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A Novel Person-Centered Treatment Component for Substance Use Treatment

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ClinicalTrials.gov Identifier: NCT02005367
Recruitment Status : Completed
First Posted : December 9, 2013
Last Update Posted : December 9, 2013
Sponsor:
Information provided by (Responsible Party):
Dr. Kathleen Decker, Hampton VA Medical Center

Brief Summary:
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.

Condition or disease Intervention/treatment Phase
Substance Use Disorders Depression Bipolar Disorder Psychosis Personality Disorders Behavioral: Natural Recovery-Horticulture Behavioral: Natural Recovery-Art/Music Not Applicable

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.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 643 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Outcome of a Novel Person-Centered Treatment Component for Substance Use Treatment
Study Start Date : June 2011
Actual Primary Completion Date : December 2011
Actual Study Completion Date : December 2011

Resource links provided by the National Library of Medicine


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.




Primary Outcome Measures :
  1. Treatment Completion [ Time Frame: Up to 150 days ]
    Treatment completion was defined as regular discharge from the program, which was between 1 and 150 days.


Secondary Outcome Measures :
  1. Treatment Retention [ Time Frame: up to 150 days ]
    Treatment retention was defined as the number of days in treatment, from 1-150 days.

  2. Satisfaction with program [ Time Frame: up to 150 days ]
    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.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • All patients enrolled in the residential substance use treatment program

Exclusion Criteria:

  • None

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02005367


Locations
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United States, Virginia
Hampton VAMC, Department of Mental Health & Behavioral Sciences
Hampton, Virginia, United States, 23667
Sponsors and Collaborators
Hampton VA Medical Center
Investigators
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Principal Investigator: Kathleen Decker, MD Hampton VAMC

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.

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Responsible Party: Dr. Kathleen Decker, Prinicipal Investigator, Hampton VA Medical Center
ClinicalTrials.gov Identifier: NCT02005367     History of Changes
Other Study ID Numbers: 2013-001
First Posted: December 9, 2013    Key Record Dates
Last Update Posted: December 9, 2013
Last Verified: December 2013

Keywords provided by Dr. Kathleen Decker, Hampton VA Medical Center:
substance use treatment
person-centered treatment
residential treatment outcomes
dual diagnosis
recovery model
psychosocial treatment

Additional relevant MeSH terms:
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Disease
Bipolar Disorder
Personality Disorders
Substance-Related Disorders
Pathologic Processes
Bipolar and Related Disorders
Mental Disorders
Chemically-Induced Disorders