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Home-based Continuing Care for Young Adults Leaving Residential Substance Abuse Treatment

Not Applicable
Completed
Conditions
Substance Use Disorders
Interventions
Behavioral: Home-based Continuing Care
Behavioral: Services as Usual
Registration Number
NCT02152033
Lead Sponsor
Treatment Research Institute
Brief Summary

The purpose of this project is to develop and test a Home-based Continuing Care intervention that will help parents support the recovery of their Young Adult (YA) child who is leaving residential substance abuse treatment. The two phase pilot study will 1) interview 50 parents and 50 YAs recruited from residential treatment programs and from parent groups to inform the development of the intervention and 2) conduct a two-arm pilot study that will recruit a maximum of 20 parents and their young adult children into one of two conditions (Home-based Continuing Care \[HCC\] intervention group or Services as Usual \[SAU\] comparison group) with the main goal of determining whether conducting such an intervention is acceptable and sustainable, and to collect preliminary efficacy data. We hypothesize that pilot testing will indicate that: (a) HCC is acceptable and potentially sustainable; (b) conducting a randomized clinical trial is feasible, and (c) the magnitude of outcomes from HCC will be clinically meaningful.

Detailed Description

Several models of continuing care (CC) have been studied for adolescents and Young Adults (YAs) including online relapse prevention, brief telephone counseling and Assertive Continuing Care (ACC). Five sessions of in-person therapy or brief telephone counseling both have reduced relapse in youth completing treatment relative to a no CC condition, consistent with a growing body of research with adults supporting the efficacy of telephone-based CC (TCC). ACC has been thoroughly evaluated for adolescents. Some applications also have incorporated contingency management (CM) for engaging in activities including needed services; but ACC has not applied CM to biologically-verified abstinence -- an efficacious approach in adult CC. A significant drawback of ACC is that it is quite intensive, requiring extended clinician training and home visits. This increases the costs of the intervention and the difficulty of dissemination and implementation; therefore we plan to develop a less clinician-intensive continuing care model for YAs.

The two phase pilot study will 1) interview 50 parents and 50 YAs recruited from residential substance abuse treatment programs and from parent groups to inform the development of the intervention and 2) conduct a two-arm pilot study that will recruit a maximum of 20 parents and their YA children into one of two conditions (Home-based Continuing Care \[HCC\] intervention group or Services as Usual \[SAU\] comparison group) with the main goal of determining whether conducting such an intervention is acceptable and sustainable, and to collect preliminary efficacy data. We hypothesize that pilot testing will indicate that: (a) HCC is acceptable and potentially sustainable; (b) conducting a randomized clinical trial is feasible, and (c) the magnitude of outcomes from HCC will be clinically meaningful.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Parent is 21 years of age or older
  • Young Adult (YA) is 18-25 years of age
  • YA's primary drug of abuse is prescription or other opiates
  • Parent must be the custodial parent or former guardian or other caretaker of the YA
  • YA is in residential treatment
  • Parent and YA plan to live in the same residence during the intervention (32 weeks)
  • Both Parent and YA provide written informed consent and pass the consent quiz testing knowledge of basic elements of informed consent and study requirements (including home urine testing).
Exclusion Criteria
  • Parent currently has a substance use disorder (SUD) as determined via DSM-IV-TR criteria or a history of SUD and in recovery for less than 2 years
  • Parent or YA has been diagnosed as having, or behaves in, a manner consistent with having significant cognitive impairment (e.g., an unrelieved psychosis or other serious mental illness)
  • YA reports suicidal ideation with a plan, or engaged in suicidal behavior during residential treatment
  • YA has a recent history of severe violence toward the parent (e.g., involving weapons or hospitalization)
  • YA's residential program provides comprehensive continuing services
  • YA does not consent to participation within 2 weeks of discharge

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Home-based Continuing CareHome-based Continuing CareThe components of Home-based Continuing Care (HCC) include brief parent training, brief Young Adult (YA) orientation and recovery planning, telephone-based continuing care (TCC) and home-based contingency management. Both parent and YA participants will attend sessions with a family specialist.
Services as UsualServices as UsualYAs completing residential care usually are referred to continuing outpatient services and/or self-help groups.
Primary Outcome Measures
NameTimeMethod
Change in Young Adult Drug Use from Baseline to 16 week and 32 week follow-upsBaseline, Weekly, 16 week and 32 week follow-ups

Young Adult participants will complete a Timeline Follow Back (Baseline, 16 week and 32 week follow-ups) and provide a urine sample to be tested for drug and alcohol use (Baseline, Weekly, 16 week and 32 week follow-ups).

Secondary Outcome Measures
NameTimeMethod
Parent and Young Adult Recruitment Rate by percent approached10 month recruitment period

We will measure the percent of young adults and parents that were approached and agreed to participate in the study.

Parent and Young Adult Treatment Acceptability16 week and 32 week follow-ups

Participants will complete the Treatment Evaluation Inventory

Parent and Young Adult Research Retention16 week and 32 week follow-ups

Follow-up rates

Parent and Young Adult Recruitment Rate by monthly recruitment rate10 month recruitment period

We will measure the mean number of parent and young adult participants that are recruited per month.

Change in Parent and Young Adult Relationship Satisfaction from Baseline to 16 week and 32 week follow-upsBaseline, 16 week and 32 week follow-ups

Parent participants will complete the Parent Happiness with Youth Scale and young adult participants will complete the Youth Happiness with Parents scale.

Parent and Young Adult Treatment Retention32 weeks post baseline

Weeks of participation in the home-based continuing care intervention

Parent and Young Adult Engagement in HCC by urine sample collected32 week intervention period

We will measure the percent of urine samples the parent collects from the young adult.

Parent and Young Adult Engagement in HCC by number of calls completed32 week intervention period

We will measure the number of telephone counseling calls completed by the parent and young adult.

Trial Locations

Locations (1)

Family Training Program

🇺🇸

Philadelphia, Pennsylvania, United States

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