Concomitant cocaine abuse is common in patients who receive Social Security Income (SSI) and Supplemental Security Disability Insurance (SSDI). Possession of a large amount of money is a well-recognized relapse trigger, and it has been asserted that unrestricted access to SSI and SSDI payments may actually exacerbate cocaine use. Although many types of money management are provided to recipients, their effect on substance abuse is unknown. We propose a Stage I Behavioral Therapies Development project to develop and pilot a new treatment, Abstinence-Linked Money Management, for cocaine-using patients who have a psychotic disorder and receive SSI or SSDI. The new treatment will involve: 1) Active management of benefit payments and patient expenses designed to restrict direct access to unbudgeted funds; 2) training around money management, and 3) incorporation of contingency management and behavioral contracting principles into funds dispensing. At weekly therapy appointments, therapists and patients will negotiate a contract around two treatment goal-activities. Verified completion of each activity will be reinforced by disbursement of 5 percent (per activity) of available discretionary income. In weeks 16-24, a third activity, providing a cocaine-negative toxicology, will be added. The scheduling of activities that promote abstinence (e.g., attending an NA meeting) will be a focus of a pre-pilot trial with 16 subjects. Based on this pre-pilot, a manual will be developed that will define the new intervention and guide its implementation. Psychotherapy process measures needed to document adherence to the treatment protocol, the clinical competence of therapists, and critical dimensions of the change process will also be developed. Videotaped sessions will be culled to assemble educational materials. These materials will be used in the selection, training, and supervision of a cohort of therapists for a pilot trial. In this 24-week pilot, 40 cocaine-using recipients of SSI or SSDI with psychotic disorders will be randomized to Abstinence-Linked Money Management or to client-directed money management with less therapist control of funds disbursement than the experimental intervention. The primary goal of this stage I project is to develop the materials, measures, procedures, and evidence of efficacy necessary to support Stage II testing of the intervention.
| Thornhill, Thomas A; Black, Anne C; Rosen, Marc I (2018) Financial Capability: Clinicians' Assessment of Beneficiaries with Dual Diagnoses. J Dual Diagn :1-21 |
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| Moore, Brent A; Black, Anne C; Rosen, Marc I (2016) Factors Associated with Money Mismanagement Among Adults with Severe Mental Illness and Substance Abuse. Int J Ment Health Addict 14:400-409 |
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| Serowik, Kristin L; Rowe, Michael; Black, Anne C et al. (2014) Financial motivation to work among people with psychiatric disorders. J Ment Health 23:186-90 |
| Rosen, Marc I; Ablondi, Karen; Black, Anne C et al. (2014) Pathways to assignment of payees. Community Ment Health J 50:270-4 |
| Rowe, Michael; Serowik, Kristin L; Ablondi, Karen et al. (2013) Recovery and money management. Psychiatr Rehabil J 36:116-8 |
| Claycomb, Meredith; Black, Anne C; Wilber, Charles et al. (2013) Financial victimization of adults with severe mental illness. Psychiatr Serv 64:918-20 |
| Rosen, Marc I; Afshartous, David R; Nwosu, Samuel et al. (2013) Racial differences in veterans' satisfaction with examination of disability from posttraumatic stress disorder. Psychiatr Serv 64:354-9 |
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