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Balmuth EA, Iyer S, Scales DA, Avery J. Perspectives and Recommendations from Hospitalized Patients with Substance Use Disorders: A Qualitative Study. J Gen Intern Med 2024; 39:2087-2096. [PMID: 38698295 PMCID: PMC11306722 DOI: 10.1007/s11606-024-08745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/25/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Individuals with substance use disorders (SUDs) are hospitalized in growing numbers. Stigma is pervasive among their hospital providers, and SUD management during medical admissions is often inadequate. However, little is known about how these patients perceive their care quality. In particular, few studies have explored their positive care perceptions or recommendations for improvement. OBJECTIVE To explore perspectives on positive aspects, negative aspects, and consequences of care, as well as recommendations for improvement among hospitalized patients with SUDs. DESIGN AND PARTICIPANTS We conducted semi-structured, in-depth bedside interviews (n = 15) with patients who have been diagnosed with a SUD and were admitted to medical or surgical floors of an urban academic medical center. APPROACH Interviews explored patients' hospital experiences and recommendations for improvement. The interviews were audio-recorded, transcribed verbatim, and imported into NVivo software. Two reviewers independently coded the transcripts using interpretative phenomenological analysis and inductive thematic analysis according to grounded theory, and recurring themes were identified from the data. Patients' demographic and clinical data were analyzed with descriptive statistics. KEY RESULTS Perceived clinical and emotional proficiency were the most important components of positive experiences, whereas perceived bias and stigmatized attitudes, clinical improficiency, and inhumane treatment were characteristic of negative experiences. Such care components were most consequential for patients' emotional well-being, trust, and care quality. Recommendations for improving care included specific suggestions for initiating and promoting continued recovery, educating, and partnering in compassionate care. CONCLUSIONS Hospitalized patients with SUDs often experience lower quality and less compassionate care linked to pervasive stigma and poor outcomes. Our study highlights under-recognized perspectives from this patient population, including socioemotional consequences of care and recommendations grounded in lived experiences. By striving to advance our care in accordance with patients' viewpoints, we can turn hospitalizations into opportunities for engagement and promoting recovery.
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Affiliation(s)
| | - Sonali Iyer
- Weill Cornell Medical College, New York, NY, USA
| | - David A Scales
- Department of Medicine, Division of General Internal Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA
| | - Jonathan Avery
- Department of Psychiatry, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA
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Young AS, Reboussin BA, Riehm K, Mojtabai R, Green KM, O'Gorman ET, Susukida R, Amin-Esmaeili M, Crum RM. Associations between mental health & substance use treatment and alcohol use progression and recovery among US women drinkers. PLoS One 2024; 19:e0306820. [PMID: 38976705 PMCID: PMC11230554 DOI: 10.1371/journal.pone.0306820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Alcohol use has profound public health impact on women; however, modifiable factors that may influence alcohol use progression/recovery, including health service utilization, are understudied in women. OBJECTIVE To investigate the association between mental health (MH) and substance use (SU) treatment with alcohol use progression and recovery among women who currently use alcohol or have in the past. METHODS This study is a secondary data analysis of prospective data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; a US-nationally representative sample of adults). The analytic sample was limited to women who reported past or current alcohol use at wave 1 (N = 15,515). Latent transition analysis (LTA) examined whether receiving SU/MH treatment in the year prior to wave 1 was associated with transitioning between three empirically-derived stages of alcohol involvement (no, moderate, and severe problems classes), between Waves 1 and 2 adjusting for possible confounders using propensity score weight. RESULTS Compared to White female drinkers, female drinkers who were from Black, Hispanic, or other races were less likely to receive SU/MH treatment (p-values ≤. 001). SU/MH treatment in the year prior to wave 1 was associated with transitioning from the moderate problems class to the no problems class between Waves 1 and 2 (p-value = .04). CONCLUSION Receipt of SU or MH treatment among women, was associated with a higher likelihood of remission from moderate alcohol use problems to no problems over time. Future research, including investigation into treatment characteristics (e.g., frequency, duration, type) should further explore why women initially experiencing severe alcohol use problems did not experience similar remission.
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Affiliation(s)
- Andrea S Young
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Kira Riehm
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Ramin Mojtabai
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Emily T O'Gorman
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Rosa M Crum
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Andrews K, Ross D, Maroney TL. Online Group Psychotherapy: A Systematic Review. Community Ment Health J 2024:10.1007/s10597-024-01304-4. [PMID: 38970740 DOI: 10.1007/s10597-024-01304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/23/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION There is a need within counselling and psychotherapy to ensure their ability to respond to endemic presences such as the COVID-19 pandemic, by utilising rapid technological advances without compromising effectiveness. To do so, existing research about online group therapy must be built upon to provide a comprehensive understanding of the efficacious delivery of this therapy modality. Thus, a systematic review was conducted to collate what is currently known in the published and grey literature on online group therapy, using the PRISMA framework. Thirty-three articles were identified as including information regarding facilitating group therapy online. After appraising each article using appropriate quality appraisal tools, a thematic analysis was conducted on the papers, arriving at seven main themes summarising the main findings regarding online versus in-person groups, group planning, counselling micro skills, group processes, ethics, technology, and unique online therapy issues. There is a growing but incomplete body of knowledge that informs the group therapist regarding the ethical delivery of groups online. A more comprehensive review can enable group therapists to feel confident they are across best practice guidelines. Limitations and research implications are considered.
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Affiliation(s)
- Katrina Andrews
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
| | - Dyann Ross
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Tenelle L Maroney
- School of Law and Society, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Kroener J, Eickholt ML, Sosic-Vasic Z. Group based metacognitive therapy for alcohol use disorder: a pilot study. Front Psychiatry 2024; 15:1375960. [PMID: 39015882 PMCID: PMC11249785 DOI: 10.3389/fpsyt.2024.1375960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/12/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Alcohol use disorder (AUD) is a severe clinical disorder, which has been associated with 5.3% of death worldwide. Although several treatments have been developed to improve AUD symptomatology, treatment effects were moderate, with a certain amount of patients displaying symptom deterioration after treatment termination. Moreover, outpatient treatment placements become increasingly scarce, thus necessitating more efficient treatment options. Therefore, the aim of the present study was to investigate the efficacy, feasibility, and acceptability of a newly invented, short, group based metacognitive therapy (MCT) for patients diagnosed with AUD. Method Seven patients were treated with eight sessions of group based MCT using a single case series design with an A-B replication across patients. Patients were assessed one month and one week before treatment, as well as one week and three months after treatment termination. Results Patients improved significantly and with large effect sizes regarding dysfunctional metacognitive beliefs, desire thinking/craving and depressive symptoms up to three months after treatment termination. AUD symptomatology as well as positive and negative metacognitive beliefs improved at post-treatment, but improvements could not be maintained at follow-up. All included patients completed the treatment and were highly satisfied. Conclusion The presented findings show preliminary evidence for the efficacy, feasibility, and acceptability of the implemented group based MCT treatment. Large scale randomized controlled trials (RCTs) are needed to confirm the effectiveness of the developed program for patients diagnosed with AUD.
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Goeppingen, Germany
- Medical Department, University of Ulm, Ulm, Germany
| | - Maja Lara Eickholt
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Goeppingen, Germany
- Medical Department, University of Ulm, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Goeppingen, Germany
- Medical Department, University of Ulm, Ulm, Germany
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Kaufman CC, Rosmarin DH. Spiritually Integrated Group Psychotherapy for First Responders: Forgiveness, Trauma, and Alcohol Use. Int J Group Psychother 2024; 74:217-243. [PMID: 38502106 PMCID: PMC11062829 DOI: 10.1080/00207284.2024.2322500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
First responders (e.g. firefighters, law enforcement, paramedics, corrections officers) experience high rates of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Despite the relevance of both spirituality and forgiveness to PTSD and AUD among first responders, spiritually integrated group interventions for this population are rare. This article discusses a forgiveness session of a spiritually integrated group psychotherapy protocol for first responders (SPIRIT-FR) in acute psychiatric care. This brief group psychotherapy intervention includes (a) psychoeducation about the intersection of PTSD, AUD, and forgiveness (b) discussion of the relevance of forgiveness to PTSD and AUD, and (c) the integration of spiritual beliefs and behaviors to move toward forgiveness. We discuss relevant clinical theory as well as the potential clinical application of this protocol.
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Affiliation(s)
- Caroline. C. Kaufman
- Spirituality and Mental Health Program, McLean Hospital
- Department of Psychiatry, Harvard Medical School
| | - David H. Rosmarin
- Spirituality and Mental Health Program, McLean Hospital
- Department of Psychiatry, Harvard Medical School
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Williams T. Substance Abuse Treatment, Critical Race Theory, and Counter-Storytelling, for the Black Emerging Adult Male. J Racial Ethn Health Disparities 2024; 11:1067-1076. [PMID: 37022598 DOI: 10.1007/s40615-023-01586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023]
Abstract
Black-emerging adult males face many barriers to the effective engagement in substance abuse treatment including stigma, lack of access to resources, and engagement with the criminal justice system. This case study introduces a group therapy and counter-storytelling intervention to understand and effectively mitigate some of these barriers. Counter-storytelling, derived from critical race theory (CRT) framework, focuses on marginalized individuals sharing how various aspects of society impact them, which is often different from the majority narrative. Through this intervention, Black-emerging adult males discussed the challenges they face when engaging in treatment, coping skills for barriers they face, and overcoming stigma of substance abuse recovery. Using a group therapy and counter-storytelling intervention, clinicians can begin to suspend how they traditionally think about treatment for Black-emerging adult males and engage in more effective practices to support this population.
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Affiliation(s)
- Tempestt Williams
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
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Trick L, Butler K, Bourgault Z, Vandervoort J, Le Foll B. Implementation and Preliminary Evaluation of a 12-Week Cognitive Behavioural and Motivational Enhancement Group Therapy for Cannabis Use Disorder. Subst Abuse 2023; 17:11782218231205840. [PMID: 37904747 PMCID: PMC10613350 DOI: 10.1177/11782218231205840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/19/2023] [Indexed: 11/01/2023]
Abstract
Background The purpose of this paper is to provide a preliminary evaluation of treatment outcomes, retention and client satisfaction following a 12-week combined cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) group treatment for cannabis use disorder (CUD) delivered in an outpatient setting. Implementation of the program is also described. Methods A retrospective observational cohort study was conducted using data collected from medical records and self-report assessments. Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto. Cannabis use, cannabis-related problems, craving, withdrawal symptoms, self-efficacy for remaining abstinent, depression and anxiety were assessed pre- and post-treatment. Treatment retention was calculated by inspecting clinic attendance records, and client satisfaction was evaluated using an anonymous feedback survey. Potential predictors of treatment outcomes and retention were investigated in exploratory analyses. Results Cannabis use was lower and days of abstinence higher post-treatment (vs pre-treatment). Post-treatment improvements in cannabis-related problems, craving, withdrawal symptoms, self-efficacy and mood were also observed. Completion of group treatment (⩾75% of sessions attended) was 57% and moderate levels of treatment satisfaction were reported. Conclusions This study provides preliminary evidence that a 12-week combined CBT and MET treatment for cannabis use disorder delivered in a novel group setting improves cannabis use outcomes. Potential predictors of reduced cannabis use and retention were identified. Future controlled studies are warranted, and strategies for increasing retention should be explored.
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Affiliation(s)
- Leanne Trick
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, ON, Canada
- Department of Psychology, Durham University, Durham, UK
| | - Kevin Butler
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, ON, Canada
- School of Psychology, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Zoe Bourgault
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Julianne Vandervoort
- Concurrent Outpatient Medical & Psychosocial Addiction Support Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Acute Care Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, University of Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Concurrent Outpatient Medical & Psychosocial Addiction Support Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Acute Care Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Division of Brain and Therapeutics, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
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Rivera AP, Maisto SA, Connors GJ, Schlauch RC. Therapists' first impression of treatment motivation moderates the relationship between the client-rated therapeutic alliance and drinking outcomes during treatment. Alcohol Clin Exp Res 2023; 47:806-821. [PMID: 36863860 DOI: 10.1111/acer.15040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 01/09/2023] [Accepted: 02/08/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION First impressions can influence interpersonal relationships for extended periods, with negative first impressions leading to more negative judgments and behaviors between individuals months after their initial meeting. Although common factors such as therapeutic alliance (TA) are well studied, less is known of the potential influence of a therapist's first impression of their client's motivation on TA and drinking outcomes. Based on data from a prospective study of the perceptions of the TA among clients receiving cognitive-behavioral treatment (CBT), this study examined how therapists' first impressions may moderate the relationship between client-rated TA and drinking outcomes during treatment. METHODS One hundred fifty-four adults participated in a 12-week course of CBT and completed measures of TA and drinking behaviors following each treatment session. Additionally, therapists completed a measure of their first impression of their client's motivation for treatment following the first session. RESULTS Time-lagged multilevel modeling revealed a significant within-person TA by therapists' first impression interaction that predicted percent days abstinent (PDA). Specifically, among participants rated as lower on first impressions of treatment motivation, higher within-person TA predicted greater PDA in the interval prior to the next treatment session. Within-person working alliance was not associated with PDA among individuals rated higher on first impressions of treatment motivation who demonstrated higher PDA throughout treatment. Furthermore, significant between-person TA by first impressions interactions were found for both PDA and drinks per drinking day (DDD), such that among individuals with lower treatment motivation, TA positively predicted PDA and negatively predicted DDD. CONCLUSION Although therapists' first impressions of a client's treatment motivation are positively associated with treatment outcomes, clients' perception of the TA may mitigate the impact of poor first impressions. These findings highlight the need for additional nuanced examinations of the relationship between TA and treatment outcomes, emphasizing the contextual factors that influence this relationship.
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Affiliation(s)
- Alexander P Rivera
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Stephen A Maisto
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Gerard J Connors
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Robert C Schlauch
- Department of Psychology, University of South Florida, Tampa, Florida, USA
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Sistad RE, Enggasser J, Livingston NA, Brief D. Comparing substance use treatment initiation and retention between telehealth delivered during COVID-19 and in-person treatment pre-COVID-19. Am J Addict 2023; 32:301-308. [PMID: 36645267 DOI: 10.1111/ajad.13385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/19/2022] [Accepted: 12/24/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A large portion of veterans referred to substance use disorder (SUD) treatment do not attend their first appointment or leave treatment prematurely. Telehealth options may increase access to care and treatment attendance. This study compared treatment initiation and retention between in-person treatment pre-COVID-19 and telehealth treatment during COVID-19 in a VA hospital outpatient alcohol and drug treatment clinic. METHODS Electronic health record data were collected on 373 veterans out of 481 referrals. Mixed logistic and negative binomial regression models were used for estimating the effect of treatment modality on treatment initiation and retention, respectively. RESULTS The odds of initiating treatment were 2.6 times greater when referred to a telehealth appointment during COVID-19 compared to an in-person appointment pre-COVID-19. Months retained in treatment postinitiation was similar between treatment modalities. Each month in treatment corresponded to a subsequently lower rate of treatment session attendance and by the fourth month, the average number of sessions attended was significantly lower for those receiving in-person treatment compared to those receiving telehealth treatment. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE The odds of initiating SUD treatment and rate of treatment attendance over time was greater for services delivered via telehealth during COVID-19 compared to in-person pre-COVID-19. Extending telehealth services as an option for individual and group SUD treatment may promote treatment initiation and potentially higher rate of attendance over time. This study provides additional evidence for the feasibility and utility of rapidly expanding telehealth for veterans seeking outpatient substance use treatment.
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Affiliation(s)
- Rebecca E Sistad
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Massachusetts, Boston, USA
| | - Justin Enggasser
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Massachusetts, Boston, USA.,Pear Therapeutics, Boston, Massachusetts, USA
| | - Nicholas A Livingston
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Massachusetts, Boston, USA.,Behavioral Science Division, National Center for PTSD, Massachusetts, Boston, USA
| | - Deborah Brief
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Massachusetts, Boston, USA
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Li C, Tang H, Yang Z, Tang Z, Cheng N, Huang J, Zhou X. Mechanism of CAV and CAVIN Family Genes in Acute Lung Injury based on DeepGENE. Curr Gene Ther 2023; 23:72-80. [PMID: 36043785 DOI: 10.2174/1566523222666220829140649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The fatality rate of acute lung injury (ALI) is as high as 40% to 60%. Although various factors, such as sepsis, trauma, pneumonia, burns, blood transfusion, cardiopulmonary bypass, and pancreatitis, can induce ALI, patients with these risk factors will eventually develop ALI. The rate of developing ALI is not high, and the outcomes of ALI patients vary, indicating that it is related to genetic differences between individuals. In a previous study, we found multiple functions of cavin-2 in lung function. In addition, many other studies have revealed that CAV1 is a critical regulator of lung injury. Due to the strong relationship between cavin-2 and CAV1, we suspect that cavin-2 is also associated with ALI. Furthermore, we are curious about the role of the CAV family and cavin family genes in ALI. METHODS To reveal the mechanism of CAV and CAVIN family genes in ALI, we propose DeepGENE to predict whether CAV and CAVIN family genes are associated with ALI. This method constructs a gene interaction network and extracts gene expression in 84 tissues. We divided these features into two groups and used two network encoders to encode and learn the features. RESULTS Compared with DNN, GBDT, RF and KNN, the AUC of DeepGENE increased by 7.89%, 16.84%, 20.19% and 32.01%, respectively. The AUPR scores increased by 8.05%, 15.58%, 22.56% and 23.34%. DeepGENE shows that CAVIN-1, CAVIN-2, CAVIN-3 and CAV2 are related to ALI. CONCLUSION DeepGENE is a reliable method for identifying acute lung injury-related genes. Multiple CAV and CAVIN family genes are associated with acute lung injury-related genes through multiple pathways and gene functions.
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Affiliation(s)
- Changsheng Li
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hexiao Tang
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zetian Yang
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zheng Tang
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Nitao Cheng
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jingyu Huang
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xuefeng Zhou
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
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The influence of members’ attachment style on group cohesion in substance use therapy groups. DISCOVER PSYCHOLOGY 2022. [PMCID: PMC8785002 DOI: 10.1007/s44202-022-00022-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Group cohesion is an important factor in group therapy as it influences treatment outcomes and group processes. One’s attachment style has been found to impact experiences of group cohesion, however research into this relationship in substance use disorder (SUD) group treatment is lacking. This is of particular concern as insecure attachment presentations are more prevalent in this clinical population and group therapy is often treatment of choice. The current study sought to determine whether attachment style significantly predicted group cohesion. It also provided a qualitative exploration of factors that promote group cohesion in SUD group treatment. Participants (N = 38) attending a SUD therapy program completed self-report measures. Attachment avoidance was a significant negative predictor of positive bonding and positive working, and a significant positive predictor of negative relationships. Attachment anxiety was a significant negative predictor of negative relationships, however, unexpectedly did not significantly predict positive bonding or positive working. The current findings highlight the importance of group therapists tailoring group treatment to meet the attachment needs of individuals to promote a group therapy environment conducive to recovery.
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Bel-Bahar TS, Khan AA, Shaik RB, Parvaz MA. A scoping review of electroencephalographic (EEG) markers for tracking neurophysiological changes and predicting outcomes in substance use disorder treatment. Front Hum Neurosci 2022; 16:995534. [PMID: 36325430 PMCID: PMC9619053 DOI: 10.3389/fnhum.2022.995534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies that explored putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD.
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Affiliation(s)
- Tarik S. Bel-Bahar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anam A. Khan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Riaz B. Shaik
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Muhammad A. Parvaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Dalgaard NT, Flensborg Jensen MC, Bengtsen E, Krassel KF, Vembye MH. PROTOCOL: Group-based community interventions to support the social reintegration of marginalised adults with mental illness. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1254. [PMID: 36909877 PMCID: PMC9283853 DOI: 10.1002/cl2.1254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This is the protocol for a Campbell systematic review. The main objective is to explore the general efficacy of group-based community interventions aimed at supporting marginalised adults with mental illness and related problems on outcomes such as problem behaviour, subjective well-being, homelessness, poverty and employment. Furthermore, the objective is to explore the potential advantages/disadvantages of using a group-based versus an individual intervention when targeting specific problems or when using specific types of interventions.
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Affiliation(s)
- Nina T. Dalgaard
- VIVE—The Danish Centre for Social Science ResearchCopenhagenDenmark
| | | | | | - Karl F. Krassel
- VIVE—The Danish Centre for Social Science ResearchCopenhagenDenmark
| | - Mikkel H. Vembye
- VIVE—The Danish Centre for Social Science ResearchCopenhagenDenmark
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14
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Kayaoğlu K, Şahin Altun Ö. The effect of combined cognitive-behavioral psychoeducation and music intervention on stress, self-efficacy, and relapse rates in patients with alcohol and substance use disorders: A randomized controlled trial. Perspect Psychiatr Care 2022; 58:968-977. [PMID: 34114223 DOI: 10.1111/ppc.12884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study was conducted to determine the effect of psychoeducation and music intervention on stress, self-efficacy, and relapse rates in alcohol and substance use disorders. DESIGN AND METHODS This was a randomized controlled study. The study sample included 62 patients who met the inclusion criteria. For 3 weeks, the patients in the experimental group received eight sessions of psychoeducation and music intervention. FINDINGS The total mean Self-Efficacy Scale score of the participants in the experimental group significantly increased as compared with that of the control group. The experimental group's total mean Perceived Stress Scale score and relapse rate significantly decreased compared to that of the control group. PRACTICE IMPLICATIONS Psychoeducation and music intervention effectively reduced stress, increased self-efficacy, and prevented relapses.
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Affiliation(s)
- Kübra Kayaoğlu
- Department of Medical Services and Techniques, Kovancılar Vocational School, Fırat University, Kovancılar, Elazığ, Turkey
| | - Özlem Şahin Altun
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
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15
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Messas G, Fernandez AV. Recontextualizing the subject of phenomenological psychopathology: Establishing a new paradigm case. Front Psychiatry 2022; 13:1035967. [PMID: 36339859 PMCID: PMC9634405 DOI: 10.3389/fpsyt.2022.1035967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Recently, there have been calls to develop a more contextual approach to phenomenological psychopathology-an approach that attends to the socio-cultural as well as personal and biographical factors that shape experiences of mental illness. In this Perspective article, we argue that to develop this contextual approach, phenomenological psychopathology should adopt a new paradigm case. For decades, schizophrenia has served as the paradigmatic example of a condition that can be better understood through phenomenological investigation. And recent calls for a contextual approach continue to use schizophrenia as their primary example. We argue, in contrast, that substance misuse provides a better paradigm case around which to develop a contextually sensitive phenomenological psychopathology. After providing a brief vignette and analysis of a case of substance misuse, we explain why this kind of condition requires considerable sensitivity and attention to context, better motivating the incorporation and development of new contextually sensitive approaches.
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Affiliation(s)
- Guilherme Messas
- Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.,Collaborating Centre for Values-Based Practice in Health and Social Care, St. Catherine's College, University of Oxford, Oxford, United Kingdom
| | - Anthony Vincent Fernandez
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark
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16
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Park JW, Kim HS. The Effects of Group Counseling Utilizing Narrative Therapy on Self-esteem, Stress Response, and Insight for Individuals with Alcohol Dependency. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2021.1972885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jae Wan Park
- College of Nursing, the Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Hee Sook Kim
- College of Nursing, the Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
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17
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Abstract
A growing evidence base supports the use of medication to treat opioid use disorder (OUD) in adolescents, but little is known about behavioral therapies for adolescents with OUD. A systematic review using PRISMA methodology was conducted on behavioral therapy for adolescent OUD. Only three studies were identified. Combined evidence from two studies indicates initial efficacy of the Adolescent-Community Reinforcement Approach, motivational enhancement therapy, and cognitive-behavioral therapy for reducing opioid use. The only group therapy identified, which involved adolescents and their parents, demonstrated improvement in participants' knowledge of relapse-prevention strategies, drug-refusal skills, and overall psychosocial functioning. Additional studies that included behavioral therapy but that did not specifically test its efficacy are also highlighted to expand the understanding of the small literature base. This review highlights the sparse evidence base for these therapies in this population. In addition, we highlight promising areas for future research and include evidence from the adult literature that may inform that research. Studies on behavioral therapies that utilize randomized, controlled trials for this population are imperative.
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18
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Rosendahl J, Alldredge CT, Burlingame GM, Strauss B. Recent Developments in Group Psychotherapy Research. Am J Psychother 2021; 74:52-59. [PMID: 33745284 DOI: 10.1176/appi.psychotherapy.20200031] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This article reviews group psychotherapy research published within the past 30 years, predominantly focusing on outcomes of group treatments for patients with various mental disorders. Additionally, meta-analyses on the efficacy of group treatments for patients with cancer or chronic pain are summarized. Results strongly support the use of group therapy and demonstrate outcomes equivalent to those of individual psychotherapy. The research also appears to emphasize the effect of feedback on outcomes in group treatments and an association between treatment outcomes and group cohesion and alliance. Other promising developments in the field of group therapy are discussed.
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Affiliation(s)
- Jenny Rosendahl
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Friedrich Schiller University Jena, Jena University Hospital, Jena, Germany (Rosendahl, Strauss); Department of Psychology, Brigham Young University, Provo, Utah (Alldredge, Burlingame)
| | - Cameron T Alldredge
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Friedrich Schiller University Jena, Jena University Hospital, Jena, Germany (Rosendahl, Strauss); Department of Psychology, Brigham Young University, Provo, Utah (Alldredge, Burlingame)
| | - Gary M Burlingame
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Friedrich Schiller University Jena, Jena University Hospital, Jena, Germany (Rosendahl, Strauss); Department of Psychology, Brigham Young University, Provo, Utah (Alldredge, Burlingame)
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Friedrich Schiller University Jena, Jena University Hospital, Jena, Germany (Rosendahl, Strauss); Department of Psychology, Brigham Young University, Provo, Utah (Alldredge, Burlingame)
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19
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Skeva R, Gregg L, Jay C, Pettifer S. Views of Practitioners and Researchers on the Use of Virtual Reality in Treatments for Substance Use Disorders. Front Psychol 2021; 12:606761. [PMID: 34093303 PMCID: PMC8175665 DOI: 10.3389/fpsyg.2021.606761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/27/2021] [Indexed: 01/04/2023] Open
Abstract
Virtual Reality Therapy (VRT) has been shown to be effective in treating anxiety disorders and phobias, but has not yet been widely tested for Substance Use Disorders (SUDs) and it is not known whether health care practitioners working with SUDs would use VRT if it were available. We report the results of an interview study exploring practitioners’ and researchers’ views on the utility of VRT for SUD treatment. Practitioners and researchers with at least two years’ experience delivering or researching and designing SUD treatments were recruited (n = 14). Interviews were thematically analyzed, resulting in themes relating to the safety and realism of VRT, and the opportunity for the additional insight it could offer to during SUD treatment. Participants were positive about employing VRT as an additional treatment for SUD. VRT was thought suitable for treating adults and people with mental health issues or trauma, provided that risks were appropriately managed. Subsequent relapse, trauma and over-confidence in the success of treatment were identified as risks. The opportunity VRT offered to include other actors in therapy (via avatar use), and observe reactions, were benefits that could not currently be achieved with other forms of therapy. Overall, VRT was thought to offer the potential for safe, realistic, personalized and insightful exposure to diverse triggering scenarios, and to be acceptable for integration into a wide range of SUD treatments.
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Affiliation(s)
- Rigina Skeva
- Department of Computer Science, Faculty of Science and Engineering, Advanced Interfaces-Visual Computing, University of Manchester, Manchester, United Kingdom
| | - Lynsey Gregg
- School of Health Sciences, Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Caroline Jay
- Department of Computer Science, Faculty of Science and Engineering, Information Management, University of Manchester, Manchester, United Kingdom
| | - Steve Pettifer
- Department of Computer Science, Faculty of Science and Engineering, Advanced Interfaces-Visual Computing, University of Manchester, Manchester, United Kingdom
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20
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Howard KA, Rennert L, Pericot-Valverde I, Heo M, Norton BL, Akiyama MJ, Agyemang L, Litwin AH. Utilizing patient perception of group treatment in exploring medication adherence, social support, and quality of life outcomes in people who inject drugs with hepatitis C. J Subst Abuse Treat 2021; 126:108459. [PMID: 34116813 DOI: 10.1016/j.jsat.2021.108459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/15/2021] [Accepted: 04/28/2021] [Indexed: 11/26/2022]
Abstract
People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV). Group treatment is a practical option for addressing barriers to treatment in this population. Prior research on group treatment has resulted in mixed conclusions about its effectiveness in addressing barriers to treatment. A patient's perception of the group environment may help to explain this variability. This study sought to explore the association between indicators of group treatment environment and improved outcomes in HCV-infected PWID. This secondary analysis of a randomized controlled trial exploring different models of treatment for HCV in a PWID population consisted of 42 participants randomized to the group treatment branch of the trial. Independent variables consisted of group sessions attended and group climate constructs of engagement, conflict, and avoidance. Dependent variables consisted of medication adherence, social support, and health-related quality of life. The study implemented generalized estimating equations to assess associations with the outcomes at the end of treatment. Factors indicative of group treatment environment were related to medication adherence and other barriers to health for HCV-infected PWID: social support and health-related quality of life. Perceptions of conflict or avoidance were associated with worse outcomes, while increased session attendance was generally associated with better outcomes. The study attests to the importance of examining group environment factors during treatment interventions. Although preliminary, the study provides specific indicators of treatment success for HCV-infected PWID and practical implications to improve patients' health outcomes and better tailor treatment to the patient.
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Affiliation(s)
- Kerry A Howard
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Lior Rennert
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Irene Pericot-Valverde
- Clemson University School of Health Research, Clemson, SC, USA; Department of Medicine, Prisma Health-Upstate, Greenville, SC, USA
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Brianna L Norton
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Matthew J Akiyama
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Linda Agyemang
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Alain H Litwin
- Clemson University School of Health Research, Clemson, SC, USA; Department of Medicine, Prisma Health-Upstate, Greenville, SC, USA; University of South Carolina School of Medicine Greenville, Greenville, SC, USA.
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21
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The Effectiveness of Acceptance-commitment Therapy and Emotion Regulation Training on Impulsivity and Distress Tolerance in
People with a History of Drug Addiction. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2021. [DOI: 10.52547/pcnm.11.2.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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Conversano C. The Psychodynamic Approach During COVID-19 Emotional Crisis. Front Psychol 2021; 12:670196. [PMID: 33897574 PMCID: PMC8062854 DOI: 10.3389/fpsyg.2021.670196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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23
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Janis RA, Burlingame GM, Svien H, Jensen J, Lundgreen R. Group therapy for mood disorders: A meta-analysis. Psychother Res 2021; 31:342-358. [PMID: 32930060 DOI: 10.1080/10503307.2020.1817603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022] Open
Abstract
The addition of group psychotherapy as a specialty by the APA in 2018 creates a need for rigorous empirical reviews of group treatments for specific disorders. We conducted a meta-analysis of randomized controlled trials (RCTs) that tested the effect of group psychotherapy for mood disorders, including depression and bipolar disorder, at posttreatment and follow-up time-points, as well as rates of recovery and attrition. Major databases were searched for RCTs of group treatment for depression and bipolar disorder published from 1990 to 2018, which identified 42 studies across both disorders. Random effects meta-analyses indicated that group therapy for depression produced superior outcomes compared to waitlist control (WLC) and treatment as usual (TAU) and equivalent outcomes to medication. Similarly, group therapy for bipolar disorder produced superior outcomes to TAU. Analyses of recovery rates were conducted for depression, producing similar results to the main outcome analyses. Rates of attrition did not differ between group and comparison conditions for either disorder. These findings support group therapy for treating depression and bipolar disorder, although further research is needed comparing group treatment for bipolar disorder to medication.
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Affiliation(s)
- Rebecca A Janis
- Department of Psychology, Pennsylvania State University, State College, PA, USA
| | | | - Hal Svien
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Jennifer Jensen
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Rachel Lundgreen
- Department of Psychology, Brigham Young University, Provo, UT, USA
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24
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Karsberg SH, Pedersen MU, Hesse M, Thylstrup B, Pedersen MM. Group versus individual treatment for substance use disorders: a study protocol for the COMDAT trial. BMC Public Health 2021; 21:413. [PMID: 33637061 PMCID: PMC7913269 DOI: 10.1186/s12889-021-10271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Alcohol and other drug use disorders contribute substantially to the global burden of illness. The majority of people with substance use disorders do not receive any treatment for their problems, and developing treatments that are attractive and effective to patients should be a priority. However, whether treatment is best delivered in a group format or an individual format has only been studied to a very limited degree. The COMDAT (Combined Drug and Alcohol Treatment) trial evaluates the feasibility, acceptability, and cost effectiveness of MOVE group (MOVE-G) treatment versus MOVE individual (MOVE-I) treatment in four community-based outpatient treatment centres in Denmark. METHODS A two-arm non-inferiority trial comparing MOVE-I (Pedersen et al., Drug Alcohol Depend 218:108363, 2020) with MOVE-G a combined group treatment for both alcohol use disorder and drug use disorder. The primary objective is to examine whether MOVE-G is non-inferior to MOVE-I in relation to abstinence from drug and/or alcohol, number of sessions received, and completion of treatment as planned. All participants will receive treatment based on cognitive behavioral therapy and motivational interviewing, vouchers for attendance and text reminders, as well as medication as needed (MOVE). Participants (n = 300) will be recruited over a one-year period at four public treatment centers in four Danish municipalities. A short screening will determine eligibility and randomization status. Hereafter, participants will be randomized to the two treatment arms. A thorough baseline assessment will be conducted approximately 1 week after randomization. Follow-up assessments will be conducted at 9 months post-randomization. In addition, patients' use of drugs and alcohol, and patients' wellbeing will be measured in all sessions. The main outcome measures are drug and alcohol intake at 9 months follow-up, number of sessions attended, and dropout from treatment. DISCUSSION The present study will examine the potential and efficacy of combined groups (patients with alcohol and drug disorders in the same group) versus individually based treatment both based on the treatment method MOVE (Pedersen et al., Drug Alcohol Depend 218:108363, 2020). TRIAL REGISTRATION ISRCTN88025085 , registration date 30/06/2020.
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Affiliation(s)
| | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
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25
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Gul M, Aqeel M. Acceptance and commitment therapy for treatment of stigma and shame in substance use disorders: a double-blind, parallel-group, randomized controlled trial. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1846803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mahvia Gul
- Department of psychology, Foundation University, Islamabad, Pakistan
| | - Muhammad Aqeel
- Department of psychology, Foundation University, Islamabad, Pakistan
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26
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Assayag N, Bonneh Y, Parush S, Mell H, Kaplan Neeman R, Bar-Shalita T. Perceived Sensitivity to Pain and Responsiveness to Non-noxious Sensation in Substance Use Disorder. PAIN MEDICINE 2020; 21:1902-1912. [PMID: 31782772 DOI: 10.1093/pm/pnz292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD. METHODS Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)-Revised. RESULTS The SUD group scored higher on the PSQ (P < 0.0001), BAS-R aversiveness (P < 0.0001), BAS-R-unpleasantness (P < 0.0001), and on the aftersensation of auditory aversiveness (P < 0.0001) and unpleasantness (P < 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P < 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ. CONCLUSIONS This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.
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Affiliation(s)
- Naama Assayag
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Yoram Bonneh
- School of Optometry and Vision Science, Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Shula Parush
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Haim Mell
- Yezreel Valley College, Afula, Israel
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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28
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Zeng X, Zhu S, Hou Y, Zhang P, Li L, Li J, Huang LF, Lewis SJ, Nussinov R, Cheng F. Network-based prediction of drug-target interactions using an arbitrary-order proximity embedded deep forest. Bioinformatics 2020; 36:2805-2812. [PMID: 31971579 PMCID: PMC7203727 DOI: 10.1093/bioinformatics/btaa010] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/24/2019] [Accepted: 01/17/2020] [Indexed: 11/14/2022] Open
Abstract
MOTIVATION Systematic identification of molecular targets among known drugs plays an essential role in drug repurposing and understanding of their unexpected side effects. Computational approaches for prediction of drug-target interactions (DTIs) are highly desired in comparison to traditional experimental assays. Furthermore, recent advances of multiomics technologies and systems biology approaches have generated large-scale heterogeneous, biological networks, which offer unexpected opportunities for network-based identification of new molecular targets among known drugs. RESULTS In this study, we present a network-based computational framework, termed AOPEDF, an arbitrary-order proximity embedded deep forest approach, for prediction of DTIs. AOPEDF learns a low-dimensional vector representation of features that preserve arbitrary-order proximity from a highly integrated, heterogeneous biological network connecting drugs, targets (proteins) and diseases. In total, we construct a heterogeneous network by uniquely integrating 15 networks covering chemical, genomic, phenotypic and network profiles among drugs, proteins/targets and diseases. Then, we build a cascade deep forest classifier to infer new DTIs. Via systematic performance evaluation, AOPEDF achieves high accuracy in identifying molecular targets among known drugs on two external validation sets collected from DrugCentral [area under the receiver operating characteristic curve (AUROC) = 0.868] and ChEMBL (AUROC = 0.768) databases, outperforming several state-of-the-art methods. In a case study, we showcase that multiple molecular targets predicted by AOPEDF are associated with mechanism-of-action of substance abuse disorder for several marketed drugs (such as aripiprazole, risperidone and haloperidol). AVAILABILITY AND IMPLEMENTATION Source code and data can be downloaded from https://github.com/ChengF-Lab/AOPEDF.
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Affiliation(s)
- Xiangxiang Zeng
- Department of Computer Science, College of Information Science and Engineering, Hunan University, Changsha, Hunan 410082, China
| | - Siyi Zhu
- Department of Computer Science, Xiamen University, Xiamen 361005, China
| | - Yuan Hou
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Pengyue Zhang
- Department of Biomedical Informatics, Ohio State University, Columbus, OH 43210, USA
| | - Lang Li
- Department of Biomedical Informatics, Ohio State University, Columbus, OH 43210, USA
| | - Jing Li
- Department of Computer and Data Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - L Frank Huang
- Division of Experimental Hematology and Cancer Biology, Brain Tumor Center, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Stephen J Lewis
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ruth Nussinov
- Computational Structural Biology Section, Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute at Frederick, Frederick, MD 21702, USA
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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29
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Lander LR, Zheng W, Hustead JD, Mahoney JJ, Berry JH, Marshalek P, Winstanley EL. Long-term treatment retention in West Virginia's comprehensive opioid addiction treatment (COAT) program. J Neurol Sci 2020; 411:116712. [PMID: 32058182 PMCID: PMC7409552 DOI: 10.1016/j.jns.2020.116712] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/22/2020] [Accepted: 01/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The United States continues to experience an opioid epidemic of unprecedented proportions despite FDA approval of life saving medications, such as buprenorphine. This paper describes a novel group-based buprenorphine treatment model and summarizes patient characteristics and treatment retention. This model, known as the Comprehensive Opioid Addiction Treatment (COAT) program, was developed in West Virginia, the epicenter of the opioid epidemic. METHODS Data on 454 patients actively enrolled in the COAT program were extracted from an administrative clinical data set and electronic medical records and analyzed using descriptive and quantitative analysis to determine long-term retention in treatment using frequencies and means. RESULTS The characteristics of the 454 patients are as follows: average age of 39, 53% female, predominantly white (94%) and Medicaid was the primary insurance provider (68%). Analysis of retention showed 37.8% of patents were retained less than one year and 14.7% were retained 10 or more years. Initiating treatment at a younger age was associated with long-term retention. CONCLUSION Opioid use disorder is a chronic relapsing disease and treatment models that retain patients long-term have the greatest benefit. The COAT model has been successful in retaining patients long-term in a rural setting where barriers to treatment are many.
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Affiliation(s)
- Laura R Lander
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States.
| | - Wanhong Zheng
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Jeremy D Hustead
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - James J Mahoney
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - James H Berry
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Patrick Marshalek
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Erin L Winstanley
- West Virginia University, School of Medicine, Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, West Virginia, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
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Morgan N, Daniels W, Subramaney U. An Inverse Relationship Between Alcohol and Heroin Use in Heroin Users Post Detoxification. Subst Abuse Rehabil 2020; 11:1-8. [PMID: 32021548 PMCID: PMC6955608 DOI: 10.2147/sar.s228224] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/22/2019] [Indexed: 11/23/2022] Open
Abstract
Background Given that fewer than 50% of countries provide Opioid Agonist Maintenance Therapies (OAMT), it is important to assess whether other substances act as a substitute for heroin in recovering heroin users who receive detoxification models of treatment. There is a dearth of prospective studies from low-and-middle-income countries evaluating these patterns of substance use. Methods 300 heroin users from the Gauteng province of South Africa were assessed on entry into inpatient detoxification and then followed-up 3 and 9 months after leaving treatment. Treatment consisted of 1 week of detoxification followed by 6-8 weeks of psychosocial therapy. We measured the overall changes in the prevalence of heroin, alcohol and other drug use at baseline and postrehabilitation. Comparison of these outcomes at enrolment, 3 months and 9 months was performed by a Generalised Estimating Equation (GEE) with the outcome as the dependent variable, observation point as the independent variable, and participant as the repeated measure. Injecting status and treatment completion were included as covariates. We also measured the individual pathways between heroin and alcohol use in the 210 participants that were seen at all three timepoints. Results Of the original cohort, 252 (84.0%) were re-interviewed at 3 months and 225 (75.0%) at 9 months. From baseline to 3 months, the proportion of past month heroin users decreased significantly to 65.5%; however, during this time, the proportion of past month alcohol users increased from 16.3% to 55.2% (p<0.0001). When assessing the pathways between heroin and alcohol use at an individual level, 55.4% (n-97) of those who were past month alcohol abstinent prior to rehabilitation were using alcohol at 3 months. From 3 to 9 months the proportion of heroin users increased to 72.4% (p<0.0001), and during this time, the proportion of alcohol users decreased. Conclusion After detoxification, a significant reduction in heroin use was observed with a concomitant increase in alcohol consumption. Under these circumstances, alcohol may have acted as a substitute for heroin in the short term. The initial reduction in heroin use 3 months postrehabilitation was followed by increased consumption 6 months later. This observation supports the need for interventions to prevent, monitor and treat high levels of alcohol use in heroin users post detoxification. The provision of OAMT is a necessary consideration to address both the risk of increased alcohol intake as well as the decline in heroin abstinence rates.
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Affiliation(s)
- Nirvana Morgan
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - William Daniels
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ugasvaree Subramaney
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Stevens M, Hubbard E, Leutwyler H. Tools You'll Have for the Rest of Your Life: A Qualitative Evaluation of a Fitness and Vocational Training Program for Substance Use Recovery. Subst Use Misuse 2020; 55:628-635. [PMID: 31782333 DOI: 10.1080/10826084.2019.1691599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Substance use disorder (SUD) is a problem within the United States and warrants attention. Despite growing concerns, there exists a research-to-practice gap in the implementation of evidence-based treatment strategies, particularly in the area of physical activity as a low-cost adjunct to treatment programs. Additionally, people with SUD often face challenges in re-entering the workforce, due to multiple factors including long absences, incarceration, or lack of experience and training. Method: Our group conducted focus group interviews with 26 participants to evaluate a 12-week fitness and health education program (Live Fitness) using grounded theory methodology. Live Fitness also served as a vocational training opportunity in collaboration with a large fitness facility and a residential SUD treatment program. Results: Three broad categories emerged from the focus group interviews: The program serves as an aide for recovery, confers physical benefits from participation, and helps participants feel that they are part of the community with a way to ease back into life. Conclusion: The results of our study suggest that treatment centers should invest attention and resources into guided fitness programs and that programs with an emphasis in vocational training should continue to be explored.
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Affiliation(s)
- Maria Stevens
- UCSF School of Nursing, Fitness SF, UCSF, San Francisco, California, USA
| | - Erin Hubbard
- UCSF School of Nursing, Fitness SF, UCSF, San Francisco, California, USA
| | - Heather Leutwyler
- UCSF School of Nursing, Fitness SF, UCSF, San Francisco, California, USA
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