First Step Program for Substance Use Disorders

This study examines whether a newly developed four-session psychosocial treatment program, called the First Step Program, can be delivered in real-world hospital settings to people receiving inpatient care for substance use disorders in Korea, and whether it shows early signs of benefit. The program combines motivational interviewing, acceptance and commitment therapy, and group activities, and is delivered twice a week over about two weeks (four 50-minute sessions). About 20 adults will take part at two psychiatric hospitals. Participants complete brief questionnaires and a short interview about their motivation to change, craving, engagement in valued living, and social support before the program, immediately before and after each session, within one week after the program ends, and again at 1 month and 3 months after completion. After the program, some participants also join a small group discussion (focus group interview) to share their experience of the program. Because this is a small, single-group preliminary (pilot) study without a comparison group, its primary purpose is to assess feasibility, that is, whether the program and the assessment approach work well enough, and to obtain preliminary effect and variability estimates to inform the design of a future large-scale randomized controlled trial.

Inclusion Criteria: * Adults aged 19 to 65 years who can understand the study purpose and procedures and provide written informed consent * Currently hospitalized (inpatient) * Able to communicate and complete questionnaires in Korean * Physically able to participate in program activities * Has completed detoxification treatment * Meets indication thresholds: DAST-10 score \>= 2, URICA-DO precontemplation or contemplation stage, and \>= 2 DSM-5 criteria Exclusion Criteria: * Cognitive impairment that precludes communication * Physical conditions that preclude program participation (e.g., musculoskeletal disorder, severe cardiopulmonary disease) * Acute psychotic symptoms or risk of self-harm or harm to others * At risk of disrupting group activities such that focus group participation is not feasible * Individuals who are inmates or incarcerated at screening are not enrolled; participants who become incarcerated after enrollment are withdrawn