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Clinical Trial of Abstinence-Linked Money Management

09:09 EDT 24th April 2014 | BioPortfolio

Summary

This is a randomized controlled trial to test whether a money-management based intervention reduces substance abuse.

Description

While the Social Security Administration (SSA) no longer provides benefits for individuals disabled by drug abuse per se, approximately 50% of recipients have a concomitant substance abuse disorder. Supported by disability payments, this substance abuse impedes recovery/remission from the comorbid mental disorder. Money management is widely implemented in dual diagnosis treatment - in patients assigned payees to manage their funds and in patients receiving case management - but whether money management reduces substance abuse is unproven. If shown to be effective, money management-based therapy can be logically integrated into these existing arrangements. There is no specific substance abuse focus to standard payee and case management arrangements.

We have developed a money management-based therapy called Advisor-Teller money manager (the bank-like acronym is ATM). ATM involves having a patient voluntarily allow a therapist/money manager to limit the patients' access to his/her funds, thus preventing unrestricted access to cash from cueing substance use. Patients meet with therapist/money managers at least weekly. Meetings begin with a review of the previous week's expenditures, including expenditures for drugs and alcohol, and an on-site urine toxicology test and breathalyzer. Patients then plan a budget that is incompatible with drug use by budgeting funds for direct payment of expenses (such as rent), abstinence-compatible activities and long-term goals. Budgeting and planning will develop patients' skills at managing their funds. Dispensing procedures build upon the principles of therapeutic contracting. Patients contract to receive their funds for specific expenditures and then review the next week whether the funds were spent as planned.

We are conducting a Stage 2 randomized clinical trial in which 120 patients will be randomly assigned to 36-weeks of either ATM or Finance Instruction Therapy (FIT), a low intensity intervention in which patients are given basic financial instruction to determine the efficacy of ATM in reducing substance use.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment

Conditions

Substance Abuse

Intervention

Advisor-Teller Money Manager, FIT

Location

Connecticut Mental Health Center
New Haven
Connecticut
United States
06519

Status

Completed

Source

Yale University

Results (where available)

View Results

Links

Medical and Biotech [MESH] Definitions

Abuse, overuse, or misuse of a substance by its injection into a vein.

An agency of the PUBLIC HEALTH SERVICE concerned with the overall planning, promoting, and administering of programs pertaining to substance abuse and mental health. It is commonly referred to by the acronym SAMHSA. On 1 October 1992, the United States Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) became SAMHSA.

Health facilities providing therapy and/or rehabilitation for substance-dependent individuals. Methadone distribution centers are included.

Disorders related to substance abuse, the side effects of a medication, toxin exposure, and ALCOHOL-RELATED DISORDERS.

The provision of monetary resources including money or capital and credit; obtaining or furnishing money or capital for a purchase or enterprise and the funds so obtained. (From Random House Unabridged Dictionary, 2d ed.)

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