Objective: Reduce drug and alcohol use and increase participation in formal substance abuse treatment programs and 12-step self-help groups such as Alcoholics Anonymous and Narcotics Anonymous.
Description: Service Outreach and Recovery (SOAR), a multicomponent program for indigent and residentially unstable clients, targets individuals at soup kitchens who acknowledge current or past substance abuse problems. The SOAR program sequentially delivers two manual-driven group counseling modules–Motivational Enhancement for Recovery (MER) followed by Education and Skills for Recovery (ESR)–to a group of 3-10 clients. The 12 one-hour sessions of MER and 36 one-hour sessions of ESR are delivered thrice weekly over a period of four months in a trailer at the conclusion of the soup kitchen’s lunchtime meal service. During MER sessions, participants learn about addiction, recovery, and readiness for change. ESR focuses on building skills for relapse prevention that include coping strategies for stress-provoking situations and painful emotions, methods to reduce the health risks associated with injection drug use (e.g., HIV infection), and identification and avoidance of emotional and situational triggers for drinking and drug use.
Another component of SOAR is the use of peer advocates, individuals who are either in recovery from substance abuse or were raised in drug- or HIV-affected families. Peer advocates renew friendly contact whenever SOAR clients return to the soup kitchen, assist the counselor at each group session, and maintain telephone and/or mail contact with each client between sessions. Peer advocates also help clients schedule appointments and complete required treatment forms, and they are available twice weekly to either escort clients to nearby self-help meetings or meet them at the meetings.
Modest incentives (i.e., food coupon books, public transit passes) are given to clients for attendance at each MER and ESR session, attendance at each self-help meeting, and enrollment in a formal treatment program. Clients also may win a raffle prize or small gift when they graduate from SOAR. There are minimal requirements for program enrollment and participation.
Results/Accomplishments/Evidence: Study findings indicated that SOAR participants reported fewer days of any alcohol use and fewer days of heavy drinking than comparison group participants. At follow-up, the percentage of individuals reporting participation in treatment or attendance (unescorted) at self-help meetings was higher in the SOAR group than the comparison group. After controlling for treatment and self-help participation at baseline, SOAR participants were more than 2.5 times as likely as comparison group participants to report having attended an outside treatment program or self-help meetings at follow-up.
At follow-up, the percentage of individuals attending self-help meetings (client-reported, unescorted attendance combined with log-documented, escorted attendance) was higher in the SOAR group than the comparison group. After controlling for self-help participation at baseline, SOAR participants were almost twice as likely as comparison group participants to have attended self-help meetings at follow-up. Among participants who reported not attending any self-help meetings at baseline, SOAR participants reported attending more self-help meetings than comparison group participants at follow -up.
Population of Focus: Black or African American, Hispanic or Latino, White, Adults, Homeless
Setting: Urban, Soup kitchen
Level of Intervention: Individual
Resources/Qualifications Needed:Funding from National Institutes of Health, 12-step self-help groups such as Alcoholics Anonymous and Narcotics Anonymous
Partners: Counselors from 12-step self-help groups such as Alcoholics Anonymous and Narcotics Anonymous, peer advocates
- Education and Skills for Recovery (ESR): http://www.ndri.org/ctrs/itsr/ESRMan.pdf
- Motivation Enhancement for Recovery (MER) Manual: http://www.ndri.org/ctrs/itsr/MERMan.pdf
Implementation: Andrew Rosenblum, Ph.D.
Research: Stephen Magura, Ph.D., CSW
National Development and Research Institutes, Inc.
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