“Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention
Abstract Background Despite efficacy of medication for opioid use disorder, low-income, ethno-racial minoritized populations often experience poor opioid use disorder treatment outcomes. Peer recovery specialists, individuals with lived experience of substance use and recovery, are well-positioned t...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13011-023-00524-3 |
| _version_ | 1797865561156222976 |
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| author | Mary B. Kleinman Morgan S. Anvari Valerie D. Bradley Julia W. Felton Annabelle M. Belcher C. J. Seitz-Brown Aaron D. Greenblatt Dwayne Dean Melanie Bennett Jessica F. Magidson |
| author_facet | Mary B. Kleinman Morgan S. Anvari Valerie D. Bradley Julia W. Felton Annabelle M. Belcher C. J. Seitz-Brown Aaron D. Greenblatt Dwayne Dean Melanie Bennett Jessica F. Magidson |
| author_sort | Mary B. Kleinman |
| collection | DOAJ |
| description | Abstract Background Despite efficacy of medication for opioid use disorder, low-income, ethno-racial minoritized populations often experience poor opioid use disorder treatment outcomes. Peer recovery specialists, individuals with lived experience of substance use and recovery, are well-positioned to engage hard-to-reach patients in treatment for opioid use disorder. Traditionally, peer recovery specialists have focused on bridging to care rather than delivering interventions. This study builds on research in other low-resource contexts that has explored peer delivery of evidence-based interventions, such as behavioral activation, to expand access to care. Methods We sought feedback on the feasibility and acceptability of a peer recovery specialist-delivered behavioral activation intervention supporting retention in methadone treatment by increasing positive reinforcement. We recruited patients and staff at a community-based methadone treatment center and peer recovery specialist working across Baltimore City, Maryland, USA. Semi-structured interviews and focus groups inquired about the feasibility and acceptability of behavioral activation, recommendations for adaptation, and acceptability of working with a peer alongside methadone treatment. Results Participants (N = 32) shared that peer recovery specialist-delivered behavioral activation could be feasible and acceptable with adaptations. They described common challenges associated with unstructured time, for which behavioral activation could be particularly relevant. Participants provided examples of how a peer-delivered intervention could fit well in the context of methadone treatment, emphasizing the importance of flexibility and specific peer qualities. Conclusions Improving medication for opioid use disorder outcomes is a national priority that must be met with cost-effective, sustainable strategies to support individuals in treatment. Findings will guide adaptation of a peer recovery specialist-delivered behavioral activation intervention to improve methadone treatment retention for underserved, ethno-racial minoritized individuals living with opioid use disorder. |
| first_indexed | 2024-04-09T23:11:08Z |
| format | Article |
| id | doaj.art-bb381e7856f945d0af25c5fa85611942 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-04-09T23:11:08Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-bb381e7856f945d0af25c5fa856119422023-03-22T10:26:24ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2023-03-0118111210.1186/s13011-023-00524-3“Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retentionMary B. Kleinman0Morgan S. Anvari1Valerie D. Bradley2Julia W. Felton3Annabelle M. Belcher4C. J. Seitz-Brown5Aaron D. Greenblatt6Dwayne Dean7Melanie Bennett8Jessica F. Magidson9Department of Psychology, University of Maryland at College ParkDepartment of Psychology, University of Maryland at College ParkDepartment of Psychology, University of Maryland at College ParkCenter for Health Policy and Health Services Research, Henry Ford Health SystemDepartment of Psychiatry, University of Maryland School of MedicineDepartment of Psychology, University of Maryland at College ParkDepartment of Psychiatry, University of Maryland School of MedicineDepartment of Psychology, University of Maryland at College ParkDepartment of Psychiatry, University of Maryland School of MedicineDepartment of Psychology, University of Maryland at College ParkAbstract Background Despite efficacy of medication for opioid use disorder, low-income, ethno-racial minoritized populations often experience poor opioid use disorder treatment outcomes. Peer recovery specialists, individuals with lived experience of substance use and recovery, are well-positioned to engage hard-to-reach patients in treatment for opioid use disorder. Traditionally, peer recovery specialists have focused on bridging to care rather than delivering interventions. This study builds on research in other low-resource contexts that has explored peer delivery of evidence-based interventions, such as behavioral activation, to expand access to care. Methods We sought feedback on the feasibility and acceptability of a peer recovery specialist-delivered behavioral activation intervention supporting retention in methadone treatment by increasing positive reinforcement. We recruited patients and staff at a community-based methadone treatment center and peer recovery specialist working across Baltimore City, Maryland, USA. Semi-structured interviews and focus groups inquired about the feasibility and acceptability of behavioral activation, recommendations for adaptation, and acceptability of working with a peer alongside methadone treatment. Results Participants (N = 32) shared that peer recovery specialist-delivered behavioral activation could be feasible and acceptable with adaptations. They described common challenges associated with unstructured time, for which behavioral activation could be particularly relevant. Participants provided examples of how a peer-delivered intervention could fit well in the context of methadone treatment, emphasizing the importance of flexibility and specific peer qualities. Conclusions Improving medication for opioid use disorder outcomes is a national priority that must be met with cost-effective, sustainable strategies to support individuals in treatment. Findings will guide adaptation of a peer recovery specialist-delivered behavioral activation intervention to improve methadone treatment retention for underserved, ethno-racial minoritized individuals living with opioid use disorder.https://doi.org/10.1186/s13011-023-00524-3Peer recovery specialistBehavioral activationMethadoneOpioid use disorderHealth disparities |
| spellingShingle | Mary B. Kleinman Morgan S. Anvari Valerie D. Bradley Julia W. Felton Annabelle M. Belcher C. J. Seitz-Brown Aaron D. Greenblatt Dwayne Dean Melanie Bennett Jessica F. Magidson “Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention Substance Abuse Treatment, Prevention, and Policy Peer recovery specialist Behavioral activation Methadone Opioid use disorder Health disparities |
| title | “Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention |
| title_full | “Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention |
| title_fullStr | “Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention |
| title_full_unstemmed | “Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention |
| title_short | “Sometimes you have to take the person and show them how”: adapting behavioral activation for peer recovery specialist-delivery to improve methadone treatment retention |
| title_sort | sometimes you have to take the person and show them how adapting behavioral activation for peer recovery specialist delivery to improve methadone treatment retention |
| topic | Peer recovery specialist Behavioral activation Methadone Opioid use disorder Health disparities |
| url | https://doi.org/10.1186/s13011-023-00524-3 |
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