Spiritual Self-Reevaluation Therapy for HIV+ Drug Users

描述（由申请人提供）：我们建议进行第一阶段行为疗法开发项目，目标是开发和试点测试手动指导的干预措施，精神自我重新评估疗法（SSRT），以减少市中心HIV阳性注射吸毒者的HIV风险行为。 SSRT将在个人和团体模式中开发，并将帮助患者在基于自我图式理论的治疗框架内表达，阐述和激活精神信仰，相对于此，灵性的概念可以操作化，并且可以严格评估治疗的变化。艾滋病毒和吸毒成瘾的文献表明，感知的精神/宗教支持是一个潜在的重要领域，以解决减少危害的干预措施与艾滋病毒阳性吸毒者。先前的研究还表明，“自我”的社会认知理论可以作为开发和评估此类干预措施的组织理论框架。自我图式的激活激发了关于自我的特定信念，并通过自动化的事件脚本和行动计划提供了与这些信念相关的行为库。SSRT的目标是促进患者的工作自我图式的转变，从“成瘾者”到“精神”自我图式的激活，这种自我图式与利他主义行为，乐观情绪以及增加的个人价值感和代理感更加相容。本提案的具体目标是基于文献中描述的第一阶段行为治疗开发项目的多个目标，并且有三个方面：1）在第一阶段，开发和完善治疗手册、工作簿、治疗师能力依从性评级量表和治疗过程测量; 2）在第二阶段，开发、实施和评估SSRT治疗顾问培训计划; 3）在第三阶段，在54名HIV阳性美沙酮维持药物使用者中进行SSRT的试点试验，患者将随机接受12周的SSRT（个体），SSRT（组）或常规治疗。 主要结果将是保留治疗和减少非法药物使用和其他高风险行为。治疗过程中的变量进行评估，包括艾滋病毒的信息，动机，行为技能和成瘾和精神自我图式从治疗前到治疗后的转变。

DESCRIPTION (provided by applicant): We propose to conduct a Stage I behavioral therapy development project with the goals of developing and pilot testing a manual-guided intervention, Spiritual Self-Reevaluation Therapy (SSRT), for reducing HIV risk behavior by inner-city HIV-positive injection drug users. SSRT will be developed in both individual and group modalities and will help patients articulate, elaborate, and activate spiritual beliefs within a therapeutic framework based on self-schema theory, relative to which the concept of spirituality can be operationalized, and change with treatment can be rigorously assessed. The HIV and addiction literature suggest that perceived spiritual/religious support is a potentially important domain to address in harm reductions interventions with HIV-positive drug users. Prior research also suggests the utility of a social-cognitive theory of "self" as an organizing theoretical framework within which to develop and evaluate such interventions. Activation of a self-schema energizes specific beliefs about the self, and provides access to the behavioral repertoire associated with those beliefs through automatized event scripts and action plans. The goal of SSRT is to facilitate a shift in the patient's working self-schema, from the "addict" to the activation of a "spiritual" self-schema that is more compatible with acts of altruism, feelings of optimism, and an increased sense of personal worth and agency. The specific aims of this proposal are based on the multiple goals of a Stage I behavioral therapy development project described in the literature and are threefold: 1) In Phase I to develop and refine the therapy treatment manuals, workbooks, therapist competence adherence ratings scales and treatment process measures; 2) In Phase II to develop, conduct, and evaluate a SSRT therapy counselor training program; 3) In Phase III to conduct a pilot trial of SSRT in a sample of 54 HIV-positive methadone-maintained drug users in which patients will be randomized to receive 12 weeks of SSRT (individual), SSRT (group) or treatment as usual. Primary outcomes will be retention in treatment and reductions in illicit drug use and other high-risk behaviors. Treatment process variables to be assessed include HIV information, motivation, and behavioral skills and the shift in addict and spiritual self-schemas from pre to post-treatment.