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: 10264895
• 负责人: DOUGLAS L POLCIN
• 金额: $ 54.02万
• 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/10264895
• 关键词: Abstinence; Affect; Age; Alcohol abuse; Alcohols; Area; Characteristics; Coping Skills; Data; Development; Emotional; Environment; Family; Feedback; Focus Groups; Friends; Gender; Helping Behavior; Home; 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; substance use; 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.

清醒的生活之家（SLH）是酒精和毒品的生活环境的人试图 戒除药物，并制定长期的康复计划。研究表明， 在这些家庭中，在多个功能领域取得了显著的持续改善，包括 戒酒复发的最强和最一致的预测指标之一是更短 留在家里。与SLH经理的焦点小组建议同伴帮助提高保留， 对家庭的承诺，以及对恢复的承诺。在持续的纵向 研究的SLH，拟议的研究将评估帮助行为对保留的相对影响， 反过来，也会导致复发。最初的目标将评估如何通过帮助广泛构思， 包括给予与接受帮助的比较，以及与同伴和他人的帮助 (i.e.,家人和朋友）。我们还将评估给予和接受不同的治疗方法对复发的影响。 帮助类型，如工具与情感。该研究将测试一种新的路径模型 这表明，由于SLH的总体文化和帮助的内在好处， 恢复，在与恢复相关的环境中帮助他人（即，在住宅和12步组）将 在康复过程中与同龄人建立更牢固的关系，提高自尊， 禁欲，更多地关注他人，并改善与恢复相关的应对技能。我们将所有这些 这样便可加强佣工对居所的承担，令佣工能更长久地留在居所。SLH 是拟议研究的理想地点，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。因为目前对这种关系的研究 帮助和恢复之间的重点是酒精问题，目前的酒精使用障碍将是一个 入选标准该研究将包括定性访谈，以告知研究程序， 确定给予和接受帮助的经验，阐明路径模型。个人进入 将对患有酒精使用障碍的SLH（N=200）进行帮助、社交网络、 物质使用，以及ASI问题的严重程度。因为复发率是最高的 进入房屋，我们将在前三个月进行基线和月度评估 6个月时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 恢复住宅正在经历快速增长，需要关于可延展因素的数据， 促进更好的结果。此外，这项研究将增加狭隘的重点文献，帮助在 恢复，并将是第一个说明的途径，帮助影响结果在SLHs。 SLH提供者将能够使用研究结果来确定干预点， 保持清醒的生活居民和持续恢复。