Susan E Collins

Susan E Collins
Washington State University | WSU · Department of Psychology

PhD

About

88
Publications
61,524
Reads
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4,367
Citations
Citations since 2016
26 Research Items
2938 Citations
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Introduction
I am a licensed clinical psychologist, Professor in the Department of Psychology at Washington State University, and Affiliate Professor in the University of Washington - School of Medicine. My research and clinical work focuses on the codevelopment and evaluation of harm-reduction interventions together with community stakeholders and people who use substances.
Additional affiliations
January 2009 - December 2012
University of Washington Seattle
January 2008 - December 2012
January 2004 - December 2008
Syracuse University

Publications

Publications (88)
Article
Full-text available
Background: Project-based Housing First (HF) programs provide immediate, permanent, low-barrier, nonabstinence-based supportive housing to chronically homeless people within a single housing project. Previous studies have shown project-based HF is associated with 6-month reductions in jail time (Larimer et al., 2009), and that people with criminal...
Article
Full-text available
Two-year alcohol use trajectories were documented among residents in a project-based Housing First program. Project-based Housing First provides immediate, low-barrier, nonabstinence-based, permanent supportive housing to chronically homeless individuals within a single housing project. The study aim was to address concerns that nonabstinence-based...
Article
The objective of this observational study was to identify multidimensional smoker profiles to aid the development of future tailored treatments for different smoker subtypes. Based on findings in the literature, it was hypothesized that smokers reporting higher levels of novelty seeking/hyperactivity, depressivity, and nicotine dependence would evi...
Article
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Prior studies with Native populations have highlighted concerns about the cultural acceptability of highly directive, Eurocentric approaches, such as cognitive behavioral therapy and 12-step programs in treating alcohol use disorder (AUD). When asked in a prior qualitative study how they would redesign AUD treatment, urban American Indian and Alask...
Article
Objective: People experiencing homelessness are disproportionately impacted by alcohol-related harm. Racially minoritized groups are disproportionately represented in the homeless population and are likewise disproportionately impacted by alcohol-related harm. Most alcohol outcome measures have not been adequately psychometrically studied in this...
Chapter
Alcohol use disorder is by far the most prevalent substance use disorder in the general population and is a major contributor to disease worldwide. Recovery from the disorder is a dynamic process of change, and individuals take many different routes to resolve their alcohol problems and seek to achieve a life worth living. Total abstention is not t...
Article
Two recent randomized controlled efficacy trials showed that harm-reduction treatment for alcohol use disorder (AUD)-or patient-driven treatment that does not require abstinence and instead supports decreased alcohol-related harm and improved quality of life (QoL)-is efficacious for adults experiencing homelessness and AUD. The present study provid...
Article
Full-text available
Background The rate of alcohol-related mortality in people experiencing homelessness and alcohol use disorder is high and necessitates accessible and effective treatment for alcohol use disorder. However, typical abstinence-based treatments do not optimally engage this population. Recent studies have shown that harm-reduction treatment, which does...
Article
Previous research has utilized survey and administrative data to document health problems among Housing First (HF) residents; however, little is known about residents' personal perspectives on their health. The purpose of this study was to utilize conventional content analysis to analyze health-related concerns among HF residents with histories of...
Article
Aims This secondary study characterized components of and engagement in the life‐enhancing alcohol‐management program (LEAP), which is resident‐driven housing first programming. Methods We used a process akin to conventional content analysis to operationalize the LEAP according to its component activities. We used generalized linear modeling to...
Article
People experiencing homelessness are disproportionately affected by alcohol use disorder (AUD). Abstinence-based treatment, however, does not optimally engage or treat this population. Thus, Harm Reduction Treatment for Alcohol (HaRT-A) was developed together with people with the lived experience of homelessness and AUD and community-based agencies...
Article
A 2‐arm, 6‐month, nonrandomized controlled pilot trial was conducted to test the initial effectiveness of the Life Enhancing Alcohol‐management Program (LEAP) as an adjunct to Housing First (HF; e.g., permanent supportive housing) on alcohol and quality‐of‐life (QoL) outcomes. The LEAP entails resident‐driven leadership opportunities, meaningful ac...
Article
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Objectives We evaluated a prebooking law enforcement assisted diversion (LEAD) program (i.e., initial diversion from the criminal justice system paired with harm-reduction case management and legal assistance to individuals with repeated, low-level drug or prostitution offenses) on criminal justice and legal system utilization and associated costs....
Article
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Background: Smoking prevalence and mortality is 5 times higher for the chronically homeless versus general population. Unfortunately, traditional smoking cessation treatment does not optimally engage this population. In a preliminary study, smokers experiencing chronic homelessness suggested providers avoid giving advice to quit and instead use a...
Article
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Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths tha...
Article
Background: Cigarette smoking is 5 times more prevalent among homeless individuals than in the general population, and homeless individuals are disproportionately affected by smoking-related morbidity and mortality. Homeless smokers report interest in changing their smoking behavior; however, established smoking cessation interventions are neither...
Article
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Background: Alcohol use disorders (AUDs) are more prevalent among people who are homeless than in the general population. Thus, homeless individuals experience disproportionately high levels of alcohol-related problems and associated publicly funded criminal justice and healthcare system utilization. Available treatment services, however, are not...
Article
Drug users and dealers frequently cycle through the criminal justice system in what is sometimes referred to as a “revolving door.” Arrest, incarceration and prosecution have not deterred this recidivism. Seattle’s Law Enforcement Assisted Diversion (LEAD) program was established to divert these individuals to case management and supportive service...
Article
Background: Despite their experience of substance-related harm, few socially marginalized alcohol and other drug (AOD) users access substance use treatment. Thus, identifying alternative approaches for this population is important. This program evaluation documented substance use and health-related quality of life (QoL) following exposure to such...
Article
Full-text available
For repeat drug offenders, homelessness, unemployment, and lack of access to legitimate income and benefits are obstacles to community integration and quality-of-life improvement. Seattle’s Law Enforcement Assisted Diversion (LEAD) is a collaborative, prebooking diversion program that provides individuals suspected of low-level drug and prostitutio...
Article
Full-text available
Engagement in religious and spiritual practices may be protective for homeless individuals with alcohol-related problems. However, little is known in this regard for urban-dwelling American Indians and Alaska Natives (AI/ANs) who have disproportionately high rates of homelessness and co-occurring alcohol use problems. Using secondary data from a no...
Article
Single-site Housing First (HF) is associated with reduced publicly funded service utilization and costs and alcohol-related harm for chronically homeless individuals with severe alcohol problems. Many residents, however, continue to experience alcohol-related problems after their move into single-site HF. Thus, it is necessary to explore areas for...
Article
Full-text available
This study is the first to document suicidality among chronically homeless people with alcohol problems (N = 134) and examine its trajectory following exposure to immediate, permanent, low-barrier housing (i.e., Housing First). Suicidal ideation, intent, plans, and prior attempts were assessed at baseline and during a 2-year follow-up. Baseline sui...
Article
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Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related conseq...
Chapter
Substance use disorders are common, and it is important to be able to track and treat in them primary care settings. This chapter reviews how a Collaborative Care team can share the assessment of substance use disorders related to alcohol, stimulants and opioids. This includes identifying chief complaints, commonly associated somatic and psychologi...
Article
Full-text available
Background: Alcohol use disorders (AUDs) are more prevalent among homeless individuals than in the general population, and homeless individuals are disproportionately affected by alcohol-related morbidity and mortality. Unfortunately, abstinence-based approaches are neither desirable to nor highly effective for most members of this population. Rec...
Article
Full-text available
Purpose – Chronic homelessness is a serious public health issue that places a strain on health-care and criminal justice systems. Typical housing models place requirements on chronically homeless individuals that are often experienced as insurmountable barriers to housing. Housing First (HF) models attempt to more effectively reach this population,...
Article
Chronically homeless individuals with alcohol dependence experience severe alcohol-related consequences. It is therefore important to identify factors that might be associated with reduced alcohol-related harm, such as the use of safer-drinking strategies. Whereas effectiveness of safer-drinking strategies has been well-documented among young adult...
Article
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Objective: Web-based personalized feedback interventions, particularly personalized normative feedback (PNF), are efficacious in improving college drinking outcomes; however, no personalized feedback interventions to date have provided college drinkers with feedback about their own decisional balance. This study tested the relative efficacy of a n...
Article
Twelve-step mutual-help groups (TMGs) are among the most available forms of support for homeless individuals with alcohol problems. Qualitative research, however, has suggested that this population often has negative perceptions of these groups, which has been shown to be associated with low TMG attendance. It is important to understand this popula...
Article
Full-text available
The decisional balance worksheet (DBW), an open-ended measure of motivation to change, may be used to record the perceived advantages and disadvantages of substance use as well as alternative behaviors. Recent findings have indicated that the open-ended DBW can be quantified to validly reflect college students' level of motivation to reduce their d...
Article
Introduction: Mindfulness-based treatments have received increasing interest and empirical support in the clinical psychology literature. There are, however, no studies to date that have systematically examined treatment enactment, which is the amount and type of home practice participants incorporate into their daily lives. Because treatment enac...
Article
Full-text available
Objective: Chronically homeless adults with severe alcohol problems are disproportionately burdened with health-care problems and are high utilizers of emergency medical services (EMS). Single-site Housing First (HF), which provides immediate, permanent, low-barrier, nonabstinence-based, supportive housing, has been associated with reduced publicl...
Article
Full-text available
Background: Abstinence-based alcohol interventions are minimally desirable to and effective for chronically homeless individuals with alcohol dependence who have multimorbidity and high publicly funded service utilization and associated costs. Lower-barrier, patient-centered combined pharmacobehavioral interventions may more effectively treat this...
Article
Full-text available
Importance Relapse is highly prevalent following substance abuse treatments, highlighting the need for improved aftercare interventions. Mindfulness-based relapse prevention (MBRP), a group-based psychosocial aftercare, integrates evidence-based practices from mindfulness-based interventions and cognitive-behavioral relapse prevention (RP) approac...
Article
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The current study describes the relative predictive power of descriptive norms (i.e., how much the target student believes referents "drink until they get drunk") and reflective injunctive norms (i.e., target student's perception of referents' approval of the target student drinking until drunk) across various reference groups. The aim of this stud...
Article
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Objectives: We studied housing retention and its predictors in the single-site Housing First model. Methods: Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005-2008) conducted in Seattle, Washington...
Article
Full-text available
The Housing First (HF) approach is a model of housing that entails the provision of immediate, permanent, low-barrier, supportive housing to chronically homeless individuals either in separate apartments within a larger community (known as scattered-site HF) or in a single building (known as project-based HF). One recent innovation is the applicati...
Article
Prior studies suggest a possible association of a promoter polymorphism in the ALDH1A1 gene ( ALDH1A1*2 ) with alcohol use or dependence. The aim of this study was to examine the association of ALDH1A1*2 with drinking behaviors in Asian young adults and to examine ALDH2 genotype as a potential moderator of these associations. Asian young adults (n...
Article
Objectives. Two-year alcohol use trajectories were documented among residents in a project-based Housing First program. Project-based Housing First provides immediate, low-barrier, nonabstinence-based, permanent supportive housing to chronically homeless individuals within a single housing project. The study aim was to address concerns that nonabst...
Article
Full-text available
Background: Housing first (HF) programmes provide low-barrier, nonabstinence-based, immediate, supportive and permanent housing to chronically homeless people who often have co-occurring substance-use and/or psychiatric disorders. Project-based HF programmes offer housing in the form of individual units within a larger housing project. Recent stud...
Article
Public service utilization data are often used as key outcomes in studies on homelessness. Although self-report data on these outcomes are accessible and cost-effective, various factors may affect retrospective recall in homeless populations. It is therefore necessary to establish validity of self-report to ensure the integrity of studies involving...
Article
Full-text available
This study tested the Theory of Planned Behavior (TPB) as a predictor of growth in risky college drinking over a 3-month period. As predicted by the TPB model, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would predict intention to engage in risky drinking, which would in turn predict growth in future risky...
Conference Paper
Background: Housing First [HF] programs provide low-barrier, nonabstinence-contigent housing for chronically homeless individuals. A Seattle-based HF intervention targeting individuals with severe alcohol problems has been shown to promote residents' health and reduce public costs; however, resident turnover has presented a challenge. Maintaining r...
Article
Full-text available
Cigarette smoking is the leading cause of preventable deaths worldwide. Long-term smoking cessation can drastically reduce people’s risk for developing smoking-related disease. The research literature points to a need for clearer operationalization and differentiation between smoking cessation and relapse prevention interventions and outcomes. That...
Article
Although readiness to change (RTC) is cited as a key mechanism underlying drinking behavior change, empirical evidence supporting RTC as a predictor of college drinking has been mixed. Considering methodological limitations of previous studies, the current aim was to conduct a more comprehensive test of longitudinal relationships between readiness...
Article
This study tested a new measure of motivation to change as a predictor of smoking behavior following smoking cessation treatment. Participants were adult, regular smokers (N=191) who took part in a randomized smoking cessation trial in southwestern Germany (Batra et al., 2010). Participants completed smoking and psychological self-report measures b...
Article
Full-text available
There is increasing interest in health interventions that incorporate genetic risk information. Although genetic feedback has been evaluated as an adjunct to smoking cessation interventions, its efficacy for reducing alcohol-related risks is unknown. The purpose of this study was to evaluate the feasibility, acceptability, and efficacy of a web-bas...
Article
Full-text available
The present study describes the development of the Mindfulness-Based Relapse Prevention Adherence and Competence Scale (MBRP-AC), a measure of treatment integrity for mindfulness-based relapse prevention (MBRP). MBRP is a newly developed treatment integrating core aspects of relapse prevention with mindfulness practices. The MBRP-AC was developed i...