The vast majority of individuals who are dependent on cocaine do not become involved in treatment. This has become a topic of considerable concern, especially since cocaine abuse is increasingly being associated with the spread of AIDS. The project proposed here will address this concern by explicating, standardizing, pilot testing and refining a method for engaging resistant cocaine-dependent individuals in treatment. The method has been developed over the past seven years and involves the use of family members and significant others to induct the cocaine abuser. Termed the Albany-Rochester Interventional Sequence for Engagement (ARISE), it is designed to maximize patient recruitment, while minimizing the amount of time and energy required of staff. Preliminary data indicate that ARISE is successful for the majority of reluctant cases. The purpose of this project will be to bring ARISE to the point where it can be used in clinical trials and generalizable to different programs. The project will initially involve a collaboration among the principals who developed and contributed to the ARISE method toward construction of a manual, accompanied by a three-volume reference guide, one volume for each of ARISE's three levels (the last of which is a modified Johnson Institute """"""""Intervention""""""""). Nine to ten families who went through the process will be interviewed for their suggestions for improving the ARISE process. The second phase of the project will be to teach ARISE to eight uninitiated senior counselors. These people will then pilot test it on 60 cases in which significant others, who desire to get a cocaine abuser into treatment, have called in. The pilot and adherence testing will be done at two different outpatient clinics in two cities. The method will then be revised and refined and a training videotape produced to accompany the written material. The training aids that issue from the project will be ready for application in a standardized way in a clinical trial. The method is also anticipated to be of use to both outpatient and inpatient programs, as well as outreach efforts.
