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Promoting holistic well-being in addiction treatment: effects of the flourishing intervention in hospitalized
Juliane P de B Gonçalves1, Willyane de Andrade Alvarenga2, Richard G Cowden3
1Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Instituto Homero Pinto Vallada, São Paulo, SP, Brazil.
Objective:
To investigate the effects of the flourishing intervention (FI) vs. usual care (UC) on craving symptoms, mental health, and quality of life among hospitalized crack/cocaine users.
Methods:
A quasi-experimental mixed-methods study was conducted in a Brazilian psychiatric hospital. Participants were inpatients (n=119) undergoing detoxification and met ICD-10 criteria for crack/cocaine use disorders. The FI included 12 meetings (10 group sessions) on virtues and human values. Outcomes included crack/cocaine craving (primary), personal flourishing, depression, anxiety, impulsivity, quality of life, readiness to change, religiosity, and spirituality. Qualitative data were collected via semi-structured interviews.
Results:
Post-treatment, the FI group (n=79) had slightly lower scores on the Cocaine Craving Questionnaire-Brief (CCQ) measure (d = -0.21) compared to the UC group (n=40); the difference between the two groups on a Visual Analog Scale (VAS) of crack/cocaine craving (d = -0.03) was negligible. Within-group analyses for the FI group supported post-intervention improvements in craving (CCQ: d = -0.51; VAS: d = -0.61) and several secondary outcomes. Qualitative findings (n=30) highlighted the value of group therapy, motivation to quit drugs and to reach personal goals, positive emotions, and strengthening protective factors.
Conclusions:
This study provided preliminary evidence suggesting that the FI may be beneficial in reducing craving symptoms and promoting personal flourishing.
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