EFFECTIVENESS OF ASSERTIVE AFTERCARE FOR YOUTH

申请者摘要：大多数青少年进入住宅区 治疗方案已经存在酒精的慢性和复发性问题 滥用和依赖以及使问题复杂化的多种并存问题 治疗。三分之二的人在出院后90天内再次饮酒 从住宅项目来看，五分之一的项目恢复了每周使用。虽然所有人都是 指的是出院时的门诊计划，在一些县 60%的人从未接受过任何治疗，其中只有一小部分人留在了善后护理 甚至四个疗程的治疗。 这项研究的主要目标是评估一种 积极的售后服务协议(AAP)提高转院成功率和 减少复发和其他与当前系统相关的问题 现状(SQ)后续护理水平。AAP旨在确保指定的 提供数量和质量的善后服务，包括 评估、善后计划、频繁的社区联系、联系 系统之间，预防复发，解决问题，社交技能培养； 家庭/社会支持和其他形式的案件管理。具体目标 是评估两个核心假设： 哈尔。在住院治疗出院后，客户随机 被分配到试验性的断言善后护理方案 改善中期结果(参与治疗、自我效能 我们将测试这些假设的即时和长期影响在一个 区块随机田间试验。在3年内约为250 病人将在住院治疗时接受面谈，出院时 住院护理，然后每季度出院后一年。在 从居民服务的卸货点，一半的客户将 随机分配到实验性断言善后护理协议(AAP)和 另一半接受目前现状的善后护理。数据将 包括自我报告、附属报告、服役记录和尿检 酒精、大麻和可卡因。还可以进行其他比较 使用另外80个客户端的实验前基线组和单独的 我们目前正在进行全州范围的研究，有38个治疗单位在为 每年大约有7200个客户。

APPLICANT'S ABSTRACT: The majority of adolescents entering residential treatment programs already have chronic and relapsing problems with alcohol abuse and dependence as well as multiple comorbid problems that complicate treatment. Two thirds relapse to alcohol use within 90 days after discharge from residential programs, a fifth returning to weekly use. While all are referred to an outpatient program at discharge, in some counties as many as 60% never get any treatment and only a fraction of these stay in aftercare treatment for even four sessions. The primary goal of this research is to evaluate the effectiveness of an Assertive Aftercare Protocol (AAP) in increasing successful transfer and decreasing relapse and other problems relative to the current system's Status Quo (SQ) level of aftercare. AAP is designed to ensure a specified quantity and quality of aftercare services are provided including assessment, aftercare planning, frequent community-based contacts, linkages between systems, relapse prevention, problem solving, social skill building; family/social support and other forms of case management. The specific aims are to evaluate two core hypotheses: Hl. Following discharge from residential treatment, clients randomly assigned to the experimental assertive aftercare protocol will have improved intermediate outcomes (treatment participation, self-efficacy We will test these hypotheses for both immediate and long-term effects in a blocked randomized field experiment. Over a 3-year period approximately 250 clients will be interviewed at intake to residential care, discharge from residential care, and then quarterly post-discharge for a year. At the point of discharge from residential services, half the clients will be randomly assigned to the experimental Assertive Aftercare Protocol (AAP) and the other half to receive the current Status Quo aftercare. Data will include self-reports, collateral reports, service records, and urine tests for alcohol, marijuana and cocaine. Additional comparisons will be possible with a pre-experimental baseline group of another 80 clients and a separate state-wide study we are currently conducting with 38 treatment units serving approximately 7200 clients per year.