Delinquency, Mental Health, Substance Abuse
Conditions
Brief summary
This study aims to address a serious public health problem (i.e., substance abusing adolescents) by testing the effectiveness of a promising substance abuse treatment implemented in a community-based treatment setting (CM-FAM, a family-based contingency management intervention) in comparison to usual treatment services.
Detailed description
The overriding purpose of the randomized trial is to examine the effectiveness of a promising and efficient outpatient treatment of adolescent substance abuse delivered in a community-based treatment setting. Although several evidence-based treatments of adolescent substance abuse are emerging, none have experienced widespread adoption in community settings. Thus, as noted by the Institute of Medicine (1998) more than a decade ago and reiterated more recently, a considerable science-service gap exists in regards to treatment of substance abuse in adolescents and adults. For the proposed study, 204 adolescents meeting diagnostic criteria for substance abuse or dependence will be randomized to either the Contingency Management-Family Engagement (CM-FAM) or Treatment as Usual (TAU) conditions. A multimethod, multirespondent approach will be used to track clinical outcomes at 3, 6, 9, 12, and 18 months post recruitment. Clinical level outcomes pertain to youth substance use, criminal behavior, mental health functioning, and key mediators of serious antisocial behavior in adolescents (e.g., self-control, parental supervision, association with deviant peers). In addition, the incremental cost of CM-FAM will be determined for use in cost effectiveness analyses. Aim 1: Over an 18-month post-recruitment follow-up, determine the relative effectiveness of CM-FAM vs. TAU in reducing adolescent participants' substance use, criminal activity (including incarceration), and mental health symptoms; and evaluate the cost effectiveness of CM-FAM in achieving these outcomes. Aim 2: Examine possible moderators and mediators of intervention effectiveness. Moderator variables will include youth demographic and clinical (e.g., co-occurring disorders) characteristics. Mediator variables will include measures of self-control, parenting, and association with deviant peers - constructs targeted by CM-FAM.
Interventions
BEHAVIORALContingency Management-Family Engagement
BEHAVIORALTreatment as Usual
Sponsors
Medical University of South Carolina
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Age of 12-17 years * Meeting criteria for substance use or abuse.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in youths' mental health functioning as measured by the Brief Problem Checklist | Youth baseline, 3, 6, 9, 12, & 18 months post-baseline |
| Change in youths' substance abuse frequency as measured by Urine Drug Screens and the Global Appraisal of Individual Needs Scale | Youth baseline, 3, 6, 9, 12, & 18 months post-baseline |
| Change in youths' delinquent behavior as measured by Juvenile Justice Archival Records and the Self-Report Delinquency Scale | Youth baseline, 3, 6, 9, 12, & 18 months post-baseline |
Secondary
| Measure | Time frame |
|---|---|
| Change in family functioning as measured by the Caregiver Supervision Scale, the Discipline Scale, and the Communication Form from the Pittsburgh Youth Study | Youth baseline, 3, 6, 9, 12, & 18 months post-baseline |
| Change in youths' peer relations as measured by the Peer Delinquency and Drug Activities Scales, the Conventional Activities of Peers Scale, and the Bad Friends Scale from the Pittsburgh Youth Study | Youth baseline, 3, 6, 9, 12, & 18 months post-baseline |
| Change in youths' self-control as measured by the Good Behavioral Self-Control and the Poor Behavioral Regulation Scales | Youth baseline, 3, 6, 9, 12, & 18 months post-baseline |
Other
| Measure | Time frame |
|---|---|
| Incremental costs associated with CM-FAM as measured by the Drug Abuse Treatment Cost Analysis Program | 6, 18, and 30 months following initiation of CM-FAM delivery |
| Change in therapists' perceptions of the functioning of their treatment facility as measured by the Organizational Readiness for Change Scale | Therapist baseline, 6, 12, 18, 24, & 30 months post-baseline |
| Change in youths' treatment duration and rates of completion as measured by clinic records | 6, 18, and 30 months following initiation of CM-FAM delivery |
Countries
United States
Outcome results
None listed