Rosenblum Andrew, Magura Stephen, Kayman Deborah J, Fong Chunki
National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA.
Drug Alcohol Depend. 2005 Oct 1;80(1):91-103. doi: 10.1016/j.drugalcdep.2005.03.012.
Soup kitchens tend to serve residentially unstable adults characterized by a high prevalence of substance abuse. In this study, 289 soup kitchen guests who reported drug or alcohol problems were randomly assigned to information and referral (I&R) plus peer advocacy (peers encouraging subjects to participate in other services) (N = 139) or to an experimental 12-session motivational group (three sessions per week for 4 weeks) followed by a 36-session cognitive-behavioral group (three sessions per week for 12 weeks), plus I&R and peer advocacy. Mean age was 42; 82% male; 68% African-American; 81% unstable residence; 14% HIV+. Experimentals were significantly more likely than the controls to have increased their participation in some type of substance abuse intervention during the follow-up period. In addition, experimentals were significantly more likely than controls to have reduced both drinking and heavy drinking at follow-up (there was no difference between groups in reduction of cocaine use). Interaction analysis indicated that the experimental intervention was more effective for participants with higher rather than lower substance abuse severity at baseline. These results support the concept that motivationally enhanced group counseling, provided as a low-threshold outreach intervention, can help to increase participation in formal treatment and 12-step groups and to reduce substance abuse, particularly for those starting with high severity of use.
施粥所往往为居住不稳定的成年人提供服务，这些人普遍存在药物滥用问题。在本研究中，289名报告有毒品或酒精问题的施粥所访客被随机分配到信息与转介（I&R）加同伴倡导组（同伴鼓励受试者参与其他服务）（N = 139），或参加一个为期12节的动机激发小组（每周三节，共四周），随后参加一个为期36节的认知行为小组（每周三节，共十二周），外加I&R和同伴倡导。平均年龄为42岁；82%为男性；68%为非裔美国人；81%居住不稳定；14%感染艾滋病毒。在随访期间，实验组比对照组更有可能增加对某种药物滥用干预措施的参与度。此外，在随访时，实验组比对照组更有可能减少饮酒和重度饮酒（两组在减少可卡因使用方面没有差异）。交互分析表明，对于基线时药物滥用严重程度较高而非较低的参与者，实验性干预更为有效。这些结果支持了这样一个概念，即作为一种低门槛外展干预措施提供的动机增强型团体咨询，有助于增加对正规治疗和12步团体的参与度，并减少药物滥用，特别是对于那些开始时使用严重程度较高的人。
