Chestnut Health Systems, Lighthouse Institute, 448 Wylie Drive, Normal, IL 61761, USA.
Drug Alcohol Depend. 2010 Jul 1;110(1-2):44-54. doi: 10.1016/j.drugalcdep.2010.02.003. Epub 2010 Mar 9.
This study evaluated the effectiveness and cost-effectiveness of two types of outpatient treatment with and without Assertive Continuing Care (ACC) for 320 adolescents with substance use disorders. Study participants were randomly assigned to one of four conditions: (a) Chestnut's Bloomington Outpatient Treatment (CBOP) without ACC; (b) CBOP with ACC; (c) Motivational Enhancement Therapy/Cognitive Behavior Therapy-7 session model (MET/CBT7) without ACC; and (d) MET/CBT7 with ACC. All study conditions attained high rates of participant engagement and retention. Follow-up interviews were completed with over 90% of the adolescents at three, six, nine, and 12 months after treatment admission. There was a significant time by condition effect over 12 months, with CBOP having a slight advantage for average percentage of days abstinent. Unlike previous findings that ACC provided incremental effectiveness following residential treatment, there were no statistically significant findings with regard to the incremental effectiveness of ACC following outpatient treatment. Analysis of the costs of each intervention combined with its outcomes revealed that the most cost-effective condition was MET/CBT7 without ACC.
本研究评估了两种门诊治疗方法（含或不含坚定延续治疗）对 320 名患有物质使用障碍的青少年的有效性和成本效益。研究参与者被随机分配到以下四种条件之一：（a）无坚定延续治疗的 Chestnut's Bloomington 门诊治疗（CBOP）；（b）含坚定延续治疗的 CBOP；（c）无坚定延续治疗的动机增强疗法/认知行为疗法-7 次模型（MET/CBT7）；以及（d）含坚定延续治疗的 MET/CBT7。所有研究条件都实现了参与者的高参与率和保留率。在治疗入院后 3、6、9 和 12 个月，对超过 90%的青少年进行了随访访谈。在 12 个月的时间里，存在显著的时间与条件效应，CBOP 在平均戒断天数方面略有优势。与坚定延续治疗对住院治疗后提供额外效果的先前发现不同，门诊治疗后坚定延续治疗的额外效果没有统计学意义。对每个干预措施的成本与其结果进行分析后发现，最具成本效益的条件是无坚定延续治疗的 MET/CBT7。
