Development of a Community-Based Care and Rehabilitation Model for Individuals with Alcohol Use Disorders through the “Dhamma-Guided Recovery” Mechanism: A Case Study of Wat Pa Kao Hug-Chumchon Center, Na Chaluai District, Ubon Ratchathani Province.

Abstract

      This Action Research aimed to: 1) develop a community-based care and rehabilitation model for individuals with alcohol use disorders, and 2) evaluate its implementation outcomes at the Wat Pa Kao Hug-Chumchon Center, Non Sombun Subdistrict, Na Chaluai District, Ubon Ratchathani Province. The study received human research ethics approval from the Ubon Ratchathani Provincial Public Health Office (SSJ.UB 04.011). The contextual study comprised 440 residents across 191 households. Purposive and simple random sampling methods were used to select 30 key participants, including 10 individuals with alcohol use disorders, 9 healthcare personnel, 3 Buddhist monks, and 8 community leaders/village health volunteers (VHVs). Data collection instruments included Focus Group discussion logs, the ASSIST screening tool, household survey questionnaires, the Thai Mental Health Indicator (TMHI-15), and follow-up tracking logs (1st-7th sessions). The instruments demonstrated acceptable validity and reliability with an Item-Objective Congruence (IOC) of 0.80 and a Cronbach's Alpha coefficient of 0.82. The study followed the 3-phase PAOR cycle by Kemmis and McTaggart. Quantitative data were analyzed using descriptive statistics, the Wilcoxon Signed-Ranks Test for ASSIST score comparisons, and the Paired t-test for TMHI-15 score comparisons, while qualitative data underwent Content Analysis.

      The results revealed that, 1) The developed “Dhamma-Guided Recovery” model established a tripartite drive mechanism involving Buddhist monks, healthcare professionals, community leaders/VHVs, and former drinkers. The process initiated with Harm Reduction educational and preventive training for community members and youth, followed by a core 7-day, 6-night “Roo Dhamma” temple-based intervention camp (integrating health education, Dhamma/Satipatthana 4 principles, and vocational skills) and a 12-month follow-up process (“Nam-Noon-Jai”) over 7 sessions. 2) At the 12-month follow-up among the case-study group, daily high-risk drinking dropped to 0%, and average household alcohol-related expenditures significantly decreased from the community baseline of 62,610 THB/month to 3,500 THB/month. ASSIST risk scores decreased significantly (Z = -2.803, p < 0.05). Furthermore, mental health scores (TMHI-15) showed a statistically significant improvement (t = 4.12, p < 0.05), with 0% remaining below normal mental health levels. The community successfully established local social norms and safe spaces for sustainable social reintegration.