Treatment for Psychological and Drug Abuse Problems
Condition: Substance Use Disorders
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      The purpose of the study is to evaluate methods to help people in substance abuse treatment
      receive better psychiatric care. Patients enrolled in the study will be offered three months
      of standard psychiatric treatment, which consists of weekly individual counseling and group
      counseling, as well as regular appointments with a psychiatrist. Patients will be randomly
      assigned to standard psychiatric care or standard psychiatric care plus voucher incentives.
      These incentives can be earned by successfully attending all scheduled psychiatric
      appointments each week. The investigators expect that patients in the voucher condition will
      attend more psychiatric sessions, which will lead to greater reductions in psychiatric
      distress.
    

Detailed description: 
      Male and female opioid-dependent patients at Addiction Treatment Services with any current
      psychiatric disorder (N = 100) will be randomly assigned to one of two psychiatric service
      conditions: 1) reinforced on-site integrated care (ROIC), with voucher incentives contingent
      on attending weekly psychiatric sessions; or 2) standard on-site integrated care (SOIC).
      Participants in both conditions will receive access to the same schedule and range of
      psychiatric and substance abuse treatment services. Participants will be assessed for
      3-months post-randomization to determine rates of service utilization and adherence to
      psychiatric care, changes in scope and severity of psychiatric and psychosocial problems, and
      rates of drug use and treatment retention. Positive findings would have considerable
      heuristic and health care policy and practice implications. The entire study, including
      dissemination of the major findings at a national meeting and submission of the first
      manuscript, is designed to be completed within 2-years.
    

Intervention name(s): Voucher Reinforcement; Standard Control
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Patients in this condition will be able to earn a voucher for each week that they have attended all scheduled psychiatric sessions. These sessions may include individual therapy appointments, group therapy appointments, or psychiatrist appointments. Each voucher will be worth $25, and can be exchanged for goods and services that will be purchased by a research assistant. The maximum amount of voucher earnings over the study is $300.; Patients assigned to this condition will be treated at ATS for psychological problems. They will be scheduled to participate in individual therapy sessions with a psychiatrist and with their substance abuse counselor. They will also be referred to attend group therapy one time per week. No voucher incentive will be offered in this condition.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Psychiatric adherence; Voucher incentives; Methadone treatment