Department of Psychiatry, Federal University of São Paulo.
Elson S. Floyd College of Medicine, Washington State University.
Exp Clin Psychopharmacol. 2022 Oct;30(5):507-513. doi: 10.1037/pha0000467. Epub 2021 Apr 12.
Homeless substance users are particularly hard to treat. In this pilot study, we evaluated the acceptability and feasibility of incorporating Contingency Management (CM) into a public Abstinent-Contingent Housing (ACH) treatment program developed to treat currently homeless crack cocaine users. A total of 21 homeless crack cocaine users were randomized to receive 12 weeks of ACH alone (n = 9) or ACH plus CM (ACH + CM) (n = 12). Twelve treatment providers in the ACH treatment program were trained to deliver the CM intervention. CM was rated as relatively (41.7%) or very (58.3%) easy to understand and relatively (50%) or very (50%) easy to conduct by the ACH treatment providers. On a 10-point Likert scale, providers rated the importance of incorporating CM into public treatment programs for crack cocaine at M = 8.3 (SD = 2). Participants exposed to CM rated as relatively (33.3%) or very (66.7%) easy to understand. One hundred percent liked receiving the intervention "a lot," and 78.9% believed it helped them achieve and maintain crack cocaine abstinence. Finally, compared to the ACH condition, the ACH + CM condition was consistently associated with better treatment retention and cocaine use outcome measures, yelling small to large effect sizes. However, possibly due to the small sample size, most of these differences did not achieve statistical significance. CM was well integrated into the ACH treatment program and was well accepted by both the providers and participants, suggesting the feasibility of incorporating CM into a public treatment program for homeless crack cocaine users from low- and middle-income countries. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
无家可归的物质使用者特别难以治疗。在这项初步研究中，我们评估了将Contingency Management（CM）纳入为治疗目前无家可归的可卡因使用者而开发的公共 Abstinent-Contingent Housing（ACH）治疗计划的可接受性和可行性。共有 21 名无家可归的可卡因使用者被随机分配接受 12 周的 ACH 单独治疗（n = 9）或 ACH 加 CM（ACH + CM）治疗（n = 12）。ACH 治疗计划中的 12 名治疗提供者接受了提供 CM 干预的培训。ACH 治疗提供者对 CM 相对（41.7%）或非常（58.3%）容易理解，以及相对（50%）或非常（50%）容易进行的评价。提供者在 10 分制的 Likert 量表上对将 CM 纳入可卡因公共治疗计划的重要性进行了评分，M = 8.3（SD = 2）。接触过 CM 的参与者认为相对（33.3%）或非常（66.7%）容易理解。100%的人非常喜欢接受该干预，78.9%的人认为它有助于他们实现并保持可卡因戒断。最后，与 ACH 条件相比，ACH + CM 条件始终与更好的治疗保留和可卡因使用结果测量相关，从较小到较大的效应量大喊大叫。然而，可能由于样本量小，大多数这些差异没有达到统计学意义。CM 很好地融入了 ACH 治疗计划，得到了提供者和参与者的广泛接受，这表明将 CM 纳入来自中低收入国家的无家可归可卡因使用者的公共治疗计划是可行的。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
