In this Issue: Working to End Homelessness among Veterans
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Homeless Veterans with substance use disorder (SUD) are vulnerable to treatment dropout, rendering them susceptible to relapse, while their continuation in outpatient care during their participation in VA housing leads to improved clinical outcomes. As VA moves toward a 'Housing First' paradigm, in which greater numbers of homeless Veterans will continue to use substances while in VA housing, the delivery of group motivational interviewing (GMI) will be important for initiating and maintaining their recovery, as well as enhancing their psychosocial integration (family and community life) and overall quality of life. This ongoing randomized controlled trial compares GMI to a Life Style Education Group (LSEG). In this study, 186 homeless and formally homeless Veterans in VA housing services (93 per treatment group), and with a diagnosis of alcohol or drug abuse/dependence, are randomly assigned to GMI or LSEG. Each treatment protocol consists of four sessions, with a booster session provided at two months after enrollment into the study. Veterans will be evaluated at one, three, and six months after treatment. Primary outcomes measured are treatment engagement and substance use behavior while additional measures include psychosocial integration, social support, community participation, and quality of life. This study began recruiting participants in the Fall of 2015. While recruitment remains ongoing, there are no findings as yet.
The cost of providing GMI within VA may be minimal, as it requires only a few staff to operate in a relatively short time (e.g., four sessions at 90 minutes each) with modest staff training (20 training hours). GMI has the potential to be offered to larger numbers of Veterans with SUDs, who are homeless and formally homeless and living in VA housing and would otherwise not receive this intervention.
Principal Investigator: Elizabeth Santa Ana, PhD, HSR&D's Charleston Health Equity and Rural Outreach Innovation Center (HEROIC), and the Ralph H. Johnson VA Medical Center, Charleston, SC.
Shorey R, Martino S, Lamb K, LaRowe S, and Santa Ana E. Change talk and relatedness in group motivational interviewing: a pilot study. Journal of Substance Abuse Treatment. April 1, 2015; 51:75-81.