Achieving Drug and Alcohol Abstinence Among Recently Incarcerated Homeless Women: A Randomized Controlled Trial Comparing Dialectical Behavioral Therapy-Case Management With a Health Promotion Program

• Published in: Nursing research (New York) Vol. 66; no. 6; pp. 432 - 441
• Main Authors: Nyamathi, Adeline M, Shin, Sanghyuk S, Smeltzer, Jolene, Salem, Benissa E, Yadav, Kartik, Ekstrand, Maria L, Turner, Susan F, Faucette, Mark
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins Ovid Technologies 01-11-2017
• Subjects: Abstinence; Adult; Alcohol; Alcohol Drinking - psychology; Alcohol Drinking - therapy; Alcohol use; Behavior modification; Behavior Therapy - methods; Case management; Clinical trials; Cognitive Therapy - methods; Cooperative Behavior; Critical junctures; Drug abuse; Drugs; Effects; Evidence-based nursing; Ex-offenders; Female; Female offenders; Females; Follow-Up Studies; Health education; Health promotion; Homeless people; Homeless Persons - psychology; Humans; Imprisonment; Logistic Models; Mental depression; Middle Aged; Motivational Interviewing; Nursing; Offenders; Prisoners; Prisoners - psychology; Probation; Probationers; Professional-Patient Relations; Psychotherapy, Brief - methods; Reentry; Substance abuse; Substance abuse treatment; Treatment Outcome; Womens health; Young Adult; United States > US
• ISSN: 0029-6562; 1538-9847
• DOI: 10.1097/NNR.0000000000000249

Homeless female ex-offenders (homeless female offenders) exiting jail and prison are at a critical juncture during reentry and transitioning into the community setting.
The purpose of the study was to compare the effect of a dialectical behavioral therapy-case management (DBT-CM) program with a health promotion (HP) program on achieving drug and alcohol abstinence among female parolees/probationers residing in the community.
We conducted a multicenter parallel randomized controlled trial with 130 female parolees/probationers (aged 19-64 years) residing in the community randomly assigned to either DBT-CM (n = 65) or HP (n = 65). The trial was conducted in four community-based partner sites in Los Angeles and Pomona, California, from February 2015 to November 2016. Treatment assignment was carried out using a computer-based urn randomization program. The primary outcome was drug and alcohol use abstinence at 6-month follow up.
Analysis was based on data from 116 participants with complete outcome data. Multivariable logistic regression revealed that the DBT-CM program remained an independent positive predictor of decrease in drug use among the DBT-CM participants at 6 months (p = .01) as compared with the HP program participants. Being non-White (p < .05) and having higher depressive symptom scores (p < .05) were associated with lower odds of drug use abstinence (i.e., increased the odds of drug use) at 6 months.
DBT-CM increased drug and alcohol abstinence at 6-month follow-up, compared to an HP program.