Adaptation of Community Reinforcement Approach for the Treatment of Drug Addiction

Muhammad Saghir

Status: Completed

Conditions: Substance Use Disorders; Comorbidities and Coexisting Conditions

Treatments: Behavioral: Indigenously Adapted CRA

Study type: Interventional

Funder types: Other

Identifiers

NCT06559631

Adaptation of CRA

Details and patient eligibility

About

Central idea of the study is to adapt a treatment program for drug addiction treatment indigenously and relapse prevention, and to establish its efficacy.

This study helps the society to have an evidence-based approach with proven efficacy to deal with drugs related issues in Pakistan along with minimizing the rate of relapse which is the major issue with current disease model for treatment of addiction in different rehabs within the country.

Present study's aim is to adapt culturally and islamically a robust treatment protocol: Reinforcement Approach (CRA) through randomized control trial to determine its efficacy in the field of drug addiction rehabilitation. Moreover, CRA is also be used with comorbid psychological illnesses. Because, in the treatment facilities disease model is currently prevailing which lacks empirical evidence, and they do not have proven efficacy.

Full description

In this study CRA is adapted and prepared as a protocol for residential treatment for drug addiction and drug induced psychosis as well. Intervention is applied to patients admitted to Islamabad Rehab Clinic (IRC). 90 days treatment plan is developed based on CRA interventions along with religious interventions. These religious interventions are based on Islamically Integrated psychotherapy. After discharge from the treatment every participant will be monitored for next 3 months through follow up session with patient and caregivers as well.

In CRA, face to face interaction is required for intervention including 8 sessions for focuses on the reality of client's social environment so that for learning real life opportunities could be focused as per client needs to enhance engagement and learning.

For internal motivation and involvement in CRA, adaptations were added to enhance CRA's effectiveness. There were two major adaptations in CRA to make it accord with the cultural relevant with the targeted population. First adaptation is based on religion Islam. It includes several sections, and these sections are adapted in CRA's counseling goals. In first section morality is being adapted with CRA, morality is about the Islamically integrated ways about hygiene, sleep, eating, clothes, meeting others, physical health, happiness and sadness related. Second section is related to internal framework of human psyche, which comprises of Cognition (Aql), Behavioral inclination (Nafs), Sprit (Ruh), Emotion (Ihsaas) and Heart (Qalb). In third section principle of change and tazkia e nafs. There are three stages in principle of change: 1.Inkishaf, 2. Itidal and 3. Itehad.

Second adaptation is about the effective coping skills related therapeutic intervention, which is comprises of four distinctive categories such as emotional management, interpersonal effectiveness: assertiveness, habit formation and relapse prevention counseling.

Enrollment: 59 patients

Sex: All

Ages: 16 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient admitted for treatment of drug addiction with or without comorbid psychological disorders.

Exclusion criteria

• Patient with no history of drug abuse.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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59 participants in 2 patient groups

Treatment Group

Experimental group

Description:

Experimental group will receive the indigenously adapted Community Reinforcement Approach based psychotherapeutic sessions after the completion of drugs related detoxification (after 21 days since hospitalization) for 90-120 days in residential treatment.

Treatment:

Behavioral: Indigenously Adapted CRA

Control Group: Treatment as usual

No Intervention group

Description:

This group will receive treatment as usual which includes detoxification of drugs, general counselling for drug addiction prevention, 12 steps program and life skills training. Duration of residential treatment is between 90-120 days.