Assertive Continuing Care for Adolescents Mark D. Godley, Ph.D., Susan H. Godley, Rh.D., Michael L. Dennis, Ph.D., Rod Funk, B.S., and Lora L. Passetti, M.A. Chestnut Health Systems Bloomington, IL This work is supported by grants from the National Institute on Alcoholism & Alcohol Abuse, the SAMHSA Center for Substance Abuse Treatment, and the Illinois Division of Alcoholism & Substance Abuse. The opinions are those of the author and do not
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Assertive Continuing Care for Adolescents Mark D. Godley, Ph.D., Susan H. Godley, Rh.D., Michael L. Dennis, Ph.D., Rod Funk, B.S., and Lora L. Passetti,
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Assertive Continuing Care for Adolescents
Mark D. Godley, Ph.D., Susan H. Godley, Rh.D.,
Michael L. Dennis, Ph.D., Rod Funk, B.S., and
Lora L. Passetti, M.A.
Chestnut Health Systems
Bloomington, IL
This work is supported by grants from the National Institute on Alcoholism & Alcohol Abuse, the SAMHSA Center for Substance Abuse Treatment, and the Illinois Division of Alcoholism & Substance Abuse. The opinions are those of the author and do not reflect official positions of the government.
CollaboratorsSeveral colleagues at Chestnut served as co-
investigators or collaborators on this study. Their contributions made this work possible: Loree Adams, Becky Buddemeyer, Michael Dennis, Rod Funk, Susan Godley, Jen Hammond, Tracy Karvinen, Matt Orndorff, Lora Passetti, Laura Sloan, Ben Wells, Jen White, and Kelli Wright
And…Drs. H. Perl & J. Hough, NIAAA; R. Muck & J.
Buttler, CSAT; and M. Whitter, Illinois OASA
Questions Why is continuing care important? What have we learned about continuing
care in treatment programs? What is an “assertive” approach to
continuing care? What is the critical roll of supervision in
Assertive Continuing Care (ACC)? How does ACC compare to standard
practice in terms of implementation and outcome?
Why is Continuing Care Important?
Like many other illnesses, addiction is a chronic, relapsing condition.
Brown et al., 1989: 60% of youth relapsed in first 90 days after res. tx.
Dennis reports that most youth treated in the CYT outpatient study moved in and out of recovery.
Most Patients Alternate Between Relapse & Recovery (30 mo. follow up)
Preservation (Woods & Haene, 2002) Case Monitoring and Telephone Support
(Foote & Erfurt, 1991; Stout et al., 1999) Assertive Continuing Care Study (Godley
et al., 2002)
Suggested Goals of CC Encouraging and Priming Prosocial
Activities Reduce Social Risk Social Skill Development Monitoring to Prevent Relapse* Support* Linkage to Other Services Re-Intervention for Major Relapse**Essential CC Functions
A Controlled Study of the Effectiveness of Assertive Continuing Care
Research Questions
To determine the effectiveness of usual vs. assertive continuing care following residential treatment in:engaging and retaining youth in continuing care services
linking youth to additional services reducing AOD use and problems
Who was eligible to participate in the study?
Adolescents admitted to residential treatment (ASAM Level 3 care)
Length of stay of 7 days or longer (not required to have a successful discharge)
Reside in one of our “aftercare target counties”
ACC Study Research Design
Intervention N Intake ResidentialTreatmentPlusAftercare
3 mo afterdischargefrom RT
6 mo afterdischargefrom RT
9 mo afterdischargefrom RT
AssertiveContinuingCare
102 O0 TUCC+ACC O3 O6 O9
UsualContinuingCare
81 O0 TUCC O3 O6 O9
Note O = participant interview T = treatment No line between rows means randomization
Core Measures
GAIN-I and GAIN M90 Form 90 TLFB BAC and Urine tests Collateral Assessment Form
Recruitment and Follow-up
81% of eligible clients agreed to participate
93% of all participants were interviewed at baseline, 3, 6, and 9 months
96% of all follow-up interviews were completed within two weeks of due date
Demographic Characteristics
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Usual Continuing Care (UCC) Assertive Continuing Care (ACC)
Baseline Substance Use Characteristics
0%10%20%30%40%50%60%70%80%90%
100%
Usual Continuing Care (UCC) Assertive Continuing Care (ACC)