Dynamic Multilevel Processes of Recovery in Therapeutic Communities in Mexico (DICO Model)

Comprehensive Behavioral Community Dynamics (DICO): A Prospective Longitudinal Study of Multilevel Community Processes in Therapeutic Communities for Substance Use Treatment in Mexico

This study aims to develop and empirically evaluate the Dinámica Integral Conductual Comunitaria (DICO) model, a multilevel framework that conceptualizes recovery from substance use disorders as a dynamic process emerging from the interaction between individual behavioral variables, social contingencies, and community-level factors within therapeutic communities in Mexico.

A prospective longitudinal design with intensive repeated measures will be implemented over 8 to 12 weeks. Data will be collected using ecological momentary assessment (EMA), psychometric instruments, behavioral records, and semi-structured interviews.

The study seeks to model recovery trajectories as nonlinear dynamic systems, identifying critical transitions, instability patterns, and contextual moderators associated with treatment adherence and relapse risk.

The study integrates three analytical levels:

1. Individual behavioral processes (e.g., craving, psychological flexibility)
2. Community-level dynamics (e.g., cohesion, reinforcement contingencies)
3. Cultural-contextual factors relevant to Mexican therapeutic communities

Quantitative data will be collected through high-frequency EMA and longitudinal assessments, enabling the estimation of dynamic parameters using nonlinear modeling techniques (e.g., differential equations, network analysis).

Qualitative data from semi-structured interviews will provide contextual interpretation of observed behavioral trajectories and system transitions.

The study does not involve manipulation or assignment to interventions; it is designed to observe naturally occurring processes within residential treatment settings.

Inclusion Criteria:

• Adults aged 18 years or older
• Currently enrolled in a residential therapeutic community for substance use treatment
• Minimum stay of at least 7 days prior to baseline assessment
• Ability to understand and provide informed consent
• Expected availability for participation during the 8-12 week follow-up period

Exclusion Criteria:

• Acute psychotic symptoms or severe psychiatric decompensation that interferes with participation
• Severe cognitive impairment limiting comprehension of study procedures
• Current medical instability requiring immediate external intervention
• Refusal to participate in any component of the study