title: Exposure to Adolescent Community Reinforcement Approach treatment procedures as a mediator of the relationship between adolescent substance abuse treatment retention and outcome.
abstract: Data from 399 adolescents, who participated in one of four randomly controlled trials of the Adolescent Community Reinforcement Approach (A-CRA) intervention, were used to examine the extent to which exposure to A-CRA procedures mediated the relationship between treatment retention and outcomes. Although zero-order correlations indicated that retention in treatment was a significant predictor of alcohol and other drug (AOD) use (r = -0.18, p < .001), this relationship was reduced to nonsignificance (p = .39) when exposure to A-CRA procedures was included in the model. Overall, the final model evidenced a very good fit (root mean square error of approximation = .00; comparative fit index = 1.00) and explained 29% and 43% of the variance in adolescents' posttreatment AOD use and AOD-related problems, respectively. In addition, Chi-Squared Automatic Interaction Detection analysis was used to derive a target level of A-CRA exposure, which was found to be significantly related to being in recovery at follow-up. The current findings are useful, as little research to date has identified significant mediators of the relationship between retention and treatment outcomes or identified target thresholds of treatment exposure.
authors: Chestnut Health Systems, Bloomington, IL 61701, USA. brgarner@chestnut.org
authors: Bryan R
authors: BR
authors: Garner
authors: Susan H
authors: SH
authors: Godley
authors: Rodney R
authors: RR
authors: Funk
authors: Michael L
authors: ML
authors: Dennis
authors: Jane Ellen
authors: JE
authors: Smith
authors: Mark D
authors: MD
authors: Godley
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D003153:Community Health Services; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010352:Patient Dropouts; D011153:Population; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome