Effectiveness of Assertive Continuing Care for Youth

Chestnut Health Systems

Status and phase: Completed; Phase 3

Conditions: Substance Use Disorders

Treatments: Behavioral: CM; Behavioral: UCC; Behavioral: ACC

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01085188

1018-1201

Details and patient eligibility

About

Following discharge from residential treatment 324 adolescents are randomly assigned to Assertive Continuing Care with and without motivational incentives in a 2 x 2 factorial design. Clinical outcomes are assessed at 3, 6, 9, and 12 months post discharge.

Enrollment: 342 patients

Sex: All

Ages: 12 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Met DSM-IV diagnostic criteria for abuse or dependence on alcohol or another drug in the past year
• Been between the ages of 12 and 18 at the time of residential admission; and (c) resided in one of ten Illinois counties targeted for the intervention

Exclusion criteria

• left residential treatment prior to the seventh day
• did not return to a target county at discharge
• showed evidence of cognitive impairment that interfered with understanding of study instruments, procedures, or the informed consent process
• were deemed dangerous to themselves or others during treatment
• were a ward of child protective services and inaccessible for the intervention
• met DSM-IV criteria for pathological gambling
• were discharged to the state department of corrections
• were already participating in a treatment study

Trial design

342 participants in 4 patient groups

Assertive Continuing Care (ACC)

Experimental group

Description:

Behavioral intervention comprised of the community reinforcement approach plus case management delivered in home and other community settings to youth and their caregivers.

Treatment:

Behavioral: UCC

Behavioral: ACC

Contingency Management (CM)

Experimental group

Description:

Using a prize drawing system (no, low, medium and large value prizes) with adolescents could earn escalating prize drawing opportunities by completing verifiable pro-social activities and providing negative urine test and breath alcohol test results.

Treatment:

Behavioral: CM

Behavioral: UCC

ACC + CM

Experimental group

Description:

This arm is the combination of arms 1 and 2.

Treatment:

Behavioral: CM

Behavioral: UCC

Behavioral: ACC

Usual Continuing Care (UCC)

Active Comparator group

Description:

UCC consists of a discharge recommendation to seek aftercare services at nearest treatment provider to where the patient lived. This service primarily consisted of outpatient group counseling.

Treatment:

Behavioral: UCC