Increasing Caregiver Engagement in Juvenile Drug Courts

Not Applicable

Completed

• Conditions: Substance Abuse
• Interventions: Behavioral: Caregiver Contingency Management + Usual Drug Court Treatment; Behavioral: Usual Drug Court Treatment

• Registration Number: NCT03051997
• Lead Sponsor: Medical University of South Carolina

Brief Summary

The purpose of this study is to test a prize-based contingency management intervention for increasing caregiver engagement in juvenile drug court and adolescent drug treatment, and for achieving the ultimate outcomes of reduced substance use and delinquent behavior among drug court-involved youth.

Detailed Description

Juvenile offenders with substance abuse problems represent a large and underserved population that is at high risk of deleterious outcomes and long-term costs for themselves, their families, communities, and society. Moreover, a high percentage of substance abusing adolescents continue to abuse substances and engage in criminal activity into adulthood. Although one juvenile justice intervention, Juvenile Drug Court (JDC), has emerged as a promising model for reducing drug use and delinquency among youth, its effectiveness is variable. Drug court outcomes may be compromised by the lack of caregiver engagement in JDC processes and adolescent drug treatment. Incorporating easily implemented evidence-based incentive programs in JDCs might improve their effectiveness in reducing youth drug use and re-offending. An extensive body of research supports the critical role that families play in the etiology, maintenance, and treatment of adolescent substance abuse. Although family-based interventions for adolescent substance abuse have been shown to be superior to other treatment modalities, parents must attend treatment and participate in meaningful ways for these superior outcomes to be realized. This randomized clinical trial will examine the efficacy of a prize-based contingency management intervention for increasing caregiver engagement (attendance and participation) in JDC and adolescent drug treatment. This caregiver contingency management intervention (CCM) will be compared with drug court treatment as usual (TAU). Increased caregiver participation is predicted to improve adolescent outcomes (decreased drug use and delinquent behavior). One hundred and eighty youth enrolled in JDC will be randomly assigned along with a parent/caregiver to TAU or CCM. Analyses will examine measures of caregiver engagement in JDC as well as youth substance use (urine drug screens) and delinquent activity. Results from this study will demonstrate the effectiveness of CCM procedures for increasing caregiver attendance and participation in JDC and adolescent drug treatment above and beyond drug court and usual care. If effective, the CCM approach may ultimately be used to enhance JDC outcomes, thereby reducing substance use and recidivism in juvenile offenders served by this promising juvenile justice intervention.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2017-02-08
• Study First Submitted QC: 2017-02-09
• Study First Posted: 2017-02-14
• Study Start: 2017-10-13
• Primary Completion: 2023-12-12
• Study Completion: 2023-12-12
• Disposition First Posted: 2024-03-07
• Disposition First Submitted: 2024-12-06
• Status Verified: 2025-01
• Last Update Submitted: 2025-01-06
• Last Update Posted: 2025-01-08

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 180

Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Caregiver Contingency Management + Usual Drug Court Treatment	Caregiver Contingency Management + Usual Drug Court Treatment	This group will receive a caregiver contingency management intervention plus the standard outpatient substance abuse treatment services provided at JDC.
Usual Drug Court Treatment	Usual Drug Court Treatment	This group will receive the standard outpatient substance abuse treatment services provided at JDC.

Primary Outcome Measures

Name	Time	Method
Changes from baseline to 18 months post-baseline in Youth Urine Drug Screens (measured at 0, 3, 5, 6, 9, 12, and 18 months).	Baseline to 18 months	Number of positive drug screens from toxicology testing with youth for tetrahydrocannabinol (THC), amphetamines, methamphetamines, opiates, cocaine, benzodiazepines, MDMA, and oxycodone.
Changes from baseline to 18 months post-baseline in Youth Substance Use Frequency and Problems (measured at 0, 1, 2, 3, 4, 5, 6, 9, 12, and 18 months).	Baseline to 18 months	Frequency of substance use and substance-related problems self-reported by youth on the Global Appraisal of Individual Needs.

Secondary Outcome Measures

Name	Time	Method
Changes from baseline to 18 months post-baseline in Youth Arrests, Charges, and Convictions.	Baseline to 18 months	Number of youth arrests, charges, and convictions measured via official arrest records.
Changes from Baseline to 18 months post-baseline in youth reports on Youth Internalizing Symptoms and Externalizing Behaviors (measured at 0, 1, 2, 3, 4, 5, 6, 9, 12, and 18 months).	Baseline to 18 months	Frequency of youth's internalizing symptoms and externalizing behaviors measured with the Brief Problem Checklist (youth report).
Changes from baseline to post-treatment in Therapist-Family Working Alliance (measured at 1, 2, 3, and 4 months, as well as post-treatment).	Baseline through treatment completion, an average of 4 months	Levels of alliance during treatment reported by therapists, caregivers, and youth on the Working Alliance Inventory.
Changes from Baseline to 18 months post-baseline in caregiver reports on Youth Internalizing Symptoms and Externalizing Behaviors (measured at 0, 1, 2, 3, 4, 5, 6, 9, 12, and 18 months).	Baseline to 18 months	Frequency of youth's internalizing symptoms and externalizing behaviors measured with the Child Behavior Checklist (caregiver report).
Changes from baseline to post-treatment in Caregiver Depressive Symptoms.	Baseline through treatment completion, an average of 4 months	Frequency and severity of depressive symptoms self-reported by caregivers on the Beck Depression Inventory.
Reports at post-treatment on Youth and Caregiver Attitudes Toward Incentive Programs.	Up to 4 months on average	Youth and caregiver attitudes toward incentive programs as measured during qualitative interviews.
Rates of Treatment Completion.	Up to 4 months on average	Rates of youth treatment completion reported by therapists using the Treatment Termination Form.
Levels of Satisfaction with Treatment and JDC.	Up to 4 months on average	Levels of satisfaction with substance use treatment and JDC reported by caregivers and youth on the Client Satisfaction Questionnaire.
Changes from baseline to 36 months post-baseline in Therapist and JDC Personnel Attitudes Toward Incentive Programs (measured at 0, 12, 24, and 36 months).	Baseline to 36 months	Therapist and JDC personnel attitudes toward incentive programs as measured during qualitative interviews.
Changes from baseline to 18 months post-baseline in Youth Delinquent Behaviors (measured at 0, 3, 5, 6, 9, 12, and 18 months).	Baseline to 18 months	Frequency of delinquent behaviors self-reported by youth using the Self-Report Delinquency Scale.
Changes from baseline to post-treatment in Caregiver Treatment Attendance and Activity Completion (measured at 1, 2, 3, and 4 months, as well as post-treatment).	Baseline through treatment completion, an average of 4 months	Frequency of caregiver attendance at their youth's substance use treatment sessions and completion of therapeutic activities reported by therapists on the Session Tracking Sheet.
Changes from baseline to the end of JDC involvement in Caregiver Attendance at JDC Sessions.	Baseline through the end of JDC involvement, an average of 12 months	Frequency of caregiver attendance at their youth's JDC sessions reported by JDC personnel on the JDC Attendance Form.
Changes from baseline to post-treatment in Caregiver Perceptions of Incentive Programs.	Baseline through treatment completion, an average of 4 months	Ratings by caregivers on perceptions of incentive-based interventions as measured by the Provider Survey of Incentives.
Changes from baseline to 36 months post-baseline in Therapist and JDC Personnel Perceptions of Incentive Programs (measured at 0, 12, 24, and 36 months).	Baseline to 36 months	Ratings by therapists and JDC personnel on perceptions of incentive-based interventions as measured by the Provider Survey of Incentives.
Changes from baseline to post-treatment in Caregiver Substance Use Problems.	Baseline through treatment completion, an average of 4 months	Frequency and severity of substance use problems self-reported by caregivers on the Addiction Severity Index.

Trial Locations

Locations (2)

Montgomer County Juvenile Court, 380 West Second Street; 🇺🇸 Dayton, Ohio, United States

Nueces County Juvenile Court/Juvenile Treatment Court; 🇺🇸 Corpus Christi, Texas, United States