to develop strategies that will enhance the effectiveness of aftercare and/or continuity-of-care approaches. Moreover, such interventions must be inexpensive and relatively easy to implement to be portable to the "real world" setting of community-based programs. We will develop and compare the efficacy of four low-cost, telephone support protocols for patients who have completed the intensive phase of a structured, outpatient stimulant abuse treatment protocol. Participants will be 500 patients who have successfully completed the 4-month Matrix Outpatient Model of stimulant abuse treatment. They will then be randomly assigned to one of five aftercare-counseling conditions (each with n=100): (1) unstructured/non-directive, (2) unstructured/directive, (3) structured/non-directive, (4) structured/directive, or (5) standard referral to aftercare without telephone counseling (control). The two structured conditions are based on the behavioral "prompts" identified by Farabee et al. (2002) as being associated with drug avoidance. In the non-directive conditions, patients will state their own goals and how they intend to achieve them. In the directive conditions, the counselor will provide specific recommendations for the adoption of as many drug-avoidance activities as possible. Certain patient personality traits or styles will also be assessed for their possible interaction with the telephone counseling dimensions. Outcomes will be tracked at 6 and 12 months following completion of primary treatment and will include measurement of participation in drug-avoidance activities (including aftercare participation), as well as self-reported and objective measures of substance use and associated prosocial behavior change.

描述（由申请人提供）： 不断发展和完善经验支持的干预措施，以增加对治疗后护理的参与并促进持续戒除非法药物使用是成瘾领域的首要任务。药物滥用干预的典型模式有密集的“治疗”期，然后是强度较低、定义不明确的“善后”期。通常，参与强化治疗阶段的患者会减少或完全戒除目标药物和其他药物的使用。然而，当治疗强度在术后护理期间降低时，复发和再成瘾很常见。为了使药物滥用治疗能够达到长期戒毒的预期结果，重要的是制定能够提高善后护理和/或连续性护理方法有效性的策略。此外，此类干预措施必须价格低廉且相对容易实施，以便能够移植到基于社区的计划的“现实世界”环境中。我们将为已完成结构化门诊兴奋剂滥用治疗方案强化阶段的患者开发并比较四种低成本电话支持方案的疗效。参与者将是 500 名已成功完成为期 4 个月的矩阵门诊模式的兴奋剂滥用治疗的患者。然后，他们将被随机分配到五种善后咨询条件之一（每种情况 n=100）：(1) 非结构化/非指导性，(2) 非结构化/指导性，(3) 结构化/非指导性，(4) 结构化/指导性，或 (5) 标准转介至善后护理，无需电话咨询（对照）。这两种结构化条件基于 Farabee 等人确定的行为“提示”。 (2002) 与避免药物有关。在非指导性条件下，患者将陈述自己的目标以及他们打算如何实现这些目标。在指导条件下，咨询师将为采取尽可能多的戒毒活动提供具体建议。还将评估某些患者的人格特征或风格与电话咨询维度可能的相互作用。结果将在完成初级治疗后 6 个月和 12 个月进行跟踪，包括对药物避免活动参与情况（包括善后护理参与情况）的测量，以及对物质使用和相关亲社会行为变化的自我报告和客观测量。