Clinical Trial: Multisystemic Therapy-Emerging Adults (MST-EA) for Substance Abuse

Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional

Official Title: Treatment of Justice-Involved Emerging Adults With Substance Use Disorders

Brief Summary: This study's purpose is to examine the effectiveness of a promising intervention for emerging adults (EAs) with alcohol and other drug (AOD) abuse and justice involvement in achieving the ultimate outcome of reduced criminal activity. The study will also examine that effect on intermediate outcomes as follows: 1) reduced AOD use; 2) greater gainful activity (increased educational success, employment and housing stability; decreased antisocial peer involvement and relationship conflict); 3) and greater improvement in self-regulation (self-efficacy, goal directedness and responsibility taking). The intervention to be tested is Multisystemic Therapy-Emerging Adults (MST-EA). MST-EA is an adaptation of MST, a well-established, effective intervention for antisocial behavior in adolescents.

Detailed Summary:

Prevalence of alcohol and other drug (AOD) abuse and criminal activity is highest during emerging adulthood compared to any other developmental period, and causes extraordinary costs to society. Emerging Adults (EAs; ages 17-21) with AOD abuse have greater incarceration rates than EAs without AOD abuse, and AOD-abusing offenders have significantly more recidivism, severe offending, and incarceration than other offenders. Such serious behavior interferes with successful transition into adulthood in areas such as school completion, employment and housing. Thus, there is a strong public health need for effective treatment to reduce AOD abuse and justice involvement in EAs. Surprisingly, there are no interventions with established efficacy to reduce criminal activity among EAs, with or without AOD abuse. Among younger adolescents, the comprehensive causes of antisocial behavior are addressed by effective interventions (e.g., Multisystemic Therapy [MST]; Treatment Foster Care Oregon [TFCO]), and the present investigative team has developed and evaluated a well-defined age-tailored intervention for EAs with criminal behavior. The developed intervention is an adaptation of MST and integrates a skills coaching component from TFCO, both well-established effective juvenile justice interventions. Initial MST-EA research focused on justice-involved young adults who had mental health problems, a high-risk subpopulation of offenders, but AOD abuse quickly became a primary problem the MST-EA team treated. As a single-source intervention, MST-EA targets the EA correlates of criminal activity and AOD abuse, including gainful EA activities (positive relationships, school, work, and housing) and reduced AOD abuse—in part by targeting the proximal mechanism of poor self-regulation. In a successfully completed community-based open trial, the safety, feasibility, and preliminary efficacy of the intervention were established.

Sponsor: Oregon Social Learning Center

Current Primary Outcome:

• Change in number and severity of criminal charges in official records in the 16 months pre-Baseline compared with the 16 months post-Baseline. [ Time Frame: 16 months pre-Baseline compared with 16 months post-Baseline. ]
  Changes from the 16 months pre-Baseline in offending as measured by the number and severity of criminal charges in official records compared to 16 months post-Baseline.
• Changes from Baseline scores compared to 16 months post-Baseline Offending Behaviors (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Offending behaviors as measured using the Self-Report Offending Scale (self- and collateral reports).

Original Primary Outcome: Same as current

Current Secondary Outcome:

• Changes from Baseline scores compared to 16 months post-Baseline Self-efficacy (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Self-efficacy as measured using the Self-Efficacy Scale (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline Goal Directedness (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Goal directedness measured using the Wills Self Control Measure (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline Responsibility Taking (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Responsibility taking measured using the Behavioral Indicators of Conscientiousness (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline Urine Drug/Alcohol Screens (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  The number of positive urine screens for tetrahydrocannabinol (THC), synthetic THC, amphetamines, methamphetamines, phencyclidine (PCP), opiates, benzodiazepines, cocaine, and specific metabolites of alcohol (Ethyl glucuronide, Ethyl sulfate).
• Changes from Baseline scores compared to 16 months post-Baseline Treatment Usage (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  The number of hospitalizations, emergency room visits and other treatments for alcohol or drug use as measured using the Time Line Follow Back (self-report) and from archival records.
• Changes from Baseline scores compared to 16 months post-Baseline Substance Use and Problems (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Frequency of substance use and substance-related problems as measured by the Global Appraisal of Individual Needs (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline Antisocial Peers Involvement (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Antisocial peer involvement measured using the Peer Delinquency Scale (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline Interpersonal Competence (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Social conflict and social functioning as measured using the Interpersonal Competence Scale (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline Housing Stability (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Housing stability as measured using the Time Line Follow Back (self- and collateral reports) and from archival records.
• Changes from Baseline scores compared to 16 months post-Baseline Relationship Closeness and Discord (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Relational closeness and relational discord as measured by the Network of Relationship Inventory (self- and collateral reports).
• Changes from Baseline scores compared to 16 months post-Baseline School/Employment Involvement (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  Days in school or work (gainful activities) as measured using the Time Line Follow Back (self- and collateral reports) and from archival records.
• Changes from Baseline scores compared to 16 months post-Baseline Mental Health Symptoms (measured at 0, 2, 4, 6, 8, 12 and 16 months). [ Time Frame: Baseline to 16 months. ]
  The severity and number of mental health symptoms as measured using the Brief Symptom Inventory and the Posttraumatic Stress Disorder Checklist (self- and collateral reports).

Original Secondary Outcome: Same as current

Information By: Oregon Social Learning Center

Dates:
Date Received: January 26, 2017
Date Started: July 15, 2017
Date Completion: April 15, 2021
Last Updated: April 26, 2017
Last Verified: April 2017