Adolescent Outpatient and Continuing Care Study
AOCCS
3 other identifiers
interventional
320
1 country
1
Brief Summary
The purpose of this study was to evaluate the effectiveness and cost-effectiveness of two types of outpatient treatment with and without Assertive Continuing Care (ACC) for 320 adolescents with substance use disorders. Study participants were randomly assigned to one of four conditions: (a) Chestnut's Bloomington Outpatient Treatment (CBOP) without ACC; (b) CBOP with ACC; (c) Motivational Enhancement Therapy/Cognitive Behavior Therapy-7 session model (MET/CBT7) without ACC; and (d) MET/CBT7 with ACC. Based on prior quasi and experimental studies, the investigators hypothesized that MET/CBT would be more effective and cost-effective than CBOP in terms of increasing days abstinent and decreasing substance abuse problems. Additionally, the investigators hypothesized that the groups receiving ACC would have significantly better outcomes than the groups without ACC. Lastly, the investigators hypothesized that adding ACC to MET/CBT would be the most cost-effective option in terms of days abstinent.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for phase_3
Started Sep 2002
Longer than P75 for phase_3
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
September 1, 2002
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 1, 2008
CompletedStudy Completion
Last participant's last visit for all outcomes
December 1, 2008
CompletedFirst Submitted
Initial submission to the registry
June 23, 2011
CompletedFirst Posted
Study publicly available on registry
June 27, 2011
CompletedAugust 14, 2013
August 1, 2013
6.3 years
June 23, 2011
August 13, 2013
Conditions
Keywords
Outcome Measures
Primary Outcomes (4)
Change in Percentage of days abstinent from any alcohol and drugs
Baseline and 3, 6, 9, and 12 months post-baseline
Change in Days abstinent from alcohol alone
Baseline and 3, 6, 9, and 12 months post-baseline
Change in Substance use problems
Measured using the Substance Problem Scale of the Global Appraisal of Individual Needs
Baseline and 3, 6, 9, and 12 months post-baseline
Change in Recovery status
Being in recovery at the end of the study was defined as living in the community (vs. being incarcerated, or residing in inpatient treatment or other controlled environment) and reporting no past month substance use, abuse, or dependence problems at the 12 month interview. Urine samples were collected as described above in Section 2.4.2, and when an adolescent reported being in recovery but the urine test result suggested a false-negative self-report, data were re-coded to show the adolescent as not being in recovery.
12 months post-baseline
Study Arms (4)
CBOP without ACC
EXPERIMENTALCBOP with ACC
EXPERIMENTALMET/CBT 7 without ACC
EXPERIMENTALMET/CBT 7 with ACC
EXPERIMENTALInterventions
CBOP is an evidence-informed intervention that has developed over 20 years and been shaped by treatment research. The underlying theory of change is that the combination of multiple evidence-based and best-practice treatment components will increase the adolescent's desire to change, provide the necessary skills, and create an environment supportive for this change. The intervention is based on a manual and is primarily delivered through skill and therapy groups, combined with a limited number of family and individual sessions for treatment planning and progress reviews.
A manual-based 5-session MET/CBT model was supplemented with 2 family sessions. First was a family session to provide parents with an overview. Next was an individual adolescent MET session that focused on building rapport, explaining treatment, building motivation, and reviewing personalized feedback. In the third session, the therapist helped the adolescent complete a functional analysis of substance use and a personal goal worksheet. During sessions 4-6, the adolescent joined a closed group of 6 for 90-min CBT skills groups focusing on substance refusal skills, enhancing social support, planning for high-risk situations, and coping with relapse. The last session was a family session to review progress, relapse signs, and continuing care plans. Treatment lasted about 12 weeks.
ACC is a home-based continuing care approach that takes place over a 12-14 week period and has shown promise in a randomized clinical trial of adolescents discharged from residential treatment. Following an operant reinforcement and skills training model, ACC combines the Adolescent Community Reinforcement Approach and case management services to help adolescents and their caregivers engage in prosocial activities, skills, and needed community services during weekly home visits.
Eligibility Criteria
You may qualify if:
- years old
- met ASAM's (2001) Patient Placement Criteria for Level I outpatient treatment based on a substance abuse or dependence diagnosis and six dimensional admission criteria (i.e., severity of intoxication/withdrawal, physical health, emotional/behavioral health, treatment readiness, relapse potential, and recovery environment)
- attended an admission appointment
You may not qualify if:
- "stepped-down" from residential treatment and were therefore more severe than adolescents who entered outpatient treatment from the community
- were recommended only for individual counseling, as both outpatient treatment conditions had group components
- were a ward of the state
- did not have a parent/guardian present during admission to outpatient treatment
- appeared to have insufficient mental capacity to provide informed consent
- did not speak English with sufficient ability to understand study procedures and instruments
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Chestnut Health Systemslead
- National Institute on Drug Abuse (NIDA)collaborator
Study Sites (1)
Chestnut Health Systems
Bloomington, Illinois, 61701, United States
Related Publications (1)
Godley SH, Garner BR, Passetti LL, Funk RR, Dennis ML, Godley MD. Adolescent outpatient treatment and continuing care: main findings from a randomized clinical trial. Drug Alcohol Depend. 2010 Jul 1;110(1-2):44-54. doi: 10.1016/j.drugalcdep.2010.02.003. Epub 2010 Mar 9.
PMID: 20219293RESULT
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Susan H Godley, Ph.D.
Chestnut Health Systems
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- FACTORIAL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 23, 2011
First Posted
June 27, 2011
Study Start
September 1, 2002
Primary Completion
December 1, 2008
Study Completion
December 1, 2008
Last Updated
August 14, 2013
Record last verified: 2013-08