Research on Outpatient Adolescent Treatment for Comorbid Substance Use and Internalizing Disorders

Study Overview
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Brief Summary
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Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth range from 25% up to 82%, and youths with a dual diagnosis are more than twice as costly to treat compared to those with no comorbidity. The applicant principal investigator recently completed a pilot project funded by the National Institute on Drug Abuse focused on developing and piloting a psychosocial treatment specifically for youth presenting for outpatient treatment with co-occurring substance use and internalizing (i.e., mood and/or anxiety) problems. Results were promising with the experimental group exhibiting significantly less substance use and more rapid reductions in anxiety and depressive symptoms compared to the control group. The proposed research is a randomized clinical trial (RCT) to compare the experimental treatment (OutPatient Treatment for Adolescents; OPT-A) to an active placebo on key clinical indices from pre-treatment through 18 months. The proposed RCT (n = 160) employs the treatment manual, quality assurance protocol, and therapist training protocol developed and successfully tested in the pilot study, to evaluate the efficacy of OPT-A for youth referred to outpatient treatment of co-occurring substance use and internalizing problems. The following outcomes will be evaluated: drug use; mental health; behavioral, school, peer, and family functioning; and consumer satisfaction. The intervention addresses one of the more prevalent and most challenging, costly, and understudied presenting problems among adolescent outpatients. If successful, this research could provide a considerable contribution in the treatment field for youth with co-occurring substance use and internalizing disorders.

Official Title
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Stage II Research on Outpatient Treatment for Adolescents With Comorbidity

Conditions
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Substance-Related Disorders, Depressive Disorder, Anxiety Disorder

Intervention / Treatment
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* Behavioral: OutPatient Treatment for Adolescents (OPT-A)
* Behavioral: Treatment As Usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 10 to 17 years of age Residing with at least one adult caregiver who serves as a parent figure In need of treatment for a Substance Abuse or Dependence Disorder In need of treatment for an Axis I Mood Disorder and/or Anxiety Disorder Exclusion Criteria: Pervasive Developmental Disorder Active Psychotic Disorder Severe or profound mental retardation

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: OPT-A<br>OPT-A is an outpatient family-based treatment for co-occurring substance use and internalizing disorders | Behavioral: OutPatient Treatment for Adolescents (OPT-A)<br> <br> |
| Active Comparator: Treatment as Usual<br>Treatment as usual in a community based mental health center | Behavioral: Treatment As Usual<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Substance use |  | baseline and 1-, 2-, 3-, 6-, 12-, and 18-month follow-up | 
| Mental Health |  | baseline and 1-, 2-, 3-, 6-, 12-, and 18-month follow-up |