Enhancing Adolescent Substance Abuse Treatment

Status Active, not recruiting

Clinical Trial Summary

The ultimate goal of this research is to facilitate rapid enhancement of youth substance abuse treatments by determining the key mechanisms of change (i.e., what to target more intensely to generate better outcomes). This work is critical because current outpatient adolescent substance abuse treatments yield only small to medium effects that diminish once treatment has ended. The proposed modern mediation study will address this serious public health problem by experimentally evaluating the most critical factors causing change in client outcomes during adolescent substance abuse treatment, directing the field to focus treatment efforts on those factors.

Clinical Trial Description

Adolescents with substance use disorders (SUD) are at high risk for significant deleterious outcomes. Although several evidence-based practices for adolescent SUD exist, they yield only small to medium effects that rapidly diminish (30-70% 6-month relapse rates). A promising approach for determining how to enhance treatment is experimental mediation research. In contrast to traditional correlational mediation approaches, experimental mediation permits causal inference and is comprised of key steps: (A) Identify the putative mediating variable for a treatment. (B) Enhance the treatment to target that mediator more intensely. (C) Randomize youth to conditions, with the standard and enhanced versions of the treatment targeting different "levels" of the same mediator. (D) Measure the mediator and outcomes longitudinally. (E) Perform modern mediation analyses, coupled with analyses evaluating causal inference, to determine if changes in the mediator are responsible for changes in outcomes. This experimental test of mediation, focused on causality, facilitates rapid improvement of treatments by specifying change mechanisms to target in order to improve outcomes. These steps will be followed to elucidate the mediating processes in treatment for adolescent SUD, with the ultimate goal of enhancing the strength and durability of SUD treatments. The three most common putative mediating variables in adolescent SUD treatments are parent management, behavioral regulation, and peer relations. For this study, parent management was chosen as the target because it has evidenced the most potential for yielding generalizable change in youth outcomes and also has been shown to indirectly improve youths' behavioral regulation and peer relations. Of existing treatments for adolescent SUD, family-based Contingency Management (CM) was chosen as the treatment to enhance because it is highly amenable to an augmented focus on parenting, is less complex relative to other SUD treatments, and has amassed considerable support in terms of efficacy and dissemination potential. Thus, following experimental mediation steps, youth with SUD will be randomized to receive either standard CM or enhanced CM (i.e., CM+) that targets parenting more intensely. Repeated assessments for 12 months and longitudinal analyses will allow testing of mediating processes. The investigators will examine whether parent management skills mediate the effect of treatment on youth substance use and behavior problems (Aim 1). In addition, the investigators will determine whether parent management skills mediate the effect of treatment on youth behavioral regulation and deviant peer relations (Aim 2). Finally, the investigators will test whether behavioral regulation and deviant peer relations mediate the effect of parent management on youth substance use and behavior problems (Aim 3). Findings could have broad impact across multiple adolescent SUD treatments. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03249350
Study type	Interventional
Source	Oregon Social Learning Center
Contact
Status	Active, not recruiting
Phase	N/A
Start date	April 23, 2018
Completion date	July 2024

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT05660434` - Using Aromatherapy in Substance Use Disorder	N/A
Active, not recruiting	`NCT05338268` - Substance Use and Loneliness	N/A
Completed	`NCT04098614` - Barriers to Substance Use Disorder Recovery	N/A
Completed	`NCT03954184` - E-health Implementation (Iowa)	N/A
Completed	`NCT03590106` - Cardiac Surgery Peer Recovery Support Program	N/A
Recruiting	`NCT05118204` - Randomized Trial of Buprenorphine Microdose Inductions During Hospitalization	Phase 4
Recruiting	`NCT06273228` - Parenting Young Children in Pediatrics	N/A
Recruiting	`NCT05327504` - Written Exposure Therapy for Veterans With SUD and PTSD	N/A
Terminated	`NCT03517111` - The Impact of a Parenting Intervention on Latino Youth Health Behaviors	N/A
Completed	`NCT04284813` - Families With Substance Use and Psychosis: A Pilot Study	N/A
Completed	`NCT04401215` - Technologically-Augmented Referrals to Mitigate Addiction Consequences	N/A
Not yet recruiting	`NCT06163651` - Evaluating a One-Year Version of the Parent-Child Assistance Program	N/A
Not yet recruiting	`NCT06187701` - Co-Active Therapeutic Theatre (Co-ATT) for Dual-Diagnosis Patients	N/A
Recruiting	`NCT04296604` - Transcranial Direct Current Stimulation (tDCS) Neuromodulation of Executive Function Across Neuropsychiatric Populations	N/A
Active, not recruiting	`NCT02382042` - Intensive Referral Intervention to Improve Substance Use Disorder Treatment Outcomes Among Rural and Highly Rural Veterans	N/A
Completed	`NCT01237366` - Study Targeting Affect Regulation	Phase 1/Phase 2
Terminated	`NCT01356667` - Drum-Assisted Therapy for Native Americans	N/A
Completed	`NCT00708890` - Twelve Step Based Self-help Groups for Substance Related Disorders	N/A
Active, not recruiting	`NCT04048850` - Zepatier in Patients With Substance Use
Recruiting	`NCT05976646` - Phase Ib/2a Drug-drug Interaction Study of a Combination of 45mg Dextromethorphan With 105 mg Bupropion	Phase 1/Phase 2