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 案件经理严重精神病药物滥用病人的一般治疗 通过对药物滥用进行独特的干预。治疗， 精神分裂症药物滥用的行为治疗--BTSAS（Bellack， Gearon，Everist，亚历山大，1998年），是一个为期6个月的干预，提供在 小组形式，旨在教授基本技能，以促进减少毒品 使用，以科普压力，并提高对负面后果的认识， 药物滥用，包括增加感染艾滋病毒的风险。BTSAS（BT）是一个 有前途的，行为技能训练治疗，根据NIDA开发 治疗开发补助金DA 09406（贝拉克），具有以下优点： 指导提供治疗和培训的全面和明确的手册 治疗师。这项研究将扩大既定的调查范围， 有效治疗药物依赖的严重精神病患者。是 符合真相与和解委员会对复杂药物滥用治疗的重点 患者，在临床环境中，通常没有提供专门的 治疗药物滥用和符合真相与和解委员会？的取向， 基于认知行为的干预。该研究将评估 将BT添加到案例管理中的有效性，并将测试是否 BT：（1）可以成功导出到临床病例管理设置;（2） 可以减少吸毒和艾滋病危险行为; 以及（3）与服务利用模式的改变相关联， 反映出危机治疗事件和治疗费用的减少。 此外，该研究将测试BT：（4）是否与改善 生活质量;（5）将对参与者产生不同的影响， 都依赖可卡因主要假设涉及社会心理和服务 利用结果和BT处理过程。次要假设涉及 可卡因依赖参与者相对于其他研究参与者的状态。 这项研究得到了贝拉克博士的加强？的协商，并作为 真相与和解委员会的科学努力真相与和解委员会的合作风格将 为吸烟治疗干预措施提供信息， 与Hall博士合作，并与Dr. 索伦森研究药物滥用者的个案管理。对假设的核心支持 测试和经济分析将确保这里应用的方法将 最强大的人之一

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.