Marijuana Treatment Project - 3

Study Overview
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Brief Summary
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The goal of this research is to improve treatment outcome for marijuana-dependent individuals. The current study builds on the findings of our prior NIDA-funded marijuana treatment study in which improved client outcomes were associated with greater treatment attendance, greater client self-efficacy, and greater use of coping skills. We will use a contingency management paradigm to provide tangible reinforcement for completing homework assignments that are designed to enhance coping skills. It is anticipated that this will result in greater homework compliance, leading to greater self-efficacy regarding one's ability to cope with high-risk situations. Improved self-efficacy will enhance the likelihood of employing coping skills in high-risk situations, thereby increasing the probability of achieving and maintaining abstinence.

Detailed Description
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Participants will receive an intervention combining one session of motivational enhancement therapy with eight sessions of cognitive-behavioral coping skills therapy (MET+CBT). A contingency management procedure will be added to this intervention, providing reinforcement for completion of homework, as verified by call-ins to an Interactive Voice Recording (IVR) system. Outcomes will be compared to an MET+CBT intervention in which reinforcement will be provided for marijuana-free urine specimens, and to a control group that receives Case Management. Recruitment of 234 marijuana-dependent participants will occur over a three-year period. They will be randomly assigned to one of the three 9-session interventions. Treatment will be individual, manualized, and provided on an outpatient basis. Pretreatment assessments will obtain baseline data; follow-up assessments at three-month intervals for one year will evaluate marijuana use outcomes, other drug or alcohol use, and psychosocial functioning. It is anticipated that the intervention in which completion of homework is reinforced will result in the best outcomes. The mechanisms by which the interventions result in behavior change will be the specific focus of attention in this study.

Official Title
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Contingency Management for Marijuana Dependence

Conditions
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Marijuana Dependence

Intervention / Treatment
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* Behavioral: Reinforcement for homework completion
* Behavioral: Reinforcement for Abstinence
* Behavioral: Case Management


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cannabis dependence Willing to accept random assignment to interventions Exclusion Criteria: Current dependence on alcohol or other drugs Problems that require inpatient hospitalization Reading ability below fifth grade level Lack of reliable transportation to treatment Excessive commuting distance

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Reinforcement for homework completion<br> | Behavioral: Reinforcement for homework completion<br>* Provides contingent reinforcement for engaging in homework activities designed to enhance coping skills<br>|
| Active Comparator: Reinforcement for Abstinence<br> | Behavioral: Reinforcement for Abstinence<br>* Provides contingent reinforcement for submitting marijuana-free urine specimen<br>|
| Active Comparator: Case Management<br> | Behavioral: Case Management<br>* Will control for the effect of therapist-client contact by providing supportive case management as an active control condition.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Marijuana abstinence |  | One-year follow-up period | 
| Self-efficacy, use of coping skills, and treatment attendance |  | During 2-month treatment period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Continuous abstinence will be predicted by (a) treatment attendance; (b) posttreatment self-efficacy for coping; and (c) use of coping skills |  | One-year follow-up period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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marijuana dependence, self-efficacy, coping skills, attendance, marijuana abstinence