Many American Indians must travel far distances to obtain substance abuse treatment, only to return home with minimal plan for aftercare counseling, and little support for their new-found sobriety. The difficulty in re-adjusting to home and work life within a new context of sobriety, while keeping a distance from substance-using friends, can cause isolation and undue stress. Without guidance through this difficult transition, the first casualties will be attention to self and vigilance against relapse-related behaviors. If access to continued care is difficult for newly sober clients (e.g., due to distance, or inconvenient hours), one alternative to ease their transition is to provide them with aftercare services through the telephone. Telephone coverage is typically low on southwestern Indian Reservations and calls into doubt the feasibility of providing telephone aftercare services to such areas. This study will determine 1) whether extending treatment through the telephone is feasible, 2) whether the clients and the counselors are satisfied with the approach, and 3) whether the execution of the approach can be carried out as planned, as well as 4) to pilot a much needed instrument to measure treatment outcomes among American Indians living on reservations. Currently, there is a dearth of treatment outcome measures or studies on reservation-based American Indians, a minority population with extremely high needs. Thirty clients, fifteen of whom will be females, will participate in this feasibility study when they discharge from an urban substance abuse treatment facility and return home to the reservation. They will be provided with six months of telephone aftercare services and followed up for research for the same amount of time. The phone calls for the aftercare contacts will revolve around the relapse prevention plan structured to the phases of the Developmental Recovery Model. To decrease clients' reliance on the telephone aftercare counselor, they will be encouraged to develop a supportive network using local entities such as the tribal alcohol and drug abuse program and self-help groups. If this study shows successful results, the stage is set for the next step - conducting a randomized experimental design testing the efficacy of telephone aftercare in extending therapeutic gains in abstinence, reduction of use, and functional improvements.
| Chong, Jenny; Herman-Stahl, Mindy (2003) Substance abuse treatment outcomes among American Indians in the Telephone Aftercare Project. J Psychoactive Drugs 35:71-7 |
