Outpatient Adolescent Treatment for Comorbid Substance Use and Internalizing Disorders

June 13, 2018 updated by: Medical University of South Carolina

Development of Outpatient MST for Dually Diagnosed Youth

Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth range from 25% up to 82%, and youths with a dual diagnosis have worse outcomes and are more than twice as costly to treat than their counterparts with no comorbidity. This project was a pilot test of a new treatment, OPTION-A, which was adapted from Multisystemic Therapist (MST) and other evidence-based interventions to specifically treat youth presenting for outpatient treatment of comorbid substance use and internalizing disorders. The project was a randomized controlled pilot trial comparing the experimental treatment to usual services in the community.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth are high and youths with a dual diagnosis are more costly to treat. At the time of this study, however, no outpatient treatments had been tested specifically for treating youth with co-occurring substance use disorders and mental health diagnoses. The current project aimed to adapt and evaluate Multisystemic Therapy (MST), a well validated treatment for chronic behavioral problems or serious emotional disturbance in adolescents, to treat dually diagnosed youth using an outpatient model of service delivery.

A pilot trial was conducted with 40 dually diagnosed youth randomly assigned to treatment conditions, with 20 receiving the experimental treatment (OPTION-A) and 20 receiving usual outpatient services. Specific aims were:

Specific Aim 1: The primary aim of the present research was to adapt and test OPTION-A for use in outpatient settings to treat youth diagnosed with a substance use disorder and comorbid internalizing disorder. We hypothesized that youth receiving OPTION-A would exhibit significantly less drug use (e.g., youth self-reports and urine screens) than control youth who received usual services, and that youth receiving OPTION-A would exhibit significant improvement on indices of mental health (e.g., combined youth and caregiver reports on diagnostic interviews and youth, caregiver, and teacher reports of internalizing symptoms) compared to control youth Specific Aim 2: In addition to improved symptomatology, the current research aimed to test the effectiveness of OPTION-A to improve youth functioning in other domains pertinent to successful adolescent development. We hypothesized that youth receiving OPTION-A would evidence improved behavioral (e.g., youth, caregiver, and teacher reports of externalizing), school (e.g., school attendance), and family functioning (e.g., youth and caregiver reports of family adaptability and cohesion) compared to control youth who received usual services.

Specific Aim 3: The final aim of the proposed research was to provide services that are more acceptable to consumers than are usual services provided in the community. We hypothesized that youth and families receiving OPTION-A would experience significantly greater consumer satisfaction than control youth and families who received usual services.

Study Type

Interventional

Enrollment

40

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • South Carolina
      • Charleston, South Carolina, United States, 29425
        • Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Family Services Research Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

12 years to 17 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Presentation for outpatient treatment
  • 12 to 17 years of age
  • Youth residing with at least one adult caregiver who serves as a parent figure
  • Substance Abuse or Dependence Disorder
  • Axis I Internalizing Disorder (Mood Disorder or Anxiety Disorder), based on the Diagnostic Interview Schedule for Children (DISC-IV; Shaffer, Fisher, Lucas, Dulcan, & Schwab-Stone, 2000)

Exclusion Criteria:

  • Pervasive Developmental Disorder
  • Psychotic Disorder
  • Severe or profound mental retardation (IQ of 45 or below)
  • Families previously receiving Multisystemic Therapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Urine Drug Screen at 4 weeks, 8 weeks, 12 weeks, 24 weeks
Score on Depression/Anxiety Scale (RCADS) at 4 weeks, 8 weeks, 12 weeks, 24 weeks

Secondary Outcome Measures

Outcome Measure
Behavioral
Measured at Intake, 3 Months, and 6 Months
Global assessment of symptoms
Parenting
School
Family relationship/communication/problem solving
Consumer satisfaction
Daily Drug/Alcohol use

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Medical University of South Carolina

Collaborators

National Institute on Drug Abuse (NIDA)

Investigators

  • Principal Investigator: Ashli J Sheidow, PhD, Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Family Services Research Center
  • Study Chair: Scott W Henggeler, PhD, Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, Family Services Research Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2004

Primary Completion (Actual)

August 1, 2007

Study Completion (Actual)

September 1, 2010

Study Registration Dates

First Submitted

February 21, 2007

First Submitted That Met QC Criteria

February 21, 2007

First Posted (Estimate)

February 22, 2007

Study Record Updates

Last Update Posted (Actual)

June 14, 2018

Last Update Submitted That Met QC Criteria

June 13, 2018

Last Verified

July 1, 2010

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1R21DA017118-01 (U.S. NIH Grant/Contract)
  • R21DA017118 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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