Mary A. Hatch , Elizabeth A. Wells , Tatiana Masters , Blair Beadnell , Robin Harwick , Lynette Wright , Michelle Peavy , Esther Ricardo-Bulis , Katerina Wiest , Carrie Shriver , John S. Baer
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This study sought to determine if the impact of treatment on sexual risk behavior can be increased.</p></div><div><h3>Methods</h3><p>In a nested 2 × 2 factorial repeated measures design, we examined outcomes of two interventions: training for counselors in talking to patients about sexual risk; and availability to both counselors and patients of a personalized feedback report based on patient self-report of sexual behavior. Counselors received either a brief, information-based, Basic Training, or a multi-session, skills-based Enhanced Training. Their patients completed an audio-assisted computerized assessment of sexual behavior and received either No Feedback or a Personalized Feedback Report (PFR). Four hundred seventy six patients participated. Patient follow-up occurred 3- and 6-months postbaseline. Primary patient outcome measures were Number of Unsafe Sex Occasions (USO) and whether patients reported talking about sex in counseling sessions (Discussed Sex), both in the past 90 days. Secondary outcomes included Number of Sexual Partners, Sex Under the Influence of Substances, and Perceived Condom Barriers.</p></div><div><h3>Results</h3><p>Patients of Enhanced-condition counselors compared to those of Basic-condition counselors were more likely to report talking about sex with their counselor at 6-month follow-up. Personalized feedback also increased the likelihood of reporting counselor discussions at 6-month follow-up. Neither the training nor the feedback condition affected USO, Number of Partners, or Sex Under the Influence.</p></div><div><h3>Discussion</h3><p>We discuss why these two interventions apparently altered counselor-patient communication about sexual risk behavior without affecting the behavior itself.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"140 ","pages":"Article 108826"},"PeriodicalIF":3.7000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A randomized clinical trial evaluating the impact of counselor training and patient feedback on substance use disorder patients' sexual risk behavior\",\"authors\":\"Mary A. Hatch , Elizabeth A. Wells , Tatiana Masters , Blair Beadnell , Robin Harwick , Lynette Wright , Michelle Peavy , Esther Ricardo-Bulis , Katerina Wiest , Carrie Shriver , John S. Baer\",\"doi\":\"10.1016/j.jsat.2022.108826\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span>High risk sex—such as sex with multiple partners, condomless sex, or transactional or commercial sex—is a risk factor in individuals with substance use disorders (SUDs). SUD treatment can reduce sexual risk </span>behavior, but interventions to reduce such behavior in this context have not been consistently effective. This study sought to determine if the impact of treatment on sexual risk behavior can be increased.</p></div><div><h3>Methods</h3><p>In a nested 2 × 2 factorial repeated measures design, we examined outcomes of two interventions: training for counselors in talking to patients about sexual risk; and availability to both counselors and patients of a personalized feedback report based on patient self-report of sexual behavior. Counselors received either a brief, information-based, Basic Training, or a multi-session, skills-based Enhanced Training. Their patients completed an audio-assisted computerized assessment of sexual behavior and received either No Feedback or a Personalized Feedback Report (PFR). Four hundred seventy six patients participated. Patient follow-up occurred 3- and 6-months postbaseline. Primary patient outcome measures were Number of Unsafe Sex Occasions (USO) and whether patients reported talking about sex in counseling sessions (Discussed Sex), both in the past 90 days. Secondary outcomes included Number of Sexual Partners, Sex Under the Influence of Substances, and Perceived Condom Barriers.</p></div><div><h3>Results</h3><p>Patients of Enhanced-condition counselors compared to those of Basic-condition counselors were more likely to report talking about sex with their counselor at 6-month follow-up. Personalized feedback also increased the likelihood of reporting counselor discussions at 6-month follow-up. Neither the training nor the feedback condition affected USO, Number of Partners, or Sex Under the Influence.</p></div><div><h3>Discussion</h3><p>We discuss why these two interventions apparently altered counselor-patient communication about sexual risk behavior without affecting the behavior itself.</p></div>\",\"PeriodicalId\":17148,\"journal\":{\"name\":\"Journal of Substance Abuse Treatment\",\"volume\":\"140 \",\"pages\":\"Article 108826\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2022-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Substance Abuse Treatment\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0740547222001088\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Substance Abuse Treatment","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0740547222001088","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
A randomized clinical trial evaluating the impact of counselor training and patient feedback on substance use disorder patients' sexual risk behavior
Introduction
High risk sex—such as sex with multiple partners, condomless sex, or transactional or commercial sex—is a risk factor in individuals with substance use disorders (SUDs). SUD treatment can reduce sexual risk behavior, but interventions to reduce such behavior in this context have not been consistently effective. This study sought to determine if the impact of treatment on sexual risk behavior can be increased.
Methods
In a nested 2 × 2 factorial repeated measures design, we examined outcomes of two interventions: training for counselors in talking to patients about sexual risk; and availability to both counselors and patients of a personalized feedback report based on patient self-report of sexual behavior. Counselors received either a brief, information-based, Basic Training, or a multi-session, skills-based Enhanced Training. Their patients completed an audio-assisted computerized assessment of sexual behavior and received either No Feedback or a Personalized Feedback Report (PFR). Four hundred seventy six patients participated. Patient follow-up occurred 3- and 6-months postbaseline. Primary patient outcome measures were Number of Unsafe Sex Occasions (USO) and whether patients reported talking about sex in counseling sessions (Discussed Sex), both in the past 90 days. Secondary outcomes included Number of Sexual Partners, Sex Under the Influence of Substances, and Perceived Condom Barriers.
Results
Patients of Enhanced-condition counselors compared to those of Basic-condition counselors were more likely to report talking about sex with their counselor at 6-month follow-up. Personalized feedback also increased the likelihood of reporting counselor discussions at 6-month follow-up. Neither the training nor the feedback condition affected USO, Number of Partners, or Sex Under the Influence.
Discussion
We discuss why these two interventions apparently altered counselor-patient communication about sexual risk behavior without affecting the behavior itself.
期刊介绍：
The Journal of Substance Abuse Treatment (JSAT) features original reviews, training and educational articles, special commentary, and especially research articles that are meaningful to the treatment of alcohol, heroin, marijuana, and other drugs of dependence. JSAT is directed toward treatment practitioners from all disciplines (medicine, nursing, social work, psychology, and counseling) in both private and public sectors, including those involved in schools, health centers, community agencies, correctional facilities, and individual practices. The editors emphasize that JSAT articles should address techniques and treatment approaches that can be used directly by contemporary practitioners.
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