? A second five-year Independent Scientist Award (K02) is requested to allow the candidate to continue to focus on and to expand his research programs on developing enhanced treatments to improve the outcomes of substance abuse patients. The award would also make it possible for the candidate to pursue further training in newer longitudinal data analytic techniques, economic research (i.e., benefit-cost, cost-effectiveness), and adaptive (i.e., flexible) treatment interventions that can be modified in response to change in patient symptoms or status over time. The proposed training will be accomplished through collaborations and guided readings with experts in these areas. ? ? During the funding period, the candidate will complete two continuing care studies for which he is the PI, and the primary manuscripts describing results from these studies. Initial results support the use of adaptive, telephone-based continuing care interventions with alcohol and cocaine dependent patients. In addition, the candidate is the PI of another NIDA-funded R01 (in year 2 of 5) that compares three enhanced treatment approaches for cocaine-dependent patients participating in an Intensive Outpatient program (lOP) to treatment as usual in lOP. Recent studies have indicated that the addition of services for concurrent psychiatric, interpersonal, and employment problems can improve substance use outcomes for patients, particularly if they have greater problem severity in these areas. An independent line of research has generated considerable evidence that providing reinforcement in the form of vouchers, contingent on providing drug-free urine samples, that can be redeemed for goods and services can also lead to improved substance use outcomes. These findings suggest that there may be two conceptually and theoretically different, behaviorally-based avenues for improving treatment outcomes for substance abusers. The candidate's current study uses a 2 x 2 design to investigate the main effects and potential interaction effects of services matched to problems and voucher reinforcement of abstinence. The cost-effectiveness and benefit cost of each of the enhanced interventions will also be determined, through a collaboration with Dr. Michael French. ? ? ? ?
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