Cost Effective Treatment for Dually Diagnosed Homeless

Study Overview
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Brief Summary
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This randomized controlled trial examined whether an abbreviated treatment using abstinence contingency management for housing and work/training (CM, n=103) with cocaine dependent, non-psychotic, dually diagnosed homeless persons, would show non-inferior outcomes compared to the full treatment (CM+, n=103). It was hypothesized that CM+ would show superior abstinence and retention outcomes, but that CM, with components derived from previously effective behavioral day treatment, would obtain non-inferior outcomes, defined as 75% or more of those observed for the full treatment (CM+) during active treatment months 1-6. The CM+ included all CM components but added behavioral day treatment that included voucher reinforcement of $7.50-15.00, for objective weekly therapeutic goal attainment in five domains of functioning: drug dependence, homelessness, unemployment, non-drug related recreational activities, and behavioral, health, or mental health problems. Abstinence was assessed by observed urine specimen collection and weekly testing weeks 1-52, and randomly, bi-monthly for months 13-18. Abstinence, homelessness, employment and other outcomes were also assessed at baseline, 2, 6, 12, and 18 months.

Official Title
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Cost Effective Treatment for Dually Diagnosed Homeless

Conditions
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Cocaine Dependence, Mental Disorder, Homelessness, Unemployment

Intervention / Treatment
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* Behavioral: contingency management and behavioral day treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: McKinney Act criteria for homelessness; DSM IV diagnosis for Cocaine Dependence; self-reported use within the last 2 weeks; psychological distress indicated by score of 70 on 1 or more Brief Symptom Inventory scales; willingness to participate; no plans to move from Birmingham area for 18 months; - Exclusion Criteria: cognitive impariment precluding informed consent; requiring immediate inpatient medical treatment

Ages Eligible for Study
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Minimum Age: 18 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

| Intervention/Treatment |
| --- |
|Behavioral: contingency management and behavioral day treatment|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| abused drug abstinence measured by observed urine specimen testing weeks 1-52, and bimonthly months 13-18 |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| abstinence, housing, employment and other outcomes at 0, 2, 6, 12 and 18 months. |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cocaine dependence, mental disorder, dual diagnoses, homelessness