The Development of Cognitive and Behavioral Modification Model for Drug Addicts with High-Risk Violent Behavior (SMI-V) in Khlong Luang Pathum Thani Province.

Abstract

      This participatory action research (PAR) aimed to develop a cognitive and behavioral modification model for substance use disorder patients with a high risk of violent behavior (SMI-V) and to examine the effectiveness of the developed model on attitudes toward violence, violent behaviors, and quality of life among substance use disorder patients. The study was conducted in three phases. Phase 1 involved a situational analysis of 94 substance use disorder patients with a high risk of violent behavior (SMI-V) in Khlong Luang District, Pathum Thani Province, and in-depth interviews with 15 community health network stakeholders. Phase 2 focused on developing the model based on findings from Phase 1 using the Appreciation–Influence–Control (AIC) participatory process and integrating the Cognitive Behavioral Therapy (CBT) approach, the CBTx concept, Case Management, and Peplau’s Interpersonal Relations Theory. Phase 3 evaluated the effectiveness of the model among 60 substance use disorder patients selected by purposive sampling and divided into an experimental group and a comparison group (30 participants per group). Research instruments included the developed cognitive–behavioral modification model, the Predictive Violence Severity Scale (PVSS), an attitude toward violence questionnaire, a violent behavior assessment, and a quality of life questionnaire. Data were analyzed using descriptive statistics, paired t-test, and independent t-test.

      The results showed that, after the intervention, the experimental group had significantly lower mean scores for attitudes toward violence than before the intervention (t=22.31, p< .01) and significantly lower than the comparison group (t=–21.44, p<.01). The experimental group also demonstrated significantly lower mean scores for violent behaviors than before the intervention (t=8.72, p<.01) and significantly lower than the comparison group (t = –6.55, p < .01). In addition, the experimental group had significantly higher mean scores for quality of life than before the intervention (t = –14.06, p < .001) and significantly higher than the comparison group (p<.001). These findings indicate that, after implementation of the developed model, the experimental group exhibited lower levels of violent attitudes and violent behaviors and a higher quality of life than the comparison group at a statistically significant level of .05.