Volunteer Telephone Continuing Care for Adolescents with AOD Use Disorders

描述(申请人提供)：虽然治疗可以减少药物使用和相关问题，但大多数患者都会经历恢复期和出院后复发。持续护理服务已被证明有助于青年保持治疗成果和改善长期结果，但实施这些服务的费用可能很高，而且治疗方案往往无法报销。拟议的工作建立在成人研究和有限的青年研究结果的基础上，这些研究证明了通过电话提供持续护理服务的有效性。我们建议将400名因酒精和其他药物使用障碍而出院的青少年随机分配到常规持续护理(UCC)或UCC加志愿者电话继续护理(VTCC)。UCC包括转介到青少年家庭社区的门诊服务和互助支持小组，通常不会启动(Donovan，1998；Godley&Godley，2011)。VTCC由志愿者提供，他们在出院后9个月内通过电信发起并维持支持性联系的时间表。VTCC议定书包括青少年社区强化方法(A-CRA；Godley等人，2001)的程序子集，包括增加亲社会行为(参与支持康复的同龄人和活动)、目标设定和客户指导的家庭作业。所有参与者将在入院时、出院时以及出院后3、6、9和12个月进行评估。数据来源包括标准化访谈、尿检和项目记录。这项研究的目的是：1)评估VTCC在出院后12个月期间对改善促进康复的同伴和活动、减少酒精和其他药物(AOD)使用频率以及AOD相关问题方面随时间变化的主要效果；2)评估促进康复的同伴和活动的变化在多大程度上调节VTCC在12个月内对AOD使用和AOD相关问题的影响；3)评估治疗准备情况在多大程度上缓和了VTCC在12个月时对促进康复的同伴和活动、AOD使用频率和AOD相关问题的主要影响。如果被证明有效，志愿者的使用将为治疗计划提供一种新的、潜在的低成本方法，以实施青少年治疗后支持并在McKay(2005；2009)建议的延长治疗时间段内维持持续护理服务。

DESCRIPTION (provided by applicant): While treatment can reduce substance use and related problems, most clients cycle through periods of recovery and relapse after discharge. Continuing care services have been shown to help youth maintain therapeutic gains and improve long-term outcomes, but they can be expensive to implement and are often not reimbursable for treatment programs. The proposed work builds on findings from adult studies and limited research with youth that have demonstrated the efficacy of delivering continuing care services by telephone. We propose to randomly assign 400 adolescents at discharge from residential treatment for alcohol and other drug use disorders to either usual continuing care (UCC) or UCC plus Volunteer Telephone Continuing Care (VTCC). UCC consists of referrals to outpatient services and mutual aid support groups in a youth's home community and are typically not initiated (Donovan, 1998; Godley & Godley, 2011). VTCC is delivered by volunteers who initiate and maintain a schedule of supportive contact through telecommunication for 9 months post-discharge. The VTCC protocol includes a subset of procedures from the Adolescent Community Reinforcement Approach (A-CRA; Godley et al., 2001), including increasing pro-social behavior (involvement with pro-recovery peers and activities), goal setting, and client-directed homework. All participants will be assessed at intake into residential treatment, discharge, and at 3, 6, 9, and 12 months post-discharge. Data sources include standardized interviews, urine tests, and project records. The aims of this study are to: 1) evaluate the main effect of VTCC on changes over time on improving pro-recovery peers and activities, decreasing alcohol and other drug (AOD) frequency of use, and AOD-related problems during the 12 months post-discharge; 2) evaluate the extent to which changes in pro-recovery peers and activities mediate the effects of VTCC on changes in AOD use and AOD-related problems over 12 months; and 3) evaluate the extent to which treatment readiness moderates the main effects of VTCC on changes in pro-recovery peers and activities, AOD frequency of use, and AOD-related problems at month 12. If proven effective, the use of volunteers will provide a new and potentially low-cost method for treatment programs to implement post- treatment support for adolescents and maintain continuing care services over the extended treatment time period recommended by McKay (2005; 2009).