MAINTENANCE OF TREATMENT GAINS IN ADOLESCENTS WITH ARD

关于青少年药物滥用治疗的有限文献揭示了酒精和大麻使用的高复发率。有人认为，复发可以减少更多的参与青年与酒精相关的疾病（ARD）的善后方案。该研究的目的是解决有效维持青少年治疗收益的需要。主要目标是评估和比较三种疗后状况的疗效，其中两种代表不同的疗后干预模式：（1）手动指导的个体化认知行为治疗（ICBT）课程，解决酒精/物质使用和多维功能;（2）手动指导的个体化简短治疗电话联系（IBTPC），利用基于CBT的问题解决技术。第三个善后条件将是无干预条件（NIC）。本研究旨在回答以下问题：NIC和其他疾病之间是否存在不同的治疗结果？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，将参加一项意向治疗研究，包括三个阶段：3个月的治疗阶段，3个月的善后阶段和12个月的随访阶段。参与者将在任何治疗之前被随机分配到三种善后条件之一中，然后他们将参加9周一次的手动指导CBT小组会议。实验性的善后条件包括：（a）5次ICBT课程，（B）5次类似时间表的IBTPC，或（c）NIC。然后将对青少年进行额外12个月的随访。在完成计划的善后护理后以及6个月和12个月后进行治疗结局评估。预期善后干预可维持清醒或减少使用，降低强度（即，频率，数量）复发和相关的负面后果，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.