title: Contracting, prompting and reinforcing substance use disorder continuing care.
abstract: The contracting, prompting and reinforcing (CPR) aftercare intervention has improved treatment adherence and outcomes in a number of clinical trials. In multisite randomized clinical trial 92 graduates of two intensive substance use disorder programs who received CPR were compared to 91 who received standard treatment (STX). The CPR group evidenced increased frequency of aftercare group therapy attendance and near significant findings suggested that more CPR than STX participants completed 3 months (76 vs. 64%), 6 months (48 vs. 35%), and 9 months (35 vs. 22%) of aftercare. However, the groups did not differ on the majority of attendance measures and had similar abstinence rates at the 3-month (67% CPR vs. 71% STX), 6-month (52% CPR vs. 51% STX), and 12-month (the primary outcome measure; 48% CPR vs. 49% STX) follow-up points. Exploratory analyses suggest that CPR might be more effective among participants not required to attend aftercare. The incremental capital and labor cost of CPR compared to STX was $98.25 per participant.
authors.affiliation: Salem Veterans Affairs Medical Center, Salem, VA 24153, USA. Steven.Lash@va.gov
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Lash
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Burden
authors.forename: Jefferson D
authors.initials: JD
authors.lastname: Parker
authors.forename: Robert S
authors.initials: RS
authors.lastname: Stephens
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Budney
authors.forename: Ronnie D
authors.initials: RD
authors.lastname: Horner
authors.forename: Santanu
authors.initials: S
authors.lastname: Datta
authors.forename: Amy S
authors.initials: AS
authors.lastname: Jeffreys
authors.forename: Steven C
authors.initials: SC
authors.lastname: Grambow
mesh_terms: D000359:Aftercare; D000436:Alcoholics Anonymous; D003362:Cost-Benefit Analysis; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D012008:Recurrence; D012054:Reinforcement, Psychology; D012114:Residential Treatment; D015813:Substance Abuse Detection; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs