Effectiveness of Assertive Continuing Care for Youth

Study Overview
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Brief Summary
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Following discharge from residential treatment 324 adolescents are randomly assigned to Assertive Continuing Care with and without motivational incentives in a 2 x 2 factorial design. Clinical outcomes are assessed at 3, 6, 9, and 12 months post discharge.

Conditions
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Substance Use Disorders

Intervention / Treatment
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* Behavioral: ACC
* Behavioral: CM
* Behavioral: UCC


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Met DSM-IV diagnostic criteria for abuse or dependence on alcohol or another drug in the past year Been between the ages of 12 and 18 at the time of residential admission; and (c) resided in one of ten Illinois counties targeted for the intervention Exclusion Criteria: left residential treatment prior to the seventh day did not return to a target county at discharge showed evidence of cognitive impairment that interfered with understanding of study instruments, procedures, or the informed consent process were deemed dangerous to themselves or others during treatment were a ward of child protective services and inaccessible for the intervention met DSM-IV criteria for pathological gambling were discharged to the state department of corrections were already participating in a treatment study

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: Factorial Assignment


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Assertive Continuing Care (ACC)<br>Behavioral intervention comprised of the community reinforcement approach plus case management delivered in home and other community settings to youth and their caregivers. | Behavioral: ACC<br>* Weekly community based behavioral counseling and case management<br>Behavioral: UCC<br>* recommendation made by discharge counselor upon leaving residential treatment to attend nearest outpatient clinic.<br>|
| Experimental: Contingency Management (CM)<br>Using a prize drawing system (no, low, medium and large value prizes) with adolescents could earn escalating prize drawing opportunities by completing verifiable pro-social activities and providing negative urine test and breath alcohol test results. | Behavioral: CM<br>* Weekly community based prize drawing opportunities contingent upon completed verifiable pro-social activities and clean urine and breath alcohol test results<br>Behavioral: UCC<br>* recommendation made by discharge counselor upon leaving residential treatment to attend nearest outpatient clinic.<br>|
| Experimental: ACC + CM<br>This arm is the combination of arms 1 and 2. | Behavioral: ACC<br>* Weekly community based behavioral counseling and case management<br>Behavioral: CM<br>* Weekly community based prize drawing opportunities contingent upon completed verifiable pro-social activities and clean urine and breath alcohol test results<br>Behavioral: UCC<br>* recommendation made by discharge counselor upon leaving residential treatment to attend nearest outpatient clinic.<br>|
| Active Comparator: Usual Continuing Care (UCC)<br>UCC consists of a discharge recommendation to seek aftercare services at nearest treatment provider to where the patient lived. This service primarily consisted of outpatient group counseling. | Behavioral: UCC<br>* recommendation made by discharge counselor upon leaving residential treatment to attend nearest outpatient clinic.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |