Maximizing Effectiveness of Integrated Treatment Approaches
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Substance Use Disorders
- Sponsor
- Johns Hopkins University
- Enrollment
- 158
- Locations
- 1
- Primary Endpoint
- Psychiatric Treatment Adherence
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
The purpose of the study is to evaluate methods to help people in substance abuse treatment receive better psychiatric care. Patients enrolled in the study will be offered three months of standard psychiatric treatment, which consists of weekly individual counseling and group counseling, as well as regular appointments with a psychiatrist. Patients will be randomly assigned to standard psychiatric care or standard psychiatric care plus voucher incentives. These incentives can be earned by successfully attending all scheduled psychiatric appointments each week. The investigators expect that patients in the voucher condition will attend more psychiatric sessions, which will lead to greater reductions in psychiatric distress.
Detailed Description
Male and female opioid-dependent patients at Addiction Treatment Services with any current psychiatric disorder (N = 100) will be randomly assigned to one of two psychiatric service conditions: 1) reinforced on-site integrated care (ROIC), with voucher incentives contingent on attending weekly psychiatric sessions; or 2) standard on-site integrated care (SOIC). Participants in both conditions will receive access to the same schedule and range of psychiatric and substance abuse treatment services. Participants will be assessed for 3-months post-randomization to determine rates of service utilization and adherence to psychiatric care, changes in scope and severity of psychiatric and psychosocial problems, and rates of drug use and treatment retention. Positive findings would have considerable heuristic and health care policy and practice implications. The entire study, including dissemination of the major findings at a national meeting and submission of the first manuscript, is designed to be completed within 2-years.
Investigators
Michael Kidorf
Associate Professor
Johns Hopkins University
Eligibility Criteria
Inclusion Criteria
- •At least 18 years of age
- •Voluntarily seeking psychiatric treatment
- •Meets DSM-IV criteria for opiate dependence
- •Meets FDA/CSAT guidelines for methadone maintenance
- •Meets DSM-IV criteria for at least one current psychiatric disorder
Exclusion Criteria
- •Pregnancy
- •Onset or acute exacerbation of a medical illness requiring immediate and intense care
- •An organic mental disorder (e.g., delirium, dementia)
- •Current participation in psychiatric care
- •Mandatory psychiatric treatment
Outcomes
Primary Outcomes
Psychiatric Treatment Adherence
Time Frame: Weekly for 12 weeks
Patient adherence to all scheduled psychiatric sessions (i.e. individual, group, psychiatrist) will be measured weekly for 12 weeks.
Level of Psychiatric Distress
Time Frame: Every 4-weeks for 12 weeks
Patients will complete the Addiction Severity Index (ASI) and the SCL-90 every 4-weeks, for 12-weeks, to measure their current levels of psychiatric distress.
Secondary Outcomes
- Treatment Retention(Weekly for 12-weeks)
- Psychiatric Medication Adherence(Every 4-weeks)
- Substance Use(Weekly for 12-weeks)