Peer Helping, Retention, and Relapse in Sober Living Houses

清醒生活之家中的同伴帮助、保留和旧病复发

• 批准号: 10118052
• 负责人: DOUGLAS L POLCIN
• 金额: $ 54.5万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10118052
• 关键词: Abstinence; Affect; Age; Alcohol abuse; Alcohol or Other Drugs use; Alcohols; Area; Characteristics; Coping Skills; Data; Development; Emotional; Environment; Family; Feedback; Focus Groups; Friends; Gender; Helping Behavior; Home environment; Household; Individual; Inpatients; Intervention; Interview; Legal; Length; Length of Stay; Literature; Longitudinal Studies; Measures; Medical; Modeling; Neighborhoods; Outcome; Pathway interactions; Persons; Pharmaceutical Preparations; Procedures; Provider; Public Health; Race; Randomized Clinical Trials; Recovery; Relapse; Research; Sampling; Services; Severities; Site; Social Environment; Social Network; Socioeconomic Status; Source; Testing; Therapeutic; Time; Woman; Work; acute care; alcohol abstinence; alcohol use disorder; drinking; enhancing factor; experience; improved; inclusion criteria; men; novel; outcome prediction; outpatient programs; parent grant; peer; peer support; primary outcome; programs; rapid growth; recruit; relapse prediction; residence; secondary outcome; self esteem; sobriety; social model; treatment services

Sober living houses (SLHs) are alcohol- and drug-free living environments for persons attempting to abstain from substances and develop a long-term program of recovery. Studies have shown residents in these homes make significant, sustained improvements in multiple areas of functioning, including abstinence from alcohol. One of the strongest and most consistent predictors of relapse is shorter retention in the house. Focus groups with SLH managers suggest peer helping enhances retention, commitment to the household, and commitment to recovery. Building upon an ongoing longitudinal study of SLHs, the proposed study will assess the relative impact of helping behaviors on retention, and in turn, on relapse. Initial aims will assess how relapse is affected by helping broadly conceived, including comparisons of giving versus receiving help and helping in relation to peers versus others (i.e., family and friends). We will also assess how relapse is affected by giving and receiving different types of help, such as instrumental versus emotional. The study will then test a novel path model suggesting that, because of the overarching culture of SLHs and the innate benefits of helping in recovery, helping others in recovery-related contexts (i.e., in the residence and in 12-step groups) will lead to stronger relationships with peers in recovery, improved self-esteem, a stronger commitment to abstinence, more focus on others, and improved recovery-related coping skills. We posit all of these effects will then reinforce helpers' commitment to the residence, resulting in longer retention. SLHs are ideal sites for the proposed study because the primary therapeutic influence involves peer support within an alcohol- and drug-free living environment. Because the current research on the relationship between helping and recovery focusses on alcohol problems, a current alcohol use disorder will be an inclusion criterion. The study will include qualitative interviews to inform study procedures and identify experiences of giving and receiving help that illuminate the path model. Individuals entering SLHs with alcohol use disorders (N=200) will be assessed on measures of helping, social networks, substance use, and severity of problems on the ASI. Because the rates of relapse are highest soon after entering the houses, we will conduct baseline and monthly assessments during the first three months and a final interview at 6 months. Significance of the study is high because SLHs and other types of recovery residences are experiencing rapid growth and data are needed on malleable factors that promote better outcomes. Further, this study will add to the narrowly focused literature on helping in recovery and will be the first to illustrate the pathways by which helping influences outcomes in SLHs. SLH providers will be able to use study findings to determine intervention points for enhancing retention and sustaining recovery among sober living residents.

清醒生活屋(SLH)是不含酒精和毒品的生活环境，适合试图 戒掉物质，制定一个长期的康复计划。研究表明，居民 这些家庭在多个功能领域取得显著、持续的改善，包括 戒酒戒酒。对复发的最有力和最一致的预测之一是较短的 留在房子里。与SLH经理组成的焦点小组建议，同伴帮助可以增强留住， 对家庭的承诺，对恢复的承诺。在持续的纵向基础上构建 在对SLH的研究中，拟议的研究将评估帮助行为对保留的相对影响， 反过来，旧病复发。最初的目标将评估通过帮助广泛设想的， 包括给予与接受帮助的比较，以及同龄人与他人之间的帮助 (即，家人和朋友)。我们还将评估给予和接受不同的东西对复发的影响 帮助的类型，如工具性帮助与情绪性帮助。然后这项研究将测试一种新的路径模型 这表明，由于SLH的总体文化和帮助 恢复，在与恢复有关的情况下(即，在住所和12步小组中)帮助其他人将 在康复中与同龄人建立更牢固的关系，提高自尊，更坚定地致力于 节制，更多地关注他人，以及改善与康复相关的应对技能。我们假设所有这些 然后，效果将加强帮助者对住所的承诺，从而导致更长的保留时间。SLH 是建议研究的理想地点，因为主要的治疗影响涉及同伴支持 在一个没有酒精和毒品的生活环境中。因为目前对这一关系的研究 在帮助和康复之间专注于酒精问题，目前的酒精使用障碍将是 纳入标准。这项研究将包括定性访谈，以告知研究程序和 确定给予和接受帮助的经验，这些经验照亮了路径模型。个人进入 将对有酒精使用障碍的SLH(N=200)进行帮助措施、社交网络、 物质使用，以及ASI上问题的严重性。因为不久之后复发率最高 进入房屋，我们将在前三个月进行基线和月度评估 并在6个月后进行最后一次面试。这项研究的意义很高，因为SLH和其他类型的 恢复式住宅正在经历快速增长，需要有关可延展性因素的数据 促进更好的结果。此外，这项研究将增加狭隘地关注帮助 这将是第一个说明帮助影响SLH结果的途径。 SLH提供者将能够使用研究结果来确定增强 在清醒生活的居民中保持和持续恢复。