Volunteer Telephone Continuing Care for Adolescents with AOD Use Disorders

描述（由申请人提供）：虽然治疗可以减少药物使用和相关问题，但大多数来访者在出院后都会经历恢复期和复发期。持续护理服务已被证明可以帮助青少年保持治疗效果并改善长期结果，但实施起来可能很昂贵，而且通常无法报销治疗项目。拟议的工作建立在成人研究的结果和对青少年的有限研究的基础上，这些研究已经证明了通过电话提供持续护理服务的有效性。我们建议随机分配400名从酒精和其他药物使用障碍住院治疗出院的青少年进行常规持续护理（UCC）或UCC加志愿者电话持续护理（VTCC）。UCC包括转介到门诊服务和青年家庭社区的互助支持小组，通常不发起（Donovan, 1998; Godley & Godley, 2011）。职业训练课由义工提供，他们在出院后9个月内，透过电讯安排及维持支援联络。VTCC协议包括青少年社区强化方法（a - cra; Godley et al., 2001）程序的一个子集，包括增加亲社会行为（参与亲康复同伴和活动）、目标设定和以客户为导向的家庭作业。所有参与者将在进入住院治疗、出院以及出院后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。本研究的目的是：1)评估VTCC在出院后12个月内对改善康复前同伴和活动、减少酒精和其他药物（AOD）使用频率和AOD相关问题的主要影响；2)评估在12个月内，支持康复的同伴和活动的变化在多大程度上介导了VTCC对AOD使用和AOD相关问题变化的影响；3)评估治疗准备程度在多大程度上调节VTCC对促康复同伴和活动、AOD使用频率和AOD相关问题变化的主要影响。如果被证明是有效的，志愿者的使用将为治疗项目提供一种新的、潜在的低成本方法，以实施对青少年的治疗后支持，并在McKay（2005; 2009）建议的延长治疗期间保持持续的护理服务。

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).