Multimedia Toolkits to Implement 12-Step Recovery Concepts in Group Counseling

Treatment Research Institute

Status: Completed

Conditions: Drug Abuse; Alcohol Abuse

Treatments: Behavioral: Multimedia 12-Step Toolkit; Behavioral: Treatment as Usual

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02333357

R01AA017867 (U.S. NIH Grant/Contract)

0905

Details and patient eligibility

About

This study is developing and testing a 12-step toolkit with five modules, training counselors to use them, and studying their frequency of use, desirability, effectiveness and patient outcomes. The toolkit includes counselor written guides, posters, client worksheets, engagement activities, and videos designed to be shown during substance abuse treatment group sessions to explain and encourage 12-step participation.

Full description

The study has three aims. Aim 1 involves the development of an evidence-based 12-step facilitation toolkit curriculum. Toolkit structure and content is grounded in theory and empirical findings, and incorporates feedback from 12-step facilitation experts and individuals with a history of substance abuse. Aim 2 consists of implementing the resulting five-module Toolkit in a multi-site randomized controlled trial using a pre-/post-Toolkit training design that includes 1- and 6-month post-training assessments. Group counselors employed at community-based outpatient and inpatient substance abuse treatment programs will be randomly assigned to a Toolkit or treatment-as-usual condition. Data obtained from audiotaped sessions will identify between group differences in counselor adherence to 12-step content and skillfulness. Additional data will be collected on counselor satisfaction, 12-step attitudes and beliefs, and 12-step knowledge, as well as on Toolkit acceptability, feasibility, and short-term sustainability. Aim 3 will determine whether exposure to the Toolkit curriculum results in stable 12-step involvement and decreased self-reported substance use among clients.

Enrollment: 3,483 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for Counselors:

• Over 18 years of age
• Employed at a participating substance abuse treatment facility
• Provide treatment in a group format

Exclusion Criteria for Counselors:

• At the time of the project they do not have primary responsibility for conducting at least three substance abuse group sessions per week
• Their therapy group is normally scheduled to run less than 50 minutes, or more than 150 minutes
• Unable to provide valid informed consent

Inclusion Criteria for Clients:

• Over 18 years of age
• Attending an observed group of a participating counselor
• (For participation in the Follow-Up Study/Aim 3 only) patients must endorse heavy drinking, alcohol-related difficulties, or poor prior 12-step participation

Exclusion Criteria for Clients:

• Unable to provide valid informed consent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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3,483 participants in 2 patient groups

Toolkit

Experimental group

Description:

Counselors randomized to the toolkit (TK) condition will receive a one to three hour standardized toolkit orientation that will include a description of the overall goal of the toolkit curriculum comprised of five modules, the purpose of each individual element of the toolkit, and an introduction to the toolkit teaching aids such as counselor guides, posters, and patient materials (hand-outs, sampling menus, worksheets, etc). TK counselor participants then conduct group treatment sessions using the toolkit materials with their patient participants.

Treatment:

Behavioral: Multimedia 12-Step Toolkit

Treatment as Usual

Active Comparator group

Description:

Counselors assigned to the Treatment as Usual (TAU) attention control condition complete a training that reviews the same five 12-step topics that are included in the toolkit, but they do not receive any toolkit materials. TAU counselor participants then conduct group treatment sessions on the 12-step topics without using toolkit materials.

Treatment:

Behavioral: Treatment as Usual