PhD Study : Harm reduction interventions to improve the health related quality of life of people with long-term alcohol dependence

Summary

Individuals with severe alcohol dependence face many acute, chronic, and social harms in their daily life. Abstinence based treatment can be a successful treatment option for some, for others, they may feel unable, or unwilling to consider a goal of abstinence or engage in structured treatment. As such, a harm reduction program of care should be considered [1-3].

There is robust evidence for harm reduction strategies to prevent the harms of illicit drug use (e.g. opiate substitution programs which may involve prescribed methadone or diamorphine), however, harm reduction interventions and models of care for long-term alcohol dependence are less clear [4]. One promising intervention is a Managed Alcohol Program (MAP) harm reduction intervention.

Mounting international studies [e.g. 5-6] show MAPs are effective in decreasing the adverse consequences of alcohol use without the requirement of abstinence in clients. Individual studies show we can retain patients in harm reduction initiatives like MAPs who may not be retained in a traditional treatment settings. Services provided by Managed Alcohol Programs can vary, often focus on the link between dependence and homelessness, and there is limited evidence on what works in the UK and Ireland, with some notable exceptions [e.g. 7].

This PhD program aims to understand acceptable, feasible harm reduction solutions to improve health related quality of life in those with long-term alcohol dependence.

This PhD project may comprise a number of different elements:

1) Developing an evidence base for interventions in the client group (with particular focus on trauma, sleep, pain, and addiction symptomatology). This is likely to be a realist review of peer-reviewed and grey literature of interventions for the client group to understand what works, for whom, and in what circumstances.

2) A mapping exercise of services for the client group across the UK and/or Ireland to understand what services are available both inside and outside the NHS, and if/how they are evaluated for effectiveness.

3) Secondary data analysis of alcohol treatment data to identify factors contributing to repeat relapse/treatment non-completion.

4) Semi-structured interviews with clients and/or other stakeholders to understand and inform recommendations for models of care.

The successful candidate will have a demonstrable interest in the health and wellbeing of the client group to be justified in application materials and demonstrated at interview.  This is an essential criterion over and above the standard entrance requirements. The Degree (or equivalent) qualification(s) must be in Psychology or a closely related discipline.

1. National Institute for Health and Care Excellence(NICE). Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. Available from https://www.nice.org.uk /guidance/cg115

2. National Institute for Health and Care Excellence(NICE). Alcohol-use disorders: diagnosis and management of physical complications. Available from https://www.nice.org.uk/guidance/cg100

3. Raistrick D, Heather N, Godfrey C: Review of the Effectiveness of Treatment for Alcohol Problems. 2006. Available from https://www.alcohollearningcentre.org.uk/Topics/Latest/Review-of-the-effectiveness-oftreatment-for-alcohol-problems

4. Marlatt GA, Witkiewitz K. Update on harm-reduction policy and intervention research. Annu Rev Clin Psychol. 2010; 6; 591-606.

5. Stockwell T, Buxton J, Duff C, Marsh D, MacDonald S, Michelow W, Richard K, Saewyc E, Hanson R, Cohen I. The British Columbia alcohol and other drug monitoring system: overview and early progress. Contemporary Drug Problems. 2009; 36 :459-484.

6. Duffin T. Past, Current and Future Perspectives on Service Responses to the Homeless Street Drinking Population of Dublin City Centre. MSc thesis submitted to the University of Dublin, Trinity College; 2006.

7. McCoy E, Oyston J, Ross-Houle K, Cochrane M, Bates G, Jones L, Whitfield M, McVeigh J. Evaluation of the Liverpool Rehabilitation, Education, Support & Treatment (REST) Centre. 2016. Liverpool: LJMU.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

• Experience using research methods or other approaches relevant to the subject domain
• Sound understanding of subject area as evidenced by a comprehensive research proposal
• A comprehensive and articulate personal statement

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

• Masters at 65%

Equal Opportunities

The University is an equal opportunities employer and welcomes applicants from all sections of the community, particularly from those with disabilities.

Appointment will be made on merit.

Funding and eligibility

The University offers the following levels of support:

Vice Chancellors Research Studentship (VCRS)

The following scholarship options are available to applicants worldwide:

• Full Award: (full-time tuition fees + £19,000 (tbc))
• Part Award: (full-time tuition fees + £9,500)
• Fees Only Award: (full-time tuition fees)

These scholarships will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance) and will provide a £900 per annum research training support grant (RTSG) to help support the PhD researcher.

Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Please note: you will automatically be entered into the competition for the Full Award, unless you state otherwise in your application.

Department for the Economy (DFE)

The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £19,237 (tbc) per annum for three years (subject to satisfactory academic performance).

This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.

• Candidates with pre-settled or settled status under the EU Settlement Scheme, who also satisfy a three year residency requirement in the UK prior to the start of the course for which a Studentship is held MAY receive a Studentship covering fees and maintenance.
• Republic of Ireland (ROI) nationals who satisfy three years’ residency in the UK prior to the start of the course MAY receive a Studentship covering fees and maintenance (ROI nationals don’t need to have pre-settled or settled status under the EU Settlement Scheme to qualify).
• Other non-ROI EU applicants are ‘International’ are not eligible for this source of funding.
• Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies. Further information on cost of living

Institute of Mental Health