MAINTENANCE OF TREATMENT GAINS IN ADOLESCENTS WITH ARD

关于青少年药物滥用治疗的有限文献显示，酗酒和吸食大麻的复吸率很高。有人认为，通过让患有酒精相关障碍(ARD)的年轻人更多地参与善后计划，可以减少复发。这项研究的目的是解决有效维持青少年治疗成果的需要。主要目标是评估和比较三种后续护理条件的疗效，其中两种代表不同形式的后续护理干预：(1)手动指导的个性化认知-行为疗法(ICBT)会议，涉及酒精/物质使用和多维功能；(2)手动指导的个性化简短治疗电话联系(IBTPC)，使用基于CBT的问题解决技术。第三个善后条件将是无干预条件(NIC)。这项调查旨在回答以下问题：NIC和其他每种情况之间的治疗结果是否不同？如果对青少年的善后护理是有效的，那么ICBT和IBTPC之间是否有不同的结果？共有240名13-18岁的青少年被诊断患有DSM-IV ARD，他们将参加一项意向治疗研究，该研究包括三个阶段：3个月的治疗阶段、3个月的后续护理阶段和12个月的随访阶段。参与者在接受任何治疗之前将被随机分配到三种善后护理条件中的一种，然后他们将参加为期9周的人工指导CBT小组会议。实验后护理条件包括：(A)5次ICBT会议，(B)5次IBTPC，按类似时间表进行，或(C)NIC。然后，这些青少年将再接受12个月的跟踪调查。治疗结果评估将在计划的善后护理完成后、6个月和12个月后进行。预计善后干预可以保持戒酒或减少使用，减少复发的强度(即频率、数量)和相关的负面后果，并改善参与者的整体功能。

The limited literature on adolescent substance abuse treatment reveals high levels of relapse to alcohol and marijuana use. It has been argued that relapse can be reduced by greater involvement of youth with alcohol related disorders (ARD) in aftercare programs. The purpose of the study is to address the need for effective maintenance of treatment gains for adolescents. The primary goal is to assess and compare the efficacy of three aftercare conditions, two of which represent different modalities of aftercare intervention: (1) manual guided Individualized Cognitive- Behavioral Therapy (ICBT) sessions addressing alcohol/substance use and multidimensional functioning; and (2) manual guided Individualized Brief Therapeutic Phone Contacts (IBTPC) utilizing CBT based problem solving techniques. The third aftercare condition will be a No Intervention Condition (NIC). This investigation is intended to answer the following questions: Is there differential treatment outcome between the NIC and each of the other conditions? If aftercare for adolescents is effective at all, are there differential outcomes between the ICBT and IBTPC? A total of 240 adolescents 13-18 years of age who have been diagnosed with DSM-IV ARD will participate in an intent-to-treat study comprised of three phases: 3-month treatment phase, 3-month aftercare phase, and 12- month follow-up phase. Participants will be randomly assigned before any treatment into one of three aftercare conditions, and then they will enroll in 9-weekly manual guided CBT group sessions. The experimental aftercare conditions include: (a) 5 ICBT sessions, (b) 5 IBTPC on a similar schedule, or (c) NIC. Then the adolescents will be followed for an additional 12- month period. Treatment outcome assessments will be conducted upon completion of planned aftercare, and at 6, and 12 months later. It is anticipated that the aftercare intervention may sustain sobriety, or reduction in use, decrease the intensity (i.e., frequency, quantity) of relapse and related negative consequences, and improve overall functioning of the participants.