Concurrent Treatment of Substance Abuse and Child Maltreatment

Study Overview
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Brief Summary
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The co-occurrence of child maltreatment and parental substance-use problems is a major public health problem with serious consequences for children, parents, families, and the community at large. The need for effective dual treatment of caregiver substance abuse and child maltreatment is unquestionable, but there is a dearth of controlled treatment outcome studies with substance-using parents who have engaged in child maltreatment. This project examines two evidence-based treatments-Contingency Management for substance-use problems and Pathways Triple P parenting intervention to improve parenting for prevention of child-maltreatment recurrence. These two systematic interventions are being tested in the context of traditional outpatient treatment for substance-use problems.

Official Title
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Concurrent Treatment of Substance Abuse and Child Maltreatment

Conditions
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Substance Use, Child Maltreatment

Intervention / Treatment
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* Behavioral: Reinforcement for drug & alcohol abstinence
* Behavioral: Parenting intervention
* Behavioral: Treatment as usual (TAU)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: open child protective services case for child maltreatment beginning intensive outpatient treatment for drug or alcohol use problem at least one child 2-8 years of age Exclusion Criteria: not primary custodial parent for child 2-8 years of age serious mental illness residing outside the two participating counties

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: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Treatment as Usual (TAU)<br>Outpatient substance-abuse treatment plus drug and alcohol screening plus brief support for personal goal setting | Behavioral: Treatment as usual (TAU)<br>* Outpatient substance-abuse therapy plus drug & alcohol screening plus support for personal goal setting<br>|
| Experimental: Contingency Management<br>Contingency management for drug and alcohol abstinence plus TAU | Behavioral: Reinforcement for drug & alcohol abstinence<br> <br> * Other names: Contingency management for negative drug & alcohol samples;Behavioral: Treatment as usual (TAU)<br>* Outpatient substance-abuse therapy plus drug & alcohol screening plus support for personal goal setting<br>|
| Experimental: Parenting Intervention<br>Parenting intervention plus TAU | Behavioral: Parenting intervention<br> <br> * Other names: Pathways Triple P;Behavioral: Treatment as usual (TAU)<br>* Outpatient substance-abuse therapy plus drug & alcohol screening plus support for personal goal setting<br>|
| Experimental: Parenting Intervention + Contingency Management<br>Parenting intervention plus contingency management for drug and alcohol abstinence plus TAU | Behavioral: Reinforcement for drug & alcohol abstinence<br> <br> * Other names: Contingency management for negative drug & alcohol samples;Behavioral: Parenting intervention<br> <br> * Other names: Pathways Triple P;Behavioral: Treatment as usual (TAU)<br>* Outpatient substance-abuse therapy plus drug & alcohol screening plus support for personal goal setting<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| longest duration of negative urine and breath samples |  | 13 weeks | 
| recurrence of child maltreatment--child protective services records |  | 18 months after baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| self-reported substance use--Addiction Severity Index-Lite | Drug and Alcohol Composite (severity) | 4 months after baseline; 12 months after baseline; 18 months after baseline | 
| parent report of child behavior problems--child behavior inventory | Intensity score for child behavior problems | 4 months after baseline; 12 months after baseline; 18 months after baseline | 
| self-reported parenting--Parenting Scale; Parenting Practices Interview | Parenting Scale: Overreactivity; Laxness Parenting Practices Interview: Appropriate Discipline; Harsh and Inconsistent Discipline | 4 months after baseline; 12 months after baseline; 18 months after baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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child welfare system, parental substance use problem, child maltreatment, parenting