Peer-Delivered Episodic Future Thinking for Returning Citizens

February 22, 2025 updated by: Julia Felton, Henry Ford Health System

Peer Delivered Episodic Future Thinking to Improve MOUD Treatment Engagement Among Returning Citizens - A Randomized Controlled Trial

The goal of this study is to examine the effectiveness of a brief, episodic future thinking (EFT) intervention in a substance use treatment setting serving returning citizens with substance use disorders (SUD).

The main questions it aims to answer are:

  1. Determine preliminary implementation potential of the EFT intervention, including acceptability and feasibility of conducting the intervention.
  2. Examine the preliminary effectiveness of this approach, with a specific focus on patient outcomes, including changes in delay discounting, treatment retention, treatment motivation, and substance use.

Participants will be asked to participant in pre and post assessment questionnaires, participate in a single-episode brief intervention followed by tailored phone call follow-ups.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Returning citizens with substance use disorders (SUD) are at the greatest risk for overdose in the first two weeks following the transition from incarceration. Thus, the reentry period is of specific importance for ensuring individuals are engaged and retained in specialized intervention services. Individuals also face numerous, and highly impactful, decisions during this period. They are required to navigate complex tasks (finding employment, securing housing), often with limited financial and social supports. Of particular concern, recent research suggests that the reentry period, often characterized by instability and limited resources, may reinforce a decision-making approach that favors meeting immediate needs relative to engaging in long-term planning. This focus on attaining smaller but immediately available rewards relative to larger, delayed, rewards (known as delay discounting), in turn, has been associated with a number of negative health outcomes, including substance use and poor treatment outcomes (higher dropout and lower motivation). In other words, the reentry context may create an environment which reinforces individuals' tendencies to engage in short-term, reward-seeking behaviors (e.g. substance use, skipping treatment appointments) at a time when their decisions have highly significant consequences (relapse, recidivism). This study will examine the efficacy of implementing a low-cost, brief intervention (Episodic Future Thinking) targeting the reduction of delay discounting with the reentry population to inform broader public health efforts aimed at reducing substance misuse and improvements in treatment outcomes.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • Not Applicable

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
    • Michigan
      • Detroit, Michigan, United States, 48208
        • Detroit Recovery Project

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. At least 18 years of age
  2. Experience in an incarceration setting within 12 months
  3. Identify as an individual in substance use recovery
  4. Willing to participate in the study
  5. Able to participate in written assessments and an intervention conducted in English
  6. Willing to receive brief bi-weekly check-in calls for one month, email, and other phone messages related to study participation including SMS/text messages as needed

Exclusion Criteria:

  1. Individuals' ineligible or unwilling to participate in study activities and assessments
  2. Self-reporting of active and untreated psychosis

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Elongating Time HOrizons for Reentry (ETHoR)
Episodic Future Thinking (EFT) utilizes participant-generated descriptions of future events to elongate an individual's temporal horizon. In EFT paradigms, the participant is asked to create and envision vivid descriptions of specific, positively valanced, events that could happen in the future. Recent research suggests that directing EFTs to focus on specific goals (i.e. evoking images of oneself engaging in activities consistent with a desired future outcome) are associated with stronger decreases in undesirable health behaviors. Thus, as part of the ETHoR condition, participants will be asked to verbally describe and imagine four specific events reflecting positive activities in which the participant engages in substance and incarceration-free activities, corresponding to predetermined future timepoints. The PRC will encourage participants to include as many contextual and emotional details as possible.
Behavioral: Elongating Time HOrizons for Reentry (ETHoR)
The adapted episodic future thinking (EFT) intervention will focus on generation of vivid, substance-free, rewarding events that could happen in an incarceration free future.
Other Names:
  • Episodic Future Thinking (EFT)
Active Comparator: Standardized Recent Thinking (ERT)
Individuals in the control group utilizes SET; an approach that controls for activation of episodic thinking but does not engage prospection (the hypothesized mechanism of episodic future thinking, future outcome) are associated with stronger decreases in undesirable health behaviors. Thus, as part of the SET condition, participants will be asked to verbally describe and imagine four current events reflecting positive activities in which the participant engages in substance and incarceration-free activities, corresponding to current experiences. The PRC will encourage participants to include as many contextual and emotional details as possible.
Behavioral: Standardized Episodic Thinking (SET)
In the standardized episodic thinking (SET) condition, the participant will instead describe in vivid details events that have occurred in the recent past.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Delay Discounting 5 Trial Adjusted Measure
Time Frame: Baseline and up to 3 months post-intervention
The computer based adjusting amount discounting task uses an adjusting algorithm to determine the amount of immediately available money that is equivalent to a large sum that is delayed by seven discrete durations of time presented in a randomized order (i.e., 1 day, 1 week, 1 month, 6 months, 1 year, 5 years, and 25 years). At each delay, a choice is first presented between the delayed larger sum and a smaller sum available immediately. For each trial, the position of the delayed and immediate amounts are randomly assigned and the participant chooses the preferred option by pressing the corresponding response button.
Baseline and up to 3 months post-intervention
Change in Consideration of Future Consequences Scale
Time Frame: Baseline and up to 3 months post-intervention
The Consideration of Future Consequences Scale1 (CFCS-14) is a 14-item self-report questionnaire that assesses active consideration of longer-term implications of an individual's actions. Lower scores on the CFCS-14 are associated with a greater focus on immediate needs and have been found to be associated with less engagement in health behaviors1819 and greater substance use. The measure has been used extensively among adult samples and demonstrates strong reliability and validity. Research suggests modest but significant correlations with the MCQ.
Baseline and up to 3 months post-intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Short Michigan Alcohol Screening Test (SMAST)
Time Frame: Baseline and up to 3 months post-intervention
The SMAST is a brief questionnaire consisting of 13 items. It can be completed in just a few minutes and is designed for individuals with a reading level equivalent to that of a 7th grader. This assessment tool was derived from the Michigan Alcoholism Screening Test and has been found to be a reliable diagnostic tool to detect at-risk alcohol use, alcohol abuse, or alcoholism. The evaluation data suggests its effectiveness, with no notable occurrence of false positives.
Baseline and up to 3 months post-intervention
Change in Drug Abuse Screen Test (DAST)
Time Frame: Baseline and up to 3 months post-intervention
The DAST offer a concise self-report tool for screening populations, identifying clinical cases, and researching treatment effectiveness related to drug abuse. It is applicable for use with both adults and older adolescents. The DAST-10 provides a numerical gauge of the extent of drug abuse-related consequences. Administering the assessment takes around 5 minutes Condensed from its longer counterpart of 28 items, the DAST-10 comprises 10 self-report items.
Baseline and up to 3 months post-intervention

Collaborators and Investigators

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

Sponsor

Henry Ford Health System

Collaborators

Michigan State University
University of Kansas
Detroit Recovery Project INC

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Actual)

November 14, 2023

Primary Completion (Actual)

December 31, 2024

Study Completion (Actual)

January 30, 2025

Study Registration Dates

First Submitted

October 25, 2023

First Submitted That Met QC Criteria

October 31, 2023

First Posted (Actual)

November 7, 2023

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

February 22, 2025

Last Verified

February 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • JRCT: 16686-01

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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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