Adolescent outpatient treatment and continuing care: Main findings from a randomized clinical trial☆

Abstract

This study evaluated the effectiveness and cost-effectiveness of two types of outpatient treatment with and without Assertive Continuing Care (ACC) for 320 adolescents with substance use disorders. Study participants were randomly assigned to one of four conditions: (a) Chestnut’s Bloomington Outpatient Treatment (CBOP) without ACC; (b) CBOP with ACC; (c) Motivational Enhancement Therapy/Cognitive Behavior Therapy-7 session model (MET/CBT7) without ACC; and (d) MET/CBT7 with ACC. All study conditions attained high rates of participant engagement and retention. Follow-up interviews were completed with over 90% of the adolescents at three, six, nine, and twelve months after treatment admission. There was a significant time by condition effect over 12 months, with CBOP having a slight advantage for average percentage of days abstinent. Unlike previous findings that ACC provided incremental effectiveness following residential treatment, there were no statistically significant findings with regard to the incremental effectiveness of ACC following outpatient treatment. Analysis of the costs of each intervention combined with its outcomes revealed that the most cost-effective condition was MET/CBT7 without ACC.

Continuing Care for Adolescents in Treatment for Substance Use Disorders

“…Most (56%) had one or more co-occurring mental health disorders. There were no statistically significant findings for the effectiveness of ACC 71 .…”

The East Tennessee Assertive Adolescent Family Treatment Program: A Three-Year Evaluation

“…H. Godley et al (2010) found that the use of ACA was related to an increase in the percentage of abstinent days compared to treatment models that did not use ACC. The participants were recruited through various outreach efforts.…”

Understanding and Treating Adolescent Substance Abuse: A Preliminary Review

“…Adolescent Community Reinforcement Approach (a-CRA) is a comprehensive substance use treatment intervention that involves both the adolescent and their families in the sessions. It seeks to increase the family, social, and educational/vocational reinforcers of an adolescent to support recovery and to encourage prosocial activities (44). Assertive Continuing Care (ACC), a home-based intervention, combines a-CRA and case management for a duration of 12-14 weeks, to work with adolescents discharged from residential or outpatient treatment to help maintain the progress achieved during active treatment.…”