Increasing Caregiver Engagement in Juvenile Drug Courts

Medical University of South Carolina (MUSC)

Status: Completed

Conditions: Substance Abuse

Treatments: Behavioral: Usual Drug Court Treatment; Behavioral: Caregiver Contingency Management + Usual Drug Court Treatment

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03051997

R01MD011322

Details and patient eligibility

About

The purpose of this study is to test a prize-based contingency management intervention for increasing caregiver engagement in juvenile drug court and adolescent drug treatment, and for achieving the ultimate outcomes of reduced substance use and delinquent behavior among drug court-involved youth.

Full description

Juvenile offenders with substance abuse problems represent a large and underserved population that is at high risk of deleterious outcomes and long-term costs for themselves, their families, communities, and society. Moreover, a high percentage of substance abusing adolescents continue to abuse substances and engage in criminal activity into adulthood. Although one juvenile justice intervention, Juvenile Drug Court (JDC), has emerged as a promising model for reducing drug use and delinquency among youth, its effectiveness is variable. Drug court outcomes may be compromised by the lack of caregiver engagement in JDC processes and adolescent drug treatment. Incorporating easily implemented evidence-based incentive programs in JDCs might improve their effectiveness in reducing youth drug use and re-offending. An extensive body of research supports the critical role that families play in the etiology, maintenance, and treatment of adolescent substance abuse. Although family-based interventions for adolescent substance abuse have been shown to be superior to other treatment modalities, parents must attend treatment and participate in meaningful ways for these superior outcomes to be realized. This randomized clinical trial will examine the efficacy of a prize-based contingency management intervention for increasing caregiver engagement (attendance and participation) in JDC and adolescent drug treatment. This caregiver contingency management intervention (CCM) will be compared with drug court treatment as usual (TAU). Increased caregiver participation is predicted to improve adolescent outcomes (decreased drug use and delinquent behavior). One hundred and eighty youth enrolled in JDC will be randomly assigned along with a parent/caregiver to TAU or CCM. Analyses will examine measures of caregiver engagement in JDC as well as youth substance use (urine drug screens) and delinquent activity. Results from this study will demonstrate the effectiveness of CCM procedures for increasing caregiver attendance and participation in JDC and adolescent drug treatment above and beyond drug court and usual care. If effective, the CCM approach may ultimately be used to enhance JDC outcomes, thereby reducing substance use and recidivism in juvenile offenders served by this promising juvenile justice intervention.

Enrollment: 195 patients

Sex: All

Ages: 13 to 89 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for youth:

• Involved in juvenile drug court
• Aged 13-17 years
• Youth is willing to participate
• At least one caregiver is willing to participate in the youth's treatment
• Fluent in English or Spanish

Exclusion Criteria for youth:

• Diagnosed with intellectual disability or autism spectrum disorder

Inclusion Criteria for caregivers:

• Caregiver of youth involved in juvenile drug court
• Caregiver is willing to participate
• Fluent in English or Spanish

Exclusion Criteria for caregivers:

• Diagnosed with intellectual disability or autism spectrum disorder

Inclusion Criteria for therapists:

• Providing substance abuse treatment to a youth in juvenile drug court

Exclusion Criteria for therapists:

• None

Inclusion Criteria for Juvenile Drug Court Personnel:

• Personnel working in juvenile drug court

Exclusion Criteria for Juvenile Drug Court Personnel:

• None

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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195 participants in 2 patient groups

Caregiver Contingency Management + Usual Drug Court Treatment

Experimental group

Description:

This group will receive a caregiver contingency management intervention plus the standard outpatient substance abuse treatment services provided at JDC.

Treatment:

Behavioral: Caregiver Contingency Management + Usual Drug Court Treatment

Usual Drug Court Treatment

Active Comparator group

Description:

This group will receive the standard outpatient substance abuse treatment services provided at JDC.

Treatment:

Behavioral: Usual Drug Court Treatment