Volunteer Telephone Continuing Care for Adolescents with AOD Use Disorders

描述（由申请人提供）：虽然治疗可以减少物质使用和相关问题，但大多数客户在出院后会经历恢复和复发的周期。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，但实施成本可能很高，而且通常无法报销治疗计划。拟议的工作建立在成人研究和对青年进行的有限研究的结果基础上，这些研究证明了通过电话提供持续护理服务的功效。我们建议随机分配400名青少年在出院时从住宅治疗酒精和其他药物使用障碍，无论是常规的持续护理（UCC）或UCC加志愿者电话持续护理（VTCC）。UCC由青少年家庭社区的门诊服务和互助支持小组组成，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个月内通过电信启动并维持支持性联系计划。VTCC方案包括来自青少年社区强化方法（A-CRA; Godley等人，2001年），包括增加亲社会行为（参与亲恢复同行和活动），目标设定，和客户导向的家庭作业。所有受试者将在住院治疗、出院以及出院后3、6、9和12个月时接受评估。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对改善康复同伴和活动，减少酒精和其他药物（AOD）使用频率以及出院后12个月内AOD相关问题随时间变化的主要影响; 2）评估支持恢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变化的影响-3）评估治疗准备程度在多大程度上缓和了VTCC对支持恢复的同伴和活动、使用AOD的频率和12个月时AOD相关问题的变化的主要影响。如果证明有效，志愿者的使用将为治疗计划提供一种新的和潜在的低成本方法，以实施对青少年的治疗后支持，并在McKay（2005; 2009）建议的延长治疗时间内维持持续的护理服务。

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).