EFFECTIVENESS OF ASSERTIVE AFTERCARE FOR YOUTH

申请人摘要：大多数进入住宅的青少年 治疗项目已经有慢性和复发性的问题与酒精 滥用和依赖以及多种并发症的问题， 治疗 三分之二的人在出院后90天内复发饮酒 五分之一回到每周使用。 虽然所有人都 在出院时提到门诊计划，在一些县， 60%的人从未得到任何治疗，只有一小部分人留在善后护理中 四个疗程的治疗。 本研究的主要目的是评估 肯定的善后方案（AAP）在增加成功的转移和 减少复发和其他问题，相对于目前的系统， 现状（SQ）的善后处理水平。 AAP旨在确保指定的 提供的善后辅导服务的数量和质量，包括 评估、安置后规划、经常的社区接触、联系 系统之间、复发预防、解决问题、社交技能建设; 家庭/社会支持和其他形式的个案管理。 具体目标 评估两个核心假设： Hl.从住院治疗出院后，客户随机 被分配到实验性的自信善后方案将有 改善中间结果（治疗参与、自我效能 我们将测试这些假设的即时和长期影响， 随机区组田间试验 三年内约250 将在入住住宿照顾时与客户面谈， 住院护理，然后每季度出院一年。 在 从住宅服务的排放点，一半的客户将是 随机分配到实验性断言善后方案（AAP）， 另一半接受目前现状的善后处理。 数据将 包括自我报告、附属报告、服务记录和尿检 酒精大麻和可卡因 可以进行其他比较 与另外80名客户的实验前基线组和一个单独的 我们目前正在进行一项全州范围的研究， 每年约有7200名客户。

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.