A Novel Person-Centered Treatment Component for Substance Use Treatment

Outcome of a Novel Person-Centered Treatment Component for Substance Use Treatment

A person-centered substance use treatment component, the Natural Recovery Program, was developed in a residential substance use treatment setting. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies. The study examined treatment retention, treatment completion and satisfaction of participants of Natural Recovery compared to those who participated in core residential treatment activities alone.

Study Overview

• Status: Completed
• Conditions: Personality Disorders; Depression; Bipolar Disorder; Substance Use Disorders; Psychosis
• Intervention / Treatment: Behavioral: Natural Recovery-Horticulture; Behavioral: Natural Recovery-Art/Music

Detailed Description

METHODS: Retrospective record review of 643 veterans in an inpatient Mental Health Recovery and Rehabilitation Program was used to determine if participants of Natural Recovery had a different rate of treatment retention and completion than those who participated in the core program alone. Univariate and multivariate analysis was conducted on: participation in the Natural Recovery Program, comorbid psychiatric disorders, legal, medical and psychiatric issues.

PARTICIPANTS: The records of 643 veterans treated in DAP (residential rehabilitation treatment program) at a Veteran's Administration hospital between November, 2009 and March, 2011 were analyzed retrospectively in a quasi-experimental design. The researchers were not blind to participation and participation in the program was an elective component, not randomized. All patients enrolled in DAP were eligible to participate in a novel program called Natural Recovery. Fifteen percent participated in Natural Recovery-Horticulture (n=101), five percent participated in Natural Recovery-Art/Music (n=30) and seventy-nine percent elected to participate in the DAP Core Program only (DAP-CP) (n=512). One percent (n=8) participated in both tracks of Natural Recovery.

PROCEDURE: Participants in Natural Recovery received a one-hour small group therapy session during the week using modules with a staff facilitator while DAP-CP participants attended a large psychoeducational group at that time. Participants in Natural Recovery were given a choice of tracks, either Horticulture or Art/Music based on personal preference. The modules employ analogies between the recovery process and their chosen hobby. Although hobbies were different between the two tracks of Natural Recovery, the fourteen modules covered the same concepts; only the analogy portion of each handout differed.

Natural Recovery participants also pursued four hours of their hobby on each weekend day while DAP-CP participants received large group psychoeducational lectures on weekends during the same amount of time. Thus, total substance use treatment hours between Natural Recovery participants and DAP core program (DAP-CP) participants were equivalent. Additionally, all Natural Recovery-Art/Music, Natural Recovery-Horticulture and DAP-CP participants received one "Leisure Education" lecture.

All participants were free to pursue hobbies during treatment but Natural Recovery participants received materials (access to gardening tools and gardening zones, were provided musical instruments and/or art supplies) to pursue their choice of hobby on the weekend. DAP-CP participants could pursue hobbies during treatment but were not provided musical instruments or art materials, nor did they have access to gardening tools to work in the garden although they could walk in it.

MATERIALS: The modules of Natural Recovery have been previously published and constitute 14 topics, each of which is discussed weekly for 14 weeks [33]. Participants could repeat Natural Recovery modules if their length of stay exceeded 14 weeks. The total number of modules was recorded for each participant.

• Study Type: Interventional
• Enrollment (Actual): 643
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Hampton, Virginia, United States, 23667
      • Hampton VAMC, Department of Mental Health & Behavioral Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All patients enrolled in the residential substance use treatment program

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: DAP-CP; 512 patients who elected to participate in the Drug Abuse Core Program alone (DAP-CP).
Experimental: Natural Recovery-Horticulture; Participants in Natural Recovery-Horticulture received a one-hour small group therapy session during the week using one module per week with a staff facilitator and also pursued four hours of their hobby on each weekend day for up to 14 weeks.	Behavioral: Natural Recovery-Horticulture; Participants in Natural Recovery-Horticulture received a one-hour small group therapy session during the week using Horticulture modules with a staff facilitator while DAP-CP participants attended a large psychoeducational group at that time. Natural Recovery participants also pursued four hours of gardening on each weekend day while DAP-CP attended large-group lectures.
Experimental: Natural Recovery-Art/Music; Participants in Natural Recovery-Art/Music received a one-hour small group therapy session during the week using one module per week with a staff facilitator and also pursued four hours of their hobby on each weekend day for up to 14 weeks.	Behavioral: Natural Recovery-Art/Music; Participants in Natural Recovery-Art/Music received a one-hour small group therapy session during the week using Art/Music modules with a staff facilitator while DAP-CP participants attended a large psychoeducational group at that time. Natural Recovery participants also pursued four hours of art or music on each weekend day while DAP-CP attended large-group lectures.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment Completion	Treatment completion was defined as regular discharge from the program, which was between 1 and 150 days.	Up to 150 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment Retention	Treatment retention was defined as the number of days in treatment, from 1-150 days.	up to 150 days
Satisfaction with program	Satisfaction with either DAP-CP, Natural Recovery-Horticulture or Natural Recovery-Art/Music was measured at the time of discharge on a Likert scale of 1-5 where 5 was highest.	up to 150 days

Collaborators and Investigators

• Sponsor: Hampton VA Medical Center
• Investigators: Principal Investigator: Kathleen Decker, MD, Hampton VAMC

Publications and helpful links

General Publications

• Decker, KP: Natural Recovery Program. In Mental Health Residential Rehabilitation Treatment Program (MH RRTP) Promising Practices Compendium: Improving Veterans' Mental Health Care for the 21st Century, Edited by Angela Gerolamo, Jennifer McGovern, Amy Krilla Overcash, Kester St. Kitts, Nikkilyn Morrison, Grace Roemer. Mathematica Policy Research; 2011: p. 24 and p. 184-222.

Study record dates

Study Major Dates

• Study Start: June 1, 2011
• Primary Completion (Actual): December 1, 2011
• Study Completion (Actual): December 1, 2011

Study Registration Dates

• First Submitted: November 26, 2013
• First Submitted That Met QC Criteria: December 4, 2013
• First Posted (Estimate): December 9, 2013

Study Record Updates

• Last Update Posted (Estimate): December 9, 2013
• Last Update Submitted That Met QC Criteria: December 4, 2013
• Last Verified: December 1, 2013

More Information

Terms related to this study

• Keywords: psychosocial treatment; dual diagnosis; substance use treatment; person-centered treatment; residential treatment outcomes; recovery model
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Pathologic Processes; Bipolar and Related Disorders; Substance-Related Disorders; Personality Disorders; Disease; Bipolar Disorder
• Other Study ID Numbers: 2013-001