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The effect of assertive continuing care on continuing care linkage, adherence and abstinence following residential treatment for adolescents with substance use disorders
Abstract
AIMS: This study compared assertive continuing care (ACC) to usual continuing care (UCC) on linkage, retention and a measure of continuing care adherence. Outcome analyses tested the direct and indirect effects of both conditions and level of adherence on early (months 1-3) and longer-term (months 4-9) abstinence. DESIGN: Two-group randomized design. SETTING: Eleven counties surrounding a community-based residential treatment program in the Midwestern section of the United States. PARTICIPANTS: A total of 183 adolescents, ages 12-17 years, with one or more Diagnostic and Statistical Manual version IV (DSM-IV) substance use dependence disorder and met American Society for Addiction Medicine (ASAM) placement criteria for non-medical residential treatment. INTERVENTION: Prior to discharge from residential treatment, participants were assigned randomly to receive either UCC, available at outpatient clinics in the 11-county study area, or ACC via home visits. MEASUREMENTS: Self-reported interview data were collected at intake, 3, 6 and 9 months post-residential discharge. Urine test data and interviews with a caregiver were conducted at baseline and 3 months. FINDINGS: ACC led to significantly greater continuing care linkage and retention and longer-term abstinence from marijuana. ACC resulted in significantly better adherence to continuing care criteria which, in turn, predicted superior early abstinence. Superior early abstinence outcomes for both conditions predicted longer-term abstinence. CONCLUSIONS: ACC appears to be an effective alternative to UCC for linking, retaining and increasing adherence to continuing care. Replication with larger samples is needed to investigate further the direct and indirect effects of ACC found in this study
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“Previous studies highlight that youth tend to return to environments that put them at high risk for relapse and problems, including untrusting or unsupportive family as well as continuing to socialize with substance-using peers/partners (Brown & Ramo, 2006; Godley et al., 2006).”
From Substance use recovery outcomes among a cohort of youth participating in a mobile-based texting aftercare pilot program (2014) · cites this paper as Godley et al., 2006
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Metadata
- Authors
- Godley, M. D., Godley, S. H., Dennis, M. L., Funk, R. R., & Passetti, L. L.
- Affiliations
- Chestnut Health Systems (US)
- Corresponding author
- Godley, Mark D.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2006-12-20
- Volume
- 102
- Issue
- 1
- Pages
- 81-93
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W1978164555
- Cited by
- 193
- References
- 59
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 8 · 2023: 4 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 2 · 2018: 11 · 2017: 17 · 2016: 6 · 2015: 11 · 2014: 18 · 2013: 11 · 2012: 15
- FWCI
- 6.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institute on Alcohol Abuse and Alcoholism (R01AA010368)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Keywords
- treatment retention, abstinence, adolescents, substance use disorders, residential treatment, cannabis use, home visits, outpatient follow-up
- MeSH terms
- Adolescent, Continuity of Patient Care, Female, Follow-Up Studies, Humans, Male, Patient Compliance, Residential Treatment, United States, Substance Abuse Treatment Centers, Substance-Related Disorders
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