This application proposes a dismantling strategy to evaluate the multi-faceted Community Reinforcement Approach (CRA) and Contingency Management (CM), promising behavioral treatments for cocaine dependence, in an inner city population of cocaine-dependent pregnant and postpartum women. In the proposed 2x2 factorial design, CRA will be compared to a standard, less intensive treatment, drug counseling (DC), and both CRA and DC will be combined with either contingency management (CM), utilizing vouchers worth a monetary value as a reward for abstinence, or non-contingent vouchers yoked in value to vouchers provided in CM (voucher control, VC). Cocaine-dependent women (N = 18O) who either are pregnant or have given birth to a child during the past three months will be randomly assigned to one of four treatment conditions: CRA+CM, CRA+VC, DC+CM, or DC+VC. Treatment will be provided for 24 weeks by trained and experienced therapists. CRA will be provided in twice weekly one hour individual sessions, and DC will be provided in a weekly 50 minute individual session and a brief 10 minute follow-up session. All treatments are manual-guided and will be carefully monitored to insure adherence to the manuals and competence of the therapists. Major outcome measures, assessed during the clinical trial and at three and six months following completion of the trial, include reductions in cocaine use, reduced HIV risk behavior, and improved knowledge of parenting and maternal- child interactions.
| Schottenfeld, Richard S; Moore, Brent; Pantalon, Michael V (2011) Contingency management with community reinforcement approach or twelve-step facilitation drug counseling for cocaine dependent pregnant women or women with young children. Drug Alcohol Depend 118:48-55 |
| Pantalon, Michael V; Chawarski, Marek C; Falcioni, Jean et al. (2004) Linking process and outcome in the community reinforcement approach for treating cocaine dependence: a preliminary report. Am J Drug Alcohol Abuse 30:353-67 |
