title: Contracting, prompting, and reinforcing substance use disorder continuing care: a randomized clinical trial.
abstract: Although continuing care is strongly related to positive treatment outcomes for substance use disorder (SUD), participation rates are low and few effective interventions are available. In a randomized clinical trial with 150 participants (97% men), 75 graduates of a residential Veterans Affairs Medical Center SUD program who received an aftercare contract, attendance prompts, and reinforcers (CPR) were compared to 75 graduates who received standard treatment (STX). Among CPR participants, 55% completed at least 3 months of aftercare, compared to 36% in STX. Similarly, CPR participants remained in treatment longer than those in STX (5.5 vs. 4.4 months). Additionally, CPR participants were more likely to be abstinent compared to STX (57% vs. 37%) after 1 year. The CPR intervention offers a practical means to improve adherence among individuals in SUD treatment.
authors.affiliation: Mental Health Service Line, Salem Veterans Affairs Medical Center, Salem, VA, USA. steven.lash@med.va.gov
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Lash
authors.forename: Robert S
authors.initials: RS
authors.lastname: Stephens
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Burden
authors.forename: Steven C
authors.initials: SC
authors.lastname: Grambow
authors.forename: Josephine M
authors.initials: JM
authors.lastname: DeMarce
authors.forename: Mark E
authors.initials: ME
authors.lastname: Jones
authors.forename: Brian E
authors.initials: BE
authors.lastname: Lozano
authors.forename: Amy S
authors.initials: AS
authors.lastname: Jeffreys
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Fearer
authors.forename: Ronnie D
authors.initials: RD
authors.lastname: Horner
mesh_terms: D000328:Adult; D000359:Aftercare; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D001521:Behavior Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012056:Reinforcement, Social; D012114:Residential Treatment; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D013695:Temperance / Q000523:psychology; D014728:Veterans / Q000523:psychology*