Supporting data for "Developing a Relapse Prevention Model and Intervention for Residential Substance Use Treatment"

Background: Relapse rates following residential substance use disorder (SUD) treatment remain high, with the transition from structured residential care to community living representing a period of extreme vulnerability. Existing relapse prevention models and interventions inadequately address the unique ecological discontinuities and empirically-validated risk and protective factors specific to this critical transitional phase.Objectives: This multi-phase sequential study aimed to develop and preliminarily evaluate a relapse prevention model and intervention, specifically designed for individuals preparing for discharge from residential SUD treatment.Methods: The research employed a five-phase design: (1) systematic meta-analysis quantifying risk and protective factors for post-residential relapse; (2) scoping review mapping current relapse prevention interventions in residential settings; (3) theoretical development of a relapse prevention model synthesizing empirical findings; (4) operationalization into a manualized 8-session intervention protocol; and (5) single-group pilot study evaluating feasibility, acceptability, and preliminary effectiveness in a Hong Kong residential treatment center.Results: The meta-analysis identified potent risk factors including heavy pre-treatment substance use (OR=11.27), treatment non-completion (OR=3.86), and substance-using social networks (OR=3.15), alongside protective factors including positive therapeutic alliance (OR=3.33), employment (OR=2.96), and aftercare engagement (OR=1.73). The scoping review revealed critical gaps in transition-focused interventions. The Transitional Relapse Intervention and Prevention (TRIP) model integrates four evidence-based components: Connection and Commitment, Core Skills for Relapse Prevention, Pro-Recovery Social and Environment, and Structured Transition Planning and Management. The pilot study demonstrated high feasibility and acceptability, with significant pre-post improvements in psychological distress, self-efficacy, and adaptive coping strategies. At six-month follow-up, 56.7% of participants maintained abstinence, with those remaining abstinent showing significantly greater increases in self-efficacy and reductions in substance-use coping during the intervention.Conclusions: The TRIP framework addresses critical theoretical and practical gaps in relapse prevention for the post-residential transition period. Preliminary findings support its feasibility, acceptability, and potential effectiveness, warranting larger-scale randomized controlled evaluation. This research contributes a novel, empirically-grounded model that systematically targets high-impact factors specific to this vulnerable population and transition period.

研究背景：物质使用障碍（Substance Use Disorder, SUD）住院治疗后的复吸率始终居高不下，从结构化住院护理过渡至社区生活的阶段，属于患者复吸风险极高的脆弱期。现有复吸预防模型与干预手段，无法充分应对这一关键过渡阶段特有的独特生态环境断层，以及经实证验证的专属风险与保护因素。
研究目标：本多阶段序贯研究旨在开发一款专为即将完成SUD住院治疗、准备出院的患者设计的复吸预防模型与干预手段，并对其进行初步评估。
研究方法：本研究采用五阶段序贯设计：(1) 开展系统元分析，量化住院治疗后复吸的风险与保护因素；(2) 进行范围综述，梳理当前住院环境下的复吸预防干预手段现状；(3) 整合实证研究结果，构建复吸预防模型的理论框架；(4) 将理论模型转化为手册化的8次疗程干预方案；(5) 在香港某住院治疗中心开展单组预试验，评估该干预方案的可行性、可接受性与初步有效性。
研究结果：元分析结果显示，多项因素为复吸的显著风险因素：治疗前大量物质使用（比值比（Odds Ratio, OR）=11.27）、未完成治疗（OR=3.86）以及存在物质滥用社交圈（OR=3.15）；同时识别出的保护因素包括良好的治疗联盟（OR=3.33）、有稳定职业（OR=2.96）以及积极参与出院后照护（OR=1.73）。范围综述结果显示，当前针对过渡阶段的干预手段存在显著缺口。本研究构建的过渡性复吸干预与预防（Transitional Relapse Intervention and Prevention, TRIP）模型整合了四项循证核心模块：联结与承诺、复吸预防核心技能、康复导向社交与环境构建，以及结构化过渡规划与管理。单组预试验结果表明，该干预方案具备较高的可行性与可接受性，受试者在心理困扰、自我效能感与适应性应对策略方面均呈现出显著的干预前后改善。在6个月随访阶段，56.7%的受试者维持戒断状态；其中维持戒断的受试者在干预期间的自我效能感提升幅度与物质使用应对策略改善幅度均显著更高。
研究结论：TRIP模型填补了住院过渡阶段复吸预防领域的关键理论与实践空白。初步研究结果证实了该方案的可行性、可接受性与潜在有效性，后续需开展更大规模的随机对照试验进行验证。本研究开发了一款新颖的、基于实证的复吸预防模型，可系统性针对这一脆弱人群与过渡阶段的高影响风险因素进行干预。