A Novel Person-Centered Treatment Component for Substance Use Treatment
Condition: Substance Use Disorders; Depression; Bipolar Disorder; Psychosis; Personality Disorders
MeSH terms: Substance-Related Disorders; Bipolar Disorder; Personality Disorders
Study type: Interventional

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.
    

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.
    

Intervention name(s): Natural Recovery-Horticulture; Natural Recovery-Art/Music
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 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.; 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.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: substance use treatment; person-centered treatment; residential treatment outcomes; dual diagnosis; recovery model; psychosocial treatment