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Sponsored by: |
National Institute on Alcohol Abuse and Alcoholism (NIAAA) |
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Information provided by: | National Institute on Alcohol Abuse and Alcoholism (NIAAA) |
ClinicalTrials.gov Identifier: | NCT00583440 |
This is a randomized trial testing the efficacy of a modified 12-step facilitation therapy for individuals with serious mental illness and alcohol use disorders, compared to usual treatment. 135 participants are randomized in 2:1 ratio to the modified 12-step facilitation (12 sessions of individual counseling) vs. treatment as usual.
The primary hypothesis is that those receiving 12-step facilitation will have better drinking outcomes (percent days abstinence and drinks per drinking day)at end of treatment.
Condition | Intervention | Phase |
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Alcoholism Diagnosis, Dual (Psychiatry) |
Behavioral: 12-step facilitation Behavioral: Treatment as usual |
Phase I Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study |
Official Title: | 12-Step Facilitation for the Dually Diagnosed |
Estimated Enrollment: | 135 |
Study Start Date: | September 2005 |
Estimated Study Completion Date: | May 2010 |
Estimated Primary Completion Date: | May 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Experimental |
Behavioral: 12-step facilitation
12 weekly individual 12-step facilitation sessions
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2: Active Comparator |
Behavioral: Treatment as usual
Usual clinical treatment in a dual diagnosis treatment program
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Although there has been relatively little work on 12-step treatment for seriously mentally ill patients, extant literature indicates that dually diagnosed individuals attend traditional 12-step programs such as AA, NA, and CA at rates comparable to singly diagnosed substance abusers, and that participation is associated with decreases in substance use. Specialized 12-step programs for the dually diagnosed, developed over the past 10 years, may offer additional benefits. In order to maximize the effectiveness of specialized and traditional 12-step programs for dually diagnosed individuals, specially adapted 12-step facilitation (TSF) treatment for the dually diagnosed should be developed and tested. Standard TSF should be modified to address the special needs of dually diagnosed individuals, mesh with specialized 12-step programs available in the area, and address barriers to attendance, participation, and engagement experienced by the dually diagnosed. We have developed a modified TSF based on the Project MATCH TSF manual. Modifications to this 12 week individual therapy include: emphasis on specialized 12-step program attendance; readings primarily from specialized 12-step program literature; participation in the second session by a community specialized 12-step program member; case management to assist participants in finding and attending meetings; omission of work on the fourth step; and the addition of topics covering medication compliance and specific social skills needed to negotiate 12-step meetings. In a pilot study with 10 dually diagnosed individuals, participants showed significant decreases in substance use and significant increases in 12-step attendance after receiving the specialized TSF. Building on this pilot study, the proposed study is a larger Stage 1b study of the modified TSF for seriously mentally ill patients engaged in dual diagnosis treatment. Participants with a psychotic or major affective disorder will be randomized to modified TSF (n=90) vs. treatment as usual (n=45). Participants will be followed for a total of 48 weeks. Assessments will include rigorous diagnosis and measures of alcohol and other drug use, consequences, psychiatric symptoms, 12-step behaviors, 12-step specific and non-specific change mechanisms, and social support. Specific Aims of the study include assessment of the integrity of the planned intervention and assessment battery; tests of the effectiveness of the adapted TSF relative to treatment as usual; determination of whether psychiatric diagnosis moderates treatment response; and investigation of causal mechanisms of response to treatment.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Aaron Baca, B.A. | 505-925-4190 | abaca@salud.unm.edu |
United States, New Mexico | |
UNM HSC Department of Psychiatry Clinical Trials | Recruiting |
Albuquerque, New Mexico, United States, 87131 |
Principal Investigator: | Michael P. Bogenschutz, MD | University of New Mexico Health Sciences Center |
Responsible Party: | University of New Mexico Health Sciences Center ( Michael P. Bogenschutz, M.D., Professor of Psychiatry ) |
Study ID Numbers: | Bogenschutz-AA015419, NIH Grant 1R01 AA015419 |
Study First Received: | December 20, 2007 |
Last Updated: | January 9, 2009 |
ClinicalTrials.gov Identifier: | NCT00583440 History of Changes |
Health Authority: | United States: Federal Government |
12-step mutual help dual diagnosis serious mental illness |
Mental Disorders Alcoholism Substance-Related Disorders Disorders of Environmental Origin Alcohol-Related Disorders |
Mental Disorders Alcoholism Substance-Related Disorders Disorders of Environmental Origin Alcohol-Related Disorders |