Schizophrenia Clinical Trial
Official title:
Novel EtG-Based Contingency Management for Alcohol in the Severely Mentally Ill
The investigators will evaluate the efficacy of a comprehensive 12-week contingency management intervention for treating alcohol dependence for persons with severe mental illness who are seen within the context of a community mental health center setting. The primary contingency will be submission of alcohol-free urines. Additional reinforcers will be provided for intensive outpatient addiction treatment attendance. Reinforcers will be vouchers or actual items useful for day-to-day living. Participants will be 120 adults diagnosed with alcohol dependance and severe mental illness.
The contingency management (CM) paradigm that will be used is the variable magnitude of
reinforcement procedure. In order to encourage engagement in study procedures and reduce
dropout in the randomized sample, all participants will undergo a 4-week pre-randomization
induction period. During the induction period, participants will be reinforced for providing
urine-tests three times a week. Those who demonstrate study participation and need for
treatment during the induction period will be randomized to receive treatment as usual and
either 1) 12 weeks of CM for alcohol abstinence (assessed by Ethyl glucuronide immunoassay
urine-test) AND weekly reinforcement for intensive outpatient addiction treatment
attendance; or 2) 12 weeks of reinforcement for providing urine-samples and continued study
involvement. Randomization will be used to assign participants to treatment conditions.
The primary outcome will be changes in alcohol use assessed by Ehyl glucuronide immunoassay
urine-tests, breath-tests, as well as self- and clinician-reported alcohol use. The
secondary outcome will be changes in intensive outpatient group attendance assessed by
intensive outpatient clinician-report, as well as administrative data sources, and
self-report. Other outcomes will include: urine-tests and self-reported illicit drug use,
psychiatric symptoms, other outpatient treatment utilization, HIV-risk, and nicotine use.
All outcomes will be assessed [for 4-weeks prior to study enrollment (self-report, clinician
ratings etc)] and throughout the 4-week induction, 12-week intervention, and 3-month
follow-up periods.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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