EFFECTIVENESS OF SOLUTION-FOCUSED APPROACH-BASED PSYCHOEDUCATION IN INDIVIDUALS DIAGNOSED WITH SUBSTANCE USE DISORDER: A RANDOMIZED CONTROLLED TRIAL

Overview

Substance use disorder (SUD) is a chronic, relapsing psychiatric disorder characterized by compulsive substance use despite harmful physical, psychological, and social consequences. It is associated with impaired psychosocial functioning, reduced self-efficacy, decreased psychological well-being, and a high risk of relapse. Although detoxification, pharmacotherapy, and routine psychoeducation constitute the standard components of treatment, many individuals continue to experience difficulties maintaining recovery after discharge. Therefore, there is an increasing need for psychosocial interventions that strengthen personal resources, promote recovery, and improve long-term treatment outcomes. The Solution-Focused Approach (SFA) is a strengths-based therapeutic model that emphasizes individuals' existing resources, successful experiences, future goals, and problem-solving abilities rather than focusing on deficits and pathology. Instead of exploring the causes of substance use, SFA encourages individuals to identify exceptions to their problems, recognize previous successes, build hope, and develop practical solutions that support behavioral change. Previous studies have suggested that solution-focused interventions may improve self-efficacy, motivation for change, coping skills, psychological well-being, and treatment engagement. However, evidence regarding the effectiveness of structured solution-focused psychoeducation programs among individuals with substance use disorder remains limited, particularly in randomized controlled trials conducted in inpatient addiction treatment settings. The purpose of this randomized controlled trial is to evaluate the effectiveness of a structured Solution-Focused Approach-based psychoeducation program on addiction profile, self-efficacy, and psychological well-being among individuals diagnosed with substance use disorder receiving inpatient treatment. The study was conducted between February and August 2025 at the Adult Detoxification Center of a Mental Health and Neurological Diseases Training and Research Hospital in Istanbul, Türkiye. Following completion of the detoxification phase and confirmation of eligibility criteria, participants were randomly assigned to either an intervention group or a control group. A total of 60 participants completed the study, with 30 individuals allocated to each group. Participants assigned to the intervention group received routine inpatient treatment in addition to a structured seven-session Solution-Focused Approach-based psychoeducation program developed by the researcher according to the principles of solution-focused therapy. Each session lasted approximately 60 to 90 minutes and was delivered twice weekly in small groups. The intervention included group orientation, identification of personal strengths and resources, goal setting, miracle questions, exception finding, scaling questions, solution-focused brainstorming, future-oriented planning, relapse prevention strategies, and termination activities. Throughout the intervention, participants were encouraged to identify successful coping experiences, develop realistic future goals, recognize their existing strengths, and enhance confidence in their ability to maintain recovery. Participants in the control group received routine inpatient addiction treatment only. Routine treatment consisted of detoxification, pharmacotherapy, therapeutic milieu interventions, psychoeducation delivered through the national SAMBA program, physician follow-up, psychiatric nursing care, family meetings, and other standard clinical services provided by the treatment center. Outcome assessments were performed before the intervention and immediately after completion of the psychoeducation program. Data were collected using the Addiction Profile Index (BAPI), the Self-Efficacy Scale, and the Psychological Well-Being Scale. Sociodemographic and clinical characteristics were also recorded. The primary objective of this study was to determine whether solution-focused psychoeducation improves psychological well-being and self-efficacy compared with routine inpatient treatment alone. Secondary objectives included evaluating changes in addiction profile and its subdimensions, particularly craving and safe behavioral characteristics. It was hypothesized that participants receiving the Solution-Focused Approach-based psychoeducation program would demonstrate greater improvements in psychological well-being and self-efficacy, together with reductions in craving and addiction-related problems, compared with participants receiving routine treatment alone. The findings of this study are expected to contribute to the development of evidence-based psychosocial nursing interventions for individuals with substance use disorder and to support the integration of recovery-oriented psychoeducation into routine addiction treatment services.