ERIC Number: EJ875661
Record Type: Journal
Publication Date: 2010-Feb
Pages: 10
Abstractor: As Provided
ISBN: N/A
ISSN: ISSN-0022-006X
EISSN: N/A
Randomized Trial of Continuing Care Enhancements for Cocaine-Dependent Patients following Initial Engagement
McKay, James R.; Lynch, Kevin G.; Coviello, Donna; Morrison, Rebecca; Cary, Mark S.; Skalina, Lauren; Plebani, Jennifer
Journal of Consulting and Clinical Psychology, v78 n1 p111-120 Feb 2010
Objective: The effects of cognitive-behavioral relapse prevention (RP), contingency management (CM), and their combination (CM + RP) were evaluated in a randomized trial with 100 cocaine-dependent patients (58% female, 89% African American) who were engaged in treatment for at least 2 weeks and had an average of 44 days of abstinence at baseline. Method: The participants were from intensive outpatient programs, which provide 10 hr per week of group counseling. The CM protocol provided gift certificates (maximum value $1,150; mean received = $740) for cocaine-free urines over 12 weeks on an escalating reinforcement schedule, and weekly individual RP sessions were offered for up to 20 weeks. Average number of RP sessions attended was 3 in RP and 13 in CM + RP. Results: Generalizing estimation equation analyses over 18 months postrandomization showed significant effects for CM (but not RP) on urine toxicology and self-reported cocaine use (p = 0.05), with no significant CM x RP interactions. Secondary analyses indicated CM + RP produced better cocaine urine toxicology outcomes at 6 months than treatment as usual, odds ratio [OR] = 3.96 (1.33, 11.80), p less than 0.01, and RP, OR = 4.89 (1.51, 15.86), p less than 0.01, and produced better cocaine urine toxicology outcomes at 9 months than treatment as usual, OR = 4.21 (1.37, 12.88), p less than 0.01, and RP, OR = 4.24 (1.32, 13.65), p less than 0.01. Trends also favored CM + RP over CM at 6 months, OR = 2.93 (0.94, 9.07), p = 0.06, and 9 months, OR = 2.93 (0.94, 9.10), p = 0.06. Differences between the conditions were not significant after 9 months. Conclusions: These results suggest CM can improve outcomes in cocaine-dependent patients in intensive outpatient programs who have achieved initial engagement, particularly when it is combined with RP. (Contains 3 figures and 2 tables.)
Descriptors: Cocaine, Contingency Management, Toxicology, Patients, Group Counseling, Drug Addiction, Cognitive Restructuring, Behavior Modification, Prevention, Drug Use Testing, Rewards, Trend Analysis, Outcomes of Treatment
American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002-4242. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org/publications
Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Audience: N/A
Language: English
Sponsor: N/A
Authoring Institution: N/A
Grant or Contract Numbers: N/A