Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence
Open accessAbstract
Introduction Most treatment programs for alcohol dependence have prioritized alcohol abstinence as the primary treatment goal. However, abstinence-based goals are not always considered desirable or attainable by more severely affected populations, such as chronically homeless people with alcohol dependence. Because these individuals comprise a multimorbid and high-utilizing population, they are in need of more focused research attention that elucidates their preferred treatment goals. The aim of this secondary study was therefore to qualitatively and quantitatively document participant-generated treatment goals Methods Participants were currently or formerly chronically homeless individuals (N=31) with alcohol dependence who participated in a pilot of extended-release naltrexone and harm-reduction counseling. Throughout the treatment period, study interventionists elicited participants' goals and recorded them on an open-ended grid. In subsequent weeks, progress towards and achievement of goals was obtained via self-report and recorded by study interventionists. Conventional content analysis was performed to classify participant-generated treatment goals Results Representation of the three top categories remained stable over the course of treatment. In the order of their frequency, they included drinking-related goals, quality-of-life goals and health-related goals. Within the category of drinking-related goals, participants consistently endorsed reducing drinking and alcohol-related consequences ahead of abstinence-based goals. Quantitative analyses indicated participants generated an increasing number of goals over the course of treatment. Proportions of goals achieved and progressed towards kept pace with this increase Conclusions Findings confirmed hypotheses that chronically homeless people with alcohol dependence can independently generate and achieve treatment goals towards alcohol harm reduction and quality-of-life improvement.
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Harm reduction-related goal setting, such as reducing substance use or avoiding negative consequences, is often more common than sobriety goal setting, though far from all individuals report such goals.
“Harm reduction-related goal setting, such as reducing substance use or avoiding negative consequences, is often more common, though far from all individuals report such goals here as well (Collins et al., 2015; Fentress et al., 2021).”
From Harm reduction outcomes and practices in Housing First: A mixed-methods systematic review (2021) · cites this paper as Collins et al., 2015
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- Authors
- Collins, S. E., Grazioli, V. S., Torres, N. I., Taylor, E. M., Jones, C. B., Hoffman, G. E., Haelsig, L., Zhu, M. D., Hatsukami, A. S., Koker, M. J., Herndon, P., Greenleaf, S. M., & Dean, P. E.
- Affiliations
- University of Washington (US)
- Corresponding author
- Collins, Susan E.
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 45
- Pages
- 184-190
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC4452113
- OpenAlex
- W2038774592
- Cited by
- 43
- References
- 41
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 6 · 2016: 2 · 2015: 3 · 2014: 1
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (K22AA018384)
- National Institute on Drug Abuse
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- harm reduction, alcoholism, chronic homelessness, treatment goal setting, extended-release naltrexone, abstinence, quality of life, goal achievement
- MeSH terms
- Adult, Alcoholism, Counseling, Female, Goals, Ill-Housed Persons, Humans, Male, Middle Aged, Naltrexone, Narcotic Antagonists, Pilot Projects, Prospective Studies, Quality of Life, Temperance, Cohort Studies, Patient-Centered Care, Qualitative Research, Harm Reduction, Alcohol Abstinence
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