Community-Based Integrated Treatment for Adolescents

Study Overview
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Brief Summary
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This study will examine the effectiveness of an integrated treatment for adolescents who are depressed and use alcohol in an intensive outpatient setting in the community.

Detailed Description
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Studies have consistently shown that alcohol use disorders (AUDs) and mental health disorders are related in adolescence. For example, in a community sample, teens who reported a history of AUD were almost four times as likely to have a history of Major Depressive Disorder (MDD) than teens with no history of AUD. The scientific community has only recently begun to examine how to treat adolescents with both AUD and MDD. Reviews have concluded that depression negatively affects treatment for substance abuse. At the same time, substance use issues are often not assessed or addressed in outpatient psychotherapy. Thus, we believe that protocols are needed to specifically address substance abusing, depressed adolescents. This study is designed to determine if an integrated (CBT-I) protocol designed to treat both substance use and depression in adolescents aged 12 to 18 years with AUD/MDD will produce better treatment outcomes compared to standard care (CBT-SC). Both the integrated CBT-I and CBT-SC conditions will be delivered by licensed mental health workers at a community mental health clinic - Gateway - that uses an Intensive Outpatient Program (IOP) model to treat adolescents with AUD and mental health disorders. Two hundred adolescents (50 per year for 4 years) will be recruited from Gateway's Dual Diagnosis IOP. If an adolescent screens in by reporting both depressed mood and substance abuse, these eligible families will complete a thorough baseline assessment and will then be assigned to either CBT-I or CBT-SC. The baseline battery will be repeated at the end of treatment, and 6 and 12 months after treatment completion to determine how families in the study do over time.

Official Title
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Adolescents With Major Depression and AUD: Community-Based Integrated Treatment

Conditions
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Depression, Alcohol Use

Intervention / Treatment
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* Behavioral: Integrated Cognitive Behavioral Therapy
* Behavioral: Standard Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: English speaking adolescent and parent Current substance use disorder Co-occurring psychiatric symptomatology Exclusion Criteria: IQ < 80 Diagnosis of psychotic disorder, pervasive developmental disorder, obsessive-compulsive disorder, bulimia nervosa or anorexia nervosa Adolescent use of illicit hard substances such as cocaine, heroine, and opiates 13 or more times over the prior 90 days

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Integrated Cognitive Behavioral Therapy<br>Adolescents and their parent(s) will receive integrated cognitive behavioral therapy. | Behavioral: Integrated Cognitive Behavioral Therapy<br>* Individual CBT sessions for parents and adolescents plus combined parent-adolescent family sessions delivered at least 1-2x each week for 6 months.<br>* Other names: CBT for adolescents and parents;|
| Active Comparator: Standard Care<br>Adolescents and their parent(s) will receive treatment as usual through a community intensive outpatient program. | Behavioral: Standard Care<br>* Intensive outpatient therapy with teens and their parents using a variety of eclectic treatments that characterize standard care for adolescents.<br>* Other names: Treatment As Usual (TAU);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression |  | Measured at 18 months from baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Alcohol/Substance Use |  | Measured at 18 months from baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Alcohol Use, Outpatient Therapy