Recovery Inspired Support Engagement (RISE) - ABSTRACT Support persons of loved ones with a substance use disorder are key components of recovery capital, especially at critical points in care such as transitioning from inpatient and residential substance use programs into the community. Having positive support systems to provide emotional and instrumental support to individuals living with addiction is associated with better recovery outcomes. However, historically, substance use interventions involve support persons (e.g., family, friends) in an ancillary manner rather than being the target of intervention, and successful implementation of individualized services for support persons is limited. Yet support persons experience significant negative impacts on their personal well-being (e.g., higher rates of depression, anxiety, lower quality of life) that strain relationships with their loved ones and weaken recovery capital (e.g., poor communication, lack of empathy, and stigma of substance use disorders). Addressing support person well-being is critical to address the exponential impact of substance use especially for those who are co-experiencing the transition from the most acute points of substance use care (inpatient and residential) to the community. Without bolstering services for support persons and their loved ones experiencing addiction, they are often left not knowing what to do, increasing vulnerability to ongoing stress, which is a predictor of substance use craving and relapse. Additionally, the support person’s ability to continue to help their loved one navigate substance use recovery is compromised. Thus, meeting the needs of support persons requires evidence-based interventions that are easy to implement, scale, and sustain that do not require clinical expertise to promote recovery across the social support system, including historically difficult to engage support persons (e.g., fathers, siblings, and adult children). To extend our preliminary data on support person interventions to promote addiction recovery, the present R61/R33 research project will test a highly accessible peer-to-peer delivered telehealth support person strategy, Invitation to Change (ITC), targeting support persons of loved ones with a substance use disorder stepping down from inpatient/residential substance use care to 1) conduct a pilot study of ITC, 2) conduct a randomized controlled trial of ITC + Treatment as Usual (TAU) compared with TAU to assess changes in support person well-being, social recovery capital, and the loved one’s substance use, and 3) identify implementation planning facilitators and barriers from clinicians/administrators/payers and understudied support persons (fathers, siblings, and adult children). Although ITC has been helpful to support persons in group settings, it is unknown whether 1-on-1 ITC is efficacious for support persons of loved ones experiencing addiction at the high-risk transition from inpatient and residential programs to outpatient community care. This R61/R33 will provide critical information to develop subsequent hybrid effectiveness-implementation trials to rapidly and sustainably implement peer-led ITC in routine care to enhance recovery outcomes.
