Day treatment for cocaine dependence: incremental utility over outpatient counseling and voucher incentives.
Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling (n=39) or day treatment (n=40). Participants in both conditions received equivalent individual cognitive-behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.
Marlowe
Douglas B
DB
Treatment Research Institute at the University of Pennsylvania, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106-3475, USA. marlowe@tresearch.org
Kirby
Kimberly C
KC
Festinger
David S
DS
Merikle
Elizabeth P
EP
Tran
Giao Q
GQ
Platt
Jerome J
JJ
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D019970:Cocaine-Related Disorders / Q000191:economics / Q000628:therapy*; D016578:Crack Cocaine; D003631:Day Care, Medical / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012052:Reimbursement, Incentive / Q000191:economics / Q000706:statistics & numerical data; D019037:Urban Health Services / Q000191:economics / Q000706:statistics & numerical data; D014505:Urban Population
D016578:Crack Cocaine