Intervention for Persons Leaving Residential Substance Abuse Treatment

Study Overview
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Brief Summary
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This research uses a multi-phase approach to adapt and implement an established intervention, Critical Time Intervention, for a new population and setting among individuals with substance use who are at risk of relapse following residential substance abuse treatment. The goals of the study are to: (PHASE 1) identify challenges and strategies of community reentry among individuals in residential substance abuse treatment and their providers and social support networks (e.g., family, friends, community members); (PHASE 2) adapt CTI for individuals in residential substance abuse treatment to prepare them for discharge and transition back into the community; and (PHASE 3) conduct a pilot study to examine the feasibility, acceptability, and preliminary outcomes of the adapted CTI compared to enhanced usual discharge planning services.

Detailed Description
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This randomized pilot study will examine the feasibility, acceptability, and preliminary outcomes of the adapted CTI compared to enhanced usual discharge planning services. More specifically, 60 participants will be randomized to either CTI (n=30) or enhanced usual discharge planning services (n=30) at the time of discharge. Participants will complete a baseline interview (prior to randomization) and 3-, 6-, 9- and 12-month follow-up assessments post-discharge.

Official Title
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Intervention for Persons With Co-Occurring Disorders Leaving Residential Tx

Conditions
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Substance Use Disorders

Intervention / Treatment
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* Behavioral: Critical Time Intervention-Residential (CTI-R)
* Behavioral: Enhanced Usual Discharge Services-Residential


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eligible participants will be enrolled in residential substance abuse treatment and who are at least 18 years of age, speak English, and expect to be discharged within 3 months. Exclusion Criteria: Individuals that do not meet the aforementioned inclusion criteria will be excluded from the study.More specifically, the following categories will be excluded: Anyone under the age of 18 Non-English speaking individuals due to limited resources Individuals who are considered vulnerable/protected populations, including children, pregnant women, and prisoners. Individuals judged by clinical treatment staff to be in immediate crisis, i.e., suicide watch or inadequate decisional capacity to participate in the study.

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Critical Time Intervention-Residential<br>CTI-R is a 9-month, assertive outreach and linkage program. | Behavioral: Critical Time Intervention-Residential (CTI-R)<br>* CTI-R is a 9-month, time-limited intervention that aims to produce an enduring impact by effectively linking individuals to both professional services (substance abuse and health and mental health providers) and social supports (e.g., family and friends) and by providing emotional and practical support. Participants in the CTI-R condition will also receive usual discharge services from the residential substance abuse treatment program.<br>Behavioral: Enhanced Usual Discharge Services-Residential<br>* The enhanced usual discharge condition encompasses the regular discharge services offered at the residential treatment program plus enhanced transition services.<br>|
| Active Comparator: Enhanced Usual Discharge-Residential<br>The enhanced usual discharge condition includes usual discharge services plus enhanced transition services. | Behavioral: Enhanced Usual Discharge Services-Residential<br>* The enhanced usual discharge condition encompasses the regular discharge services offered at the residential treatment program plus enhanced transition services.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment | Proportion of participants enrolled in the study as measured by the research records | Baseline | 
| Change in retention | Proportion of participants completed the study as measured by the research records | 3, 6, 9, and 12 months | 
| Short-term Relapse | Proportion of participants who relapsed (i.e., substance use) as measured by Addiction Severity Index | 3 months | 
| Use of aftercare services | Proportion of participants who were linked to aftercare services (i.e. substance use treatment) at the time of discharge as measured by the Treatment Service Review (TSR) | 3 months | 
| Housing | Proportion of participants housed at the time of discharge | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Short-term Social Support | Level of social support as measured by the 8-item modified Medical Outcomes Study Social Support Survey | 3 months | 
| Short-term Self-Efficacy | Level of self-efficacy as measured by I feel like I'm in control of my alcohol or drug use. | 3 months | 
| Short-term Mental Health | Level of mental health severity as measured by the Brief Symptom Inventory | 3 months | 
| Change in Relapse | Proportion of participants who relapsed (i.e., substance use) as measured by Addiction Severity Index | 3, 6, and 9 months | 
| Long-term Relapse | Proportion of participants who relapsed (i.e., substance use) as measured by Addiction Severity Index | 12 months | 
| Change in Social Support | Level of social support as measured by the 8-item modified Medical Outcomes Study Social Support Survey | 3, 6, and 9 months | 
| Long-term Social Support | Level of social support as measured by the 8-item modified Medical Outcomes Study Social Support Survey | 12 months | 
| Change in Self-Efficacy | Level of self-efficacy as measured by I feel like I'm in control of my alcohol or drug use. | 3, 6, and 9 months | 
| Long-term Self-Efficacy | Level of self-efficacy as measured by I feel like I'm in control of my alcohol or drug use. | 12 months | 
| Change in Mental Health | Level of mental health severity as measured by the Brief Symptom Inventory | 3, 6, and 9 months | 
| Long-term Mental Health | Level of mental health severity as measured by the Brief Symptom Inventory | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Residential substance use treatment, Transition