OurRelationship-S: A Digital Relationship-Strengthening Program for Couples Experiencing Substance Misuse.

PROJECT SUMMARY This Phase I SBIR application seeks to meet NIDA’s desire for “Digital health technologies to address the social determinants of health in context of SUD”. Romantic relationships are a core social determinant of health that are widely neglected in SUD treatment and recovery services. Relationship conflict and distress are common presenting complaints in SUD treatment and can lead to a reoccurrence and/or increase in use of substances. Poor romantic relationships also interfere with successful SUD recovery. However, there are three critical barriers to recovery service providers’ ability to offer existing relationship-focused interventions: they’re not adjunctive, they’re too intensive, and they require extensive staff training. In this Phase I award, we will create OurRelationship for Substance use (Our-S) to meet the needs of recovery centers nationwide as an adjunctive, brief relationship program that does not require staff training. Our-S will be adapted from OurRelationship, a brief digital program that has been shown in multiple RCTs to improve not only relationship functioning but problematic alcohol use, behavioral health, physical health, and child functioning. This adaptation will occur through three aims. In Aim 1, Determine key market requirements and barriers to adoption for Our-S, we will conduct a series of focus groups with staff and administrators from recovery service providers as well as focus groups with individuals in SUD recovery services and their partners. In Aim 2, we will develop new and adapted content for Our-S based on information gleaned from the focus groups. This development will involve an iterative process of storyboarding, validating that the new content would meet the requirements, and building that new content. In Aim 3, we will test whether Our-S is user-friendly, endorsed by providers, and improves couple outcomes. One hundred four couples – referred from a variety of recovery services providers – will be randomized to either Our-S or a recovery service as usual (SAU). Intervention couples will be assessed repeatedly during the program about its ease of use and engagement. Couples in both groups will respond to measures of relationship outcomes and relational recovery capital – putative mechanisms of ultimate outcomes of substance misuse. Recovery providers will also report on whether Our-S is valuable, feasible, and appropriate. There is strong potential for the commercialization of an adjunctive, digital relationship intervention in the SUD recovery service industries. For example, NIDA’S and SAMHSA’s push towards Certified Community Behavioral Health Clinics (CCBHCs)1 (NOT-MH-22-1702) – supported by Medicaid expansion grants and other state funding – requires family-centered and family support services. Many CCBHCs do not offer family services themselves, instead relying on contracts with Designated Collaborating Organizations. Building on OurRelationship LLC’s existing nationwide services for the US military and EAPs, we expect Our-S can fill the needs of CCBHCs and other recovery services nationwide in a cost-effective way.