This project focuses on the development of improved drug abuse treatment to help reduce client dropout and relapse rates as well as AIDS-risky behaviors of intravenous drug users (IVDUs). Established treatment agencies in three cities in Texas-Houston, Dallas, and Corpus Christi-will collaborate to implement and evaluate new intervention strategies in the context of outpatient drug-free and methadone maintenance services. The 5-year project will provide treatment for an estimated 1,560 IVDUs at a time when HIV infection rates are still low enough to have a major preventive impact on projected epidemic outbreaks of AIDS in the Southwest. Women and Mexican-American addicts represent special interest groups. The research strategy is to isolate and evaluate each separate component of the behavioral intervention process. A cognitive learning strategy--concept mapping--will be tested as a method for improving communication and understanding of AIDS information and for conducting behavioral assessment and goal-setting counseling with IVDUs. The use of consistency management, involving client-contracted schedules of treatment and economic incentives as positive reinforcers, for changing target behaviors during and after treatment will also be evaluated. Finally, the behavioral and psychological facilitation offered by life skills and ancillary training will be assessed, including assertiveness training (especially for women) to increase self-esteem and protection from risky drug use and sexual interactions, extinction training to alleviate conditioned drug-craving responses to environmental cues, relapse prevention training to sensitize IVDUs to psychological and environmental triggers for relapse and alternative coping strategies, and support training to acquaint clients with self-help and treatment aftercare procedures and benefits in an effort to increase referral and attendance rates. Appropriateness and effectiveness of these methods will also be analyzed in relation to client characteristics for evidence of optimal matches. Client sociodemographic, family and cultural background, behavioral functioning, and psychological adjustment measures will be used as predictors in the evaluations of each stage of the intervention process. Experimental and quasi-experimental methods will be employed using during-treatment and followup outcomes, including length of retention, behavioral performance (including urinalysis and self-report information), and psychological functioning indicators during treatment, as well as 1 and 2 year followup interview data.
| Simpson, D Dwayne; Joe, George W; Dansereau, Donald F et al. (2011) Addiction treatment outcomes, process and change: Texas Institute of Behavioral Research at Texas Christian University. Addiction 106:1733-40 |
| Joe, George W; Simpson, D Dwayne; Rowan-Szal, Grace A (2009) Interaction of counseling rapport and topics discussed in sessions with methadone treatment clients. Subst Use Misuse 44:3-17 |
| Johnson, J; Williams, M L; Chatham, L (1995) The Houston Advance DATAR Follow-Up project: private investigator techniques for public health. Am J Public Health 85:868-9 |
