Substance Abuse Clinical Trial
Official title:
Testing a Promising Treatment for Youth Substance Abuse in a Community Setting
This study aims to address a serious public health problem (i.e., substance abusing adolescents) by testing the effectiveness of a promising substance abuse treatment implemented in a community-based treatment setting (CM-FAM, a family-based contingency management intervention) in comparison to usual treatment services.
The overriding purpose of the randomized trial is to examine the effectiveness of a promising
and efficient outpatient treatment of adolescent substance abuse delivered in a
community-based treatment setting. Although several evidence-based treatments of adolescent
substance abuse are emerging, none have experienced widespread adoption in community
settings. Thus, as noted by the Institute of Medicine (1998) more than a decade ago and
reiterated more recently, a considerable science-service gap exists in regards to treatment
of substance abuse in adolescents and adults.
For the proposed study, 204 adolescents meeting diagnostic criteria for substance abuse or
dependence will be randomized to either the Contingency Management-Family Engagement (CM-FAM)
or Treatment as Usual (TAU) conditions. A multimethod, multirespondent approach will be used
to track clinical outcomes at 3, 6, 9, 12, and 18 months post recruitment. Clinical level
outcomes pertain to youth substance use, criminal behavior, mental health functioning, and
key mediators of serious antisocial behavior in adolescents (e.g., self-control, parental
supervision, association with deviant peers). In addition, the incremental cost of CM-FAM
will be determined for use in cost effectiveness analyses.
Aim 1: Over an 18-month post-recruitment follow-up, determine the relative effectiveness of
CM-FAM vs. TAU in reducing adolescent participants' substance use, criminal activity
(including incarceration), and mental health symptoms; and evaluate the cost effectiveness of
CM-FAM in achieving these outcomes.
Aim 2: Examine possible moderators and mediators of intervention effectiveness. Moderator
variables will include youth demographic and clinical (e.g., co-occurring disorders)
characteristics. Mediator variables will include measures of self-control, parenting, and
association with deviant peers - constructs targeted by CM-FAM.
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