Motivating Substance Abusing Veterans, via Family to Seek Treatment

通过家人激励药物滥用退伍军人寻求治疗

• 批准号: 8976091
• 负责人: SUZY B GULLIVER
• 金额: --
• 依托单位: OLIN TEAGUE VETERANS CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8976091
• 关键词: Address; Aftercare; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Alcohols; Attenuated; Behavior; Caring; Child; Clinical Trials Design; Code; Communities; Conflict (Psychology); Data; Disease; Educational Intervention; Educational process of instructing; Emotional; Enrollment; Evidence based treatment; Exposure to; Family; Family member; Freedom; Frequencies; Generations; Goals; Guidelines; Health; Health Services; Health Services Accessibility; Healthcare Systems; Individual; Intervention; Laws; Learning; Legal; Length; Life Experience; Mental Health; Mental Health Services; Methods; Military Personnel; Outcome; Outcome Measure; Outpatients; Parents; Participant; Patients; Phase; Population; Post-Traumatic Stress Disorders; Psychological reinforcement; Psychopathology; Randomized; Randomized Clinical Trials; Reporting; Research; Resistance; Risk; Sampling; Spouses; Stress; Substance Use Disorder; Substance abuse problem; Symptoms; Testing; Training; Translating; Treatment Efficacy; Veterans; alcohol misuse; arm; base; coping; drinking; effective therapy; efficacy testing; improved; innovation; intervention program; knowledge base; operation; peer; physical conditioning; primary outcome; reduced substance abuse; research study; secondary outcome; stress related disorder; substance abuse treatment; success; successful intervention; therapy design; therapy development; treatment program; willingness

DESCRIPTION (provided by applicant): In keeping with the guidelines and points of emphasis established by the VHA Uniform Mental Health Services Code, the third submission of this research study is a Phase II randomized clinical trial designed to evaluate the efficacy of two interventions for the concerned significant others (CSOs) of OEF/OIF/OND veterans with substance abuse disorders (SUD). Community Reinforcement and Family Training (CRAFT) has demonstrated efficacy in civilian populations, and will be compared to a standard community treatment option, Al-Anon Facilitation. Data obtained in recent years has made it increasingly evident that harmful levels of alcohol drinking and substance abuse are extremely prevalent amongst OEF/OIF/OND veterans who have enrolled with Veterans Affairs Health Care System (regardless of the type of health services received), as well as within the 58% of eligible OEF/OIF/OND veterans who have not pursued treatment at the VA. The consequences of SUD in families are profound, and VA is keen to offer useful interventions aiding family members of OEF/OIF/OND veterans (cf., Public Law 110-387 Veterans' Mental Health and Other Care Improvements Act of 2008). A secondary outcome of family intervention can be veteran treatment seeking. The willingness of OEF/OIF/OND veterans to access mental health services is alarmingly low, despite the negative consequences (e.g. health, financial, legal) to their families and to themselves. The overall goal of this propoal is to determine whether an intervention designed to target the CSOs of veterans will improve CSO interactions with veterans, subsequently resulting in increased use of existing evidence-based treatment for their SUD. A total of 104 CSOs (the spouse or intimate partner) who report concern about their OEF/OIF/OND veterans substance abuse will be randomly assigned to therapist-guided CRAFT (n=52) or therapist-guided Al-Anon Facilitation (e.g. 12-Step; n=52). Both treatments will be delivered in individual sessions on an outpatient basis for 12- weeks. Primary and secondary outcome measures will be assessed at baseline, at the end of treatment, and 24, 36 and 48 weeks after treatment completion. Predictive variables will be assessed weekly, following therapy sessions. The proposed research is innovative because it will teach CSOs different styles of coping with veteran's drinking and how to motivate their OEF/OIF/OND veterans who are treatment resistant to seek treatment for their SUD. We expect that this research will prove successful at improving the relationship functioning of the CSO and the veteran. The major impact of this research will be to address a gap in the knowledge-base by testing and refining a method to encourage treatment-avoidant veterans to participate in existing evidence-based treatments.

描述(由申请人提供)： 根据VHA统一精神卫生服务规范建立的指南和重点，这项研究的第三次提交是第二阶段随机临床试验，旨在评估两种干预措施对相关显着患者的疗效。 OEF/OIF/OND退伍军人药物滥用障碍(SUD)的其他(民间社会组织)。社区强化和家庭培训已在平民人口中显示出效果，并将与一种标准的社区治疗选择--Al-Anon便利化--进行比较。近年来获得的数据越来越明显地表明，酗酒和滥用药物的有害程度在参加退伍军人事务部医疗保健系统的OEF/OIF/OND退伍军人中极其普遍(无论所接受的医疗服务类型如何)，以及58%没有在退伍军人管理局寻求治疗的合格OEF/OIF/OND退伍军人中的情况。SUD对家庭的影响是深远的，退伍军人管理局热衷于为OEF/OIF/OND退伍军人的家庭成员提供有用的干预措施(参见2008年《110-387退伍军人心理健康和其他护理改进公法》)。家庭干预的次要结果可能是寻求退伍军人治疗。OEF/OIF/OND退伍军人获得心理健康服务的意愿低得令人震惊，尽管这对他们的家庭和他们自己造成了负面影响(如健康、经济、法律)。这一提案的总体目标是确定旨在针对退伍军人的民间社会组织的干预措施是否将改善民间社会组织与退伍军人的互动，从而导致更多地使用现有的循证治疗来治疗退伍军人。共有104名民间社会组织(配偶或亲密伴侣)报告对其OEF/OIF/OND退伍军人药物滥用表示担忧，他们将被随机分配到治疗师指导的手艺(n=52)或治疗师指导的Al-Anon促进会(例如，12步；n=52)。这两种治疗方法都将在门诊的基础上单独进行，为期12周。将在基线、治疗结束时以及治疗完成后24、36和48周对主要和次要结果进行评估。预测变量将在治疗后每周进行评估。这项拟议的研究具有创新性，因为它将教会民间社会组织以不同的方式处理退伍军人的饮酒问题，以及如何激励他们的OEF/OIF/OND退伍军人为他们的SUD寻求治疗。我们期望这项研究将成功地改善CSO和退伍军人的关系运作。这项研究的主要影响将是通过测试和改进一种鼓励避免治疗的退伍军人参加现有的循证治疗的方法来解决知识库中的一个缺口。