Phone app for grounding (de-escalation) of substance-abusing transition-age youth

描述（由申请人提供）：物质使用障碍（SUD）是美国人口中第二大最常见的精神疾病诊断，14.6%的人在其一生中患上这种疾病。18-24岁的过渡年龄青年（TAY）特别容易受到物质使用、滥用和SUD的影响。这一发展时期被称为“不稳定时期”，包括离开家；进入大学;第一次工作；身体和性的变化；联合的：与同伴群体联合的；对一些人来说，他们在18岁时就结束了寄养或国家监护。这一时期也是尝试使用药物和相关风险的主要时期，如酒后驾驶、事故、打架和暴力、艾滋病毒和易受性侵犯。在这个项目中，我们专注于一个主要的策略，接地，以帮助降低（减少）强烈的负面情绪和冲动。长期以来，精神病院一直使用“接地法”来提供一种安全、快速、有效的方法来减少任何强烈的负面情绪，包括伤害自己或他人的冲动、对物质的渴望、愤怒、焦虑等。在《寻求安全》（SS）一书中有详细描述，接地通过三种途径来集中精神（精神）、身体（身体）和心灵（抚慰）。接地气提供了一种调节情绪的方式，这对年轻人来说是一项重大挑战，尤其是考虑到他们的激素变化和情绪强度。事实上，物质使用通常被描述为一种调节情绪的短期方式。接地是SS的关键模块，SS是一种广泛实施的循证SUD治疗模式。在这个方案中，我们专注于接地，因为这是一项基本技能，即使是最复杂和最脆弱的客户也很容易学习。我们建议把接地变成一款智能手机应用程序，因为接地应该在经历痛苦的环境中使用；它利用了TAY对智能手机的使用；促进自律;并且是一种独立的技能和感官为主，因此非常适合移动

DESCRIPTION (provided by applicant): Substance use disorder (SUD) is the second most common psychiatric diagnosis in the U.S. population, with 14.6% developing it in their lifetime. Transition-age youth (TAY) from ages 18-24 are especially vulnerable to substance use, misuse, and SUD. This developmental period, termed the "age of instability" includes tasks such as leaving home; entering college; working for the first time; body and sexuality changes; coalescing with a peer group; and for some, aging out of foster care or state custody, which end at age 18. This period is also prime for experimentation with substance use and associated risks such as driving under the influence, accidents, fighting and violence, HIV, and vulnerability to sexual assault. In this project, we focus on a major strategy, grounding, for helping to de-escalate (reduce) intense negative emotions and impulses. Grounding has long been used in psychiatric hospitals to provide a safe, quick, and powerful way to reduce any intense negative feeling, including impulses to hurt self or others, substance craving, anger, anxiety, etc. Described in detail in the book "Seeking Safety" (SS), grounding uses three pathways to focus the mind (mental), the body (physical), and the heart (soothing). Grounding provides a way to regulate emotion, which is a major challenge for youth, especially given their hormone changes and emotional intensity. Indeed, substance use is often described as a short-term way to regulate emotion. Grounding is a key module of SS, a widely-implemented, evidence-based SUD treatment model. In this proposal we focus exclusively on grounding as it is an essential skill and widely identified as easy to learn across even the most complex and vulnerable clients. We propose to turn grounding into a smartphone app because grounding should be used in the environment in which the distress is experienced; it capitalizes on TAY use of smartphones; promotes self-regulation; and is a stand- alone skill and sensory-oriented, thus ideal for a mobile app approach. Our specific aims are: (1) to develop a new product, a smartphone Grounding App. This will be an exciting, interactive Android app that uses state-of- the-art gaming technology to engage TAY in grounding, in collaboration with an outstanding company for the technology side of the project. (2) To use an iterative product development methodology based on end-user feedback. We propose various methods to obtain initial input from TAY with SUD before beginning app programming. (3) To conduct a small feasibility study of the app. This cross-sectional pilot will obtain information on end-users experience, usage, and satisfaction with the app, which can inform a phase II study. We will assign 24 TAY with SUD to the grounding app (n=12) versus receiving hard-copy grounding handouts from the SS book (n=12), to evaluate the relative impact of the app. Our team represents an exceptional mix of expertise in SUD, TAY, app and gaming technology innovation, grounding, SBIRs, treatment development, and public-health oriented products based on evidence-based care.