TREATING ADDICTIONS OF SERIOUSLY MENTALLY ILL ADULTS

描述：(申请人？S摘要) 拟议的随机临床试验是为了测试增强的效果 案件经理？重症精神病药物滥用患者的常规治疗 通过为药物滥用提供独特的干预措施。治疗， 精神分裂症药物滥用的行为治疗--BTSAS(Bellack， Gearon，Everist，Alexander，1998)，是一项为期六个月的干预，提供于 小组形式，旨在教授基本技能，以促进减少毒品 用来应对压力，并提高对以下负面后果的认识 药物滥用，包括增加接触艾滋病毒的风险。BTSAS(BT)是一家 在NIDA下开发的有前途的行为技能培训治疗 治疗发展赠款DA09406(Bellack)，具有 指导提供治疗和培训的全面和明确的手册 心理治疗师。这项研究将扩展关于以下问题的既定调查路线 对药物依赖型严重精神病成人的有效治疗。它是 与真相与和解委员会关于复杂药物滥用治疗的重点一致 患者，在临床环境中，通常没有提供专门的 戒毒与扶轮社的契合？S朝向 以认知行为为基础的干预。这项研究将评估 像往常一样将BT添加到病例管理中的有效性，并将测试 BT：(1)可成功导出到临床病例管理设置；(2) 能有效减少吸毒和艾滋病危险行为的发生； 以及(3)与服务利用模式的改变相关联 反映危机处理事件和治疗费用的减少。 此外，这项研究将测试BT：(4)是否与改善有关 生活质量；以及(5)将对以下参与者产生不同的影响 对可卡因有依赖。主要假设涉及心理社会和服务 利用结果和Bt处理过程。次要假设令人担忧 可卡因依赖参与者相对于其他研究参与者的地位。 这项研究通过贝拉克？S博士的咨询和与 真相与和解委员会的科学努力。真相与和解委员会的协作风格将 通知将试行的吸烟治疗干预措施的开发 与霍尔博士合作，与霍尔博士共同制定流程措施。 索伦森研究吸毒者的病例管理。假说的核心支持 测试和经济分析将确保在这里应用的方法将是 在最强大的国家之列。

DESCRIPTION: (Applicant?s Abstract) The proposed randomized clinical trial is to test the effects of augmenting case managers? usual treatment of seriously mentally ill drug abusing patients by providing a distinctive intervention for drug abuse. The treatment, Behavioral Treatment for Substance Abuse in Schizophrenia--BTSAS (Bellack, Gearon, Everist, Alexander, 1998), is a six month intervention, provided in group format, designed to teach basic skills to facilitate reduction in drug use, to cope with stress, and to heighten awareness of negative consequences of substance abuse including increased risk of exposure to HIV. BTSAS (BT) is a promising, behavioral skills training treatment, developed under a NIDA treatment development grant DA09406 (Bellack) that has the advantage of a comprehensive and explicit manual to guide provision of treatment and training of therapists. The study will extend an established line of inquiry concerning effective treatments for drug-dependent seriously mentally ill adults. It is consistent with the focus of the TRC on treatment for complex drug-abusing patients, in clinical settings that have not typically provided specialized treatment for drug abuse and congruent with the TRC?s orientation towards cognitive behaviorally based interventions. The study will assess the effectiveness of adding BT to case management as usual and will test whether BT: (1) can be successfully exported to clinical case management settings; (2) can effect reduction in drug use and in the practice of AIDS risk behaviors; and (3) is associated with alterations of service utilization patterns that reflect a reduction in crisis treatment episodes and in treatment costs. Furthermore, the study will test whether BT: (4) is associated with improved quality of life; and (5) will have differential effects for participants who are cocaine-dependent. Primary hypotheses concern psychosocial and service utilization outcomes, and BT treatment processes. Secondary hypotheses concern status of cocaine-dependent participants relative to other study participants. This study is enhanced by Dr. Bellack?s consultation and by being integral to the scientific endeavors of the TRC. The collaborative style of the TRC will inform development of a smoking treatment intervention to be piloted in collaboration with Dr. Hall and the development of process measures with Dr. Sorensen to study case management for drug abusers. Core support for hypotheses testing and economic analyses will ensure the methods applied here will be among the most powerful.