Current Projects

Title of ProjectAffiliated Investigator(s)Project DescriptionContact
Medical Integration of Substance Use ServicesKimberly Kirby, PhD; Adam Brooks, PhDTRI is leading a group of Philadelphia partners in a medical integration project funded by the Commonwealth of Pennsylvania. Two procedures are being empirically evaluated, both screening low income patients when they present for medical treatment at a community health center, and providing on-site brief interventions before attempting referral to specialty substance abuse treatment for those with moderate to severe substance use. Client outcomes and other measures will be examined and costs and benefits analyzed over the life of the project.Carolyn Carpenedo, X 140
Group Contingency ManagementKimberly Kirby, PhDThis is a NIDA Behavior Therapy Development grant to develop a contingency management intervention for group therapy. Pilot studies are evaluating the 1) feasibility of targeting multiple behaviors in a group treatment format, and 2) reducing the urine monitoring schedule for treatment groups without significantly reducing the efficacy of the intervention. The ultimate goal of this project is development of new models of contingency management that are more acceptable to counselors by moving implementation of the intervention to group settings, reducing urinalysis costs, and targeting multiple behaviors.Carolyn Carpenedo, X 140
Computer-Assisted System for Patient Assessment and Referral (CASPAR): Bucks, Delaware and Montgomery Counties, PA (NIDA); Southern New Jersey (NIAAA): Deni Carise, PhDThis NIH-funded study is a replication of a previous study in Philadelphia on a computerized system for counselors fostering patient assessment and referral (CASPAR). More on CASPAR. The current projects are studies of a CASPAR-centered Quality Improvement Initiative in seven agencies, involving up to 36 counselors and 400 patients in the two Phases of the studies. In Phase I, TRI will review ASIs and completed treatment plans for six consenting clients from up to 36 counselors. In Phase II, TRI scientists will provide targeted data-driven feedback to program directors and clinical supervisors, and collaborate with them to evaluate and modify treatment plan forms. TRI will train counselors to make targeted referrals using the CASPAR system. TRI will follow all clients from Phases I and II at 2, 4, and 8 weeks post admission using the Treatment Services Review and the Treatment Planning Satisfaction Scale to measure the number and types of services received, as well as overall client satisfaction. At three months post admission, TRI will administer the ASI and TSR, along with saliva drug screen. Client data will be compared pre and post to assess replication of previous study findings and to assess the effects of CASPAR training as part of a quality improvement initiative.Carolyn Carpenedo, X 140
Toolkits: Will Implementing an Evidence Based Curriculum Improve Group Counseling?;Adam Brooks, PhDThis NIDA-funded study is evaluating the feasibility, acceptability and impact of a ñToolkitî designed to assist counselors to conduct group therapy sessions using motivational interviewing techniques with minimal prior training. The ñToolkitî is a plastic clipboard containing 1) a laminated ClinicianÍs Guide with prompts; 2) a five minute DVD played at the beginning of the group as orientation; 3) patient worksheets for listing ñgood thingsî and ñnot so good thingsî about recovery; and 4) wallet cards for patients to record reminders about their recovery process. Up to 30 counselors will be recruited from six programs in Philadelphia and asked to conduct one Toolkit-informed group session with brief advance training. They will also be invited to conduct additional sessions on a voluntary basis over a three-month period with no additional training. Survey feedback collected from patients and clinicians will evaluate patient satisfaction, increases in readiness to change, and clinician acceptance and ability to administer the technique with proficiency.Carolyn Carpenedo, X 140
Multimedia Toolkits to Implement 12-Step Recovery Concepts in Group CounselingKimberly Kirby, PhDThis NIAAA-funded study is evaluating the feasibility, acceptability and impact of a ñToolkitî designed to assist minimally trained counselors to better educate patients on the benefits of 12-Step recovery groups. The ñToolkitî contains 1) a laminated ClinicianÍs Guide with prompts; 2) a five minute DVD played at the beginning of the group as orientation; and 3) patient worksheets. Up to 80 counselors will be recruited from inpatient programs in the Philadelphia area and asked to conduct five Toolkit-informed group sessions following a brief training. Survey feedback collected from patients and clinicians will evaluate patient satisfaction, 12-Step group involvement, and clinician acceptance and ability to administer the technique with proficiency.Carolyn Carpenedo, X 140
Visual Feedback in Drug CourtsDavid Festinger, PhD; Karen Dugosh, PhDTRI is investigating the use of visual feedback to improve outcomes for drug court participants. In this procedure, the judgewill review and discuss clientsÍ patterns of drug abstinence and treatment attendance using LCD projections of client progress graphs. This two-year study funded by NIDA and building upon previous pilot work will proceed in two phases. In Phase I, the visual feedback procedures will be finalized by TRI in conjunction with participating drug court teams and expert consultants. In Phase II, the procedures will be tested in a randomized study comparing the outcomes of 45 drug court clients who receive visual feedback procedure and 45 clients who receive hearings as usual. The hypothesis is that the visual feedback procedure will result in better client outcomes (i.e., urinalysis-confirmed abstinence and treatment attendance) and greater perceptions of fairness (procedural justice), satisfaction with the program, and working alliance with the judge than hearings as usual.Thea Musselman, X 148
HIV/AIDS Drug Use and Vulnerable Populations in U.S.David Festinger, PhD; David Metzger, PhDTRI is evaluating the efficacy of a brief, computerized HIV risk reduction intervention with drug court populations. Findings will provide useful information on the utility of a strategy for reducing HIV risk in substance-using offenders, and could have major implications for expanding the focus of drug courts and other community-based correctional programs beyond reducing criminal recidivism and drug use.Thea Musselman, X 148
Improving the Ethics of Research: Development of the Coercion Assessment ScaleKaren Dugosh, PhDIn this NIDA-funded project, a Coercion Assessment Scale (CAS) is being developed and evaluated, responding to the need for an instrument to accurately measure perceptions of coercion among substance abusing criminal justice clients participating in research. Much like consent quizzes and tests of cognitive functioning, the CAS will be useful for identifying individuals who are not appropriate for research participation or who need enhanced consent procedures because of their level of perceived coercion. In this context, the CAS may be particularly useful to research staff, research intermediaries, and ethics review boards.Thea Musselman, X 148
Adaptive Services in Drug CourtDoug Marlowe, JD, PhD; David Festinger, PhDThis study extends a line of health-services research aimed at adapting services in drug courts to the needs of drug-abusing offenders. The current study is examining the incremental utility gained by re-adjusting the dosage of both court hearings and clinical case-management sessions in response to participantsÍ on-going performance in the program. Consenting misdemeanor drug court participants will be randomly assigned at entry to the full adaptive intervention or to baseline-matching only. It is hypothesized that participants in the adaptive condition will graduate at a significantly higher rate, provide fewer drug-positive urines and have fewer re-arrests than participants in the baseline-matching only condition.Thea Musselman, X 148
Incentivized Consent in Drug CourtDavid S. Festinger, Ph.D., Kimberly C. Kirby, Ph.D., and Karen Dugosh, Ph.D. This study extends the work of Dr. Festinger and TRIÍs section on Law & Ethics on improving the ethics of informed consent to participate in research studies. Participants are randomly assigned to either a (1) combined corrected feedback and incentivized consent procedure or (2) consent as usual control group. The combined condition is hypothesized to result in greater consent recall and may lead to mastery of the information because it addresses both cognitive limitations in the population as well as motivation to learn the consent material. Findings will be helpful in developing enhanced procedures for protecting the autonomy and human subject protections of vulnerable populations entering research.Thea Musselman, X 148
Contingency Management for Cocaine Dependence: Cash vs. VouchersDavid Festinger, PhD; Kimberly Kirby, PhDThis study is examining practical and ethical issues relating to monetary-based Contingency Management (CM) procedures. Consenting cocaine-dependent clients attending a community outpatient treatment program are randomly assigned to either a (1) voucher-based CM intervention, (2) cash-based CM intervention, or (3) non-CM intervention. This study will be the first to examine the differential efficacy, cost-effectiveness, and ethics of a cash- versus voucher-based CM protocol in the treatment of drug dependence. This investigation not only will address practical issues pertaining to the transfer of CM interventions into community-based treatment programs, but also will begin to shed empirical light on many of the ethical criticisms that have been levied against the use of cash and CM interventions.Thea Musselman, X 148
Evaluation of the 17th Judicial District Drug Court (Pennsylvania)David Festinger, PhDThis evaluation consists of two reports, a Process Evaluation Report in 2009 and a Final Outcome Report in 2010. The reports will consist of findings from separate focus groups with judges and court staff to learn more about the Drug CourtÍs goals, processes and procedures, planned changes that may affect client outcomes, and organizational and other current issues relevant to the program and Union/Snyder County Correctional System. In addition, TRI staff will analyze data collected using TRI-CEP» and the Treatment Research Institute Client Assessment survey (TRI-CA») designed to allow drug court and other problem solving court clients easily and confidentially complete program assessments.Thea Musselman, X 148
Enhancing Juvenile Drug Court Outcomes with EBPsSteven Belenko, PhD; David Festinger, PhDBuilding on recent research findings on juvenile drug court outcomes as well as dissemination of evidence-based practices into community treatment for adolescent offenders, TRI is collaborating with principal investigator Dr. Scott Henggeler at the Medical University of South Carolina on a NIDA-funded study to develop and test a relatively low-cost strategy for enhancing juvenile drug courts outcomes by integrating components of evidence-based treatments (contingency management and family engagement strategies) into existing treatment services. The study is examining youth level (e.g., substance use and criminal behavior) and organizational/system level (e.g., intervention fidelity, feasibility, organizational readiness to change, organizational innovation, retention, costs) effects of implementing the intervention protocols in six juvenile drug courts. Project findings will inform theory on organizational change and collaboration as well as risk and protective factors for drug use and delinquency, and help juvenile drug courts develop more effective interventions for drug-involved youth and their familiesThea Musselman, X 148
Brief Intervention for Drug-Abusing Delinquents/ParentsKen C. Winters, Ph.D., Richard Dembo, Ph.D., and Steven Belenko, Ph.D.In collaboration with Dr. Richard Dembo of the University of South Florida, this NIDA-funded project is studying the effects of a Brief Intervention for truant youths with mild to moderate substance abuse problems. Effective interventions to reduce youth drug use and improve relationships with parents/guardians are needed to reduce the risk of youthful clients moving into serious drug use and delinquency patterns. The project team is evaluating the efficacy of a manualized BI among drug-involved truant youths in this Stage 2 randomized clinical trial, comparing (1) a 2-session youth only condition (BI-Y), (2) a 3-session youth (2-session) and parent (1-session) condition (BI-YP), and (3) a standard truancy services (STS) condition. Effects on drug use, school performance and attitudes toward school are being assessed through 18 months follow-up (baseline, 3 months, 6 months, 12 months, and 18 months).Thea Musselman, X 148
Internet Availability of Drugs of AbuseDavid Festinger, PhD; Amelia Arria, PhDThis study will obtain information directly from adolescents enrolled in drug treatment programs about their use of the Internet to purchase prescription drugs for non-medical use. A user-friendly web-based assessment is being administered to a large sample of adolescents (ages 12 - 17) receiving treatment in numerous programs across the country. It will be the first to obtain information directly from adolescents regarding Internet sources of drug supply. Findings may lead to more detailed studies, possibly used to help adolescents become more aware of potential risks of non-medical use of prescription drugs as well as inform them of the important need for medical supervision when taking prescription drugs. Moreover, this research can serve as the foundation for crafting policies and legislation to reduce the marketing and sale of prescription drugs without a prescription. The long-term goal of the research is to reduce the physical health problems and social consequences associated with the non-medical use of prescription drugs that have a risk for addiction.Thea Musselman, X 148
Development of a Prevention Intervention for Low-Risk Drug Court ClientsDavid DeMatteo, JD, PhDThe purpose of this study is to develop a secondary prevention intervention for adult drug court clients who do not have a diagnosable or clinically significant substance use disorder. Best practice standards suggest these clients are best suited for a secondary prevention approach directed at interrupting the acquisition of addictive behavior. Unfortunately, extant prevention programs for substance use are designed for children, adolescents, or college students. This project is seeking to (1) finalize the content of an appropriate prevention intervention with the assistance of a multidisciplinary expert panel; (2) manualize the prevention intervention and develop therapist-fidelity and client-adherence measures; and (3) estimate an effect size for the prevention intervention by conducting a small randomized pilot study (N=40) comparing the prevention intervention to standard drug court treatment, which will allow TRI to determine whether future Stage II research is warranted.Thea Musselman, X 148
Clinical Monitoring to Facilitate Continuing Care for Substance-Abusing ClientsJohn Cacciola, PhD; Adam Brooks, PhD; A. Thomas McLellan, PhDTRI is developing and testing RT_Extended Care, a new version of RecoveryTrack» (RT) that supplements the during-treatment clinical monitoring of RT with an outreach component for clients who are not regularly attending outpatient care.Graham DiGuiseppi, X 133
Recovery Homes in PhiladelphiaAmy Mericle, PhD; John Cacciola, PhDThis is a feasibility study of recovery homes and recovery home residents in Philadelphia. The study is funded by the Commonwealth of Pennsylvania. The TRI research team is interviewing site contacts from 25 representative recovery homes in Philadelphia to assess the organizational characteristics of the houses, the services provided to the residents, and the residents served. A smaller sample of these homes will be selected for focus groups and resident surveys (self-administered) and from that resident sample (n=approximately 120) approximately 25 residents will be invited to participate in a 3 month follow-up survey collecting information on their service needs and service use. Once collected, the data will be analyzed and used for a larger, proposed NIDA-funded study evaluating the effectiveness of Philadelphia recovery homes in enhancing prospects for long-term recovery.Graham DiGuiseppi, X 133
Evaluation of Web-Based Recovery Monitoring with Clincal AlertsAdam Brooks, PhDA web-based concurrent recovery monitoring system (RecoveryTrack») has been implemented in all publicly funded outpatient substance abuse treatment programs in the state of Delaware. Although monitoring and feedback approaches have been recommended, and many lines of evidence support their potential value, none has been formally evaluated in community based substance abuse treatment. The specific aims of this project are to conduct a three-phased study to modify RecoveryTrack» so that counselors and their supervisors are provided with an automated Clinical Alert when a patientÍs regularly administered monitoring assessment indicates a high risk of drop out from treatment, and to adapt a cognitive-behavioral intervention (CBI) to equip counselors in responding to ñHigh Riskî patients. The feasibility of Clinical Alerts + CBI at a small treatment program will be assessed in advance of conducting a pilot randomized clinical trial at one large treatment program. It is hypothesized that patients who evidence a high risk for attrition will have longer lengths of stay, attend more treatment sessions, have more drug-free urine results, and receive more supplemental services in the Clinical Alerts + CBI condition. RecoveryTrack», including Clinical Alerts + CBI, will be a monitoring and intervention system by which minimally trained clinical staff can easily incorporate an evidence-based psychosocial intervention into their usual practice.Graham DiGuiseppi, X 133
Adaptive Treatment for Alcohol DependenceJames McKay, PhDOne of the major problems for outpatient specialty programs that treat alcohol use disorders is low rates of engagement following intake appointments. Even among patients who achieve initial engagement, rates of sustained participation are low, particularly following relapse. This pilot project will employ an adaptive protocol to evaluate innovative, telephone-based approaches to increasing rates of initial engagement in patients with alcohol use disorders who complete an intake in a community-based Intensive Outpatient Program (IOP), but fail to engage in treatment over the next two weeks. These interventions use motivational interviewing (MI) approaches to engage patients in IOP or an alternative form of treatment. For patients who do initially engage in IOP, a preliminary evaluation of a telephone-based method for re-engaging patients who subsequently drop out will be conducted. This pilot study will generate feasibility data for these interventions, as well as estimates of effect sizes for engagement and alcohol use outcomes.Graham DiGuiseppi, X 133
Evaluation of the Bronx Community Recovery CenterAmy Mericle, PhD The Bronx Community Recovery Center (BCRC) was developed to provide an array of services and resources that support recovery from alcohol and other drugs among individuals age 18 and over, their families, and other affected persons in the community. The primary goals of the BCRC project are to establish collaborations with recovery support services in the Bronx, increase awareness and demand for continuing support for persons in recovery, and build recovery capital to promote sustained abstinence from alcohol and drug use for individuals in recovery who are participating in BCRC recovery support services. TRI staff are partnering with staff at the BCRC to conduct an evaluation of this program and these goals. Specifically, the evaluation will entail (1) ensuring compliance to GPRA reporting requirements; (2) tracking implementation progress; (3) documenting process outcomes; (4) examining key participant outcomes.Graham DiGuiseppi, X 133
Medication Research ProjectMady Chalk, PhD; Jack Kemp; Kelly Alanis-Hirsch, PhD; Dennis McCarty, PhDTen treatment organizations with residential, intensive outpatient and/or outpatient addiction treatment sites located in Delaware, Maryland, and Pennsylvania are participating in a 24-month test of a system change strategy to enhance access to medication-assisted treatment for patients with alcohol and/or opiate addiction. With the Oregon Science and Health University, NIATx, University of California-San Francisco, and a major commercial insurer, researchers at TRI are evaluating not only whether the systems change leads to better medication access, but also whether utilization and costs of health care are simultaneously affected. The Food and Drug Administration has approved a number of medications for the treatment of alcohol and/or opioid addiction although treatment programs have been slow to use the approved medications in treatment.Kelly Alanis-Hirsch, X 180
Health Care ReformMady Chalk, PhD; Jack Kemp; Richard Rawson, PhDTRI is leading a number of projects to weave substance use/abuse issues into healthcare reform (HCR) efforts undertaken by the states. In California, Drs. Chalk and Rawson and Mr. Kemp are consulting with policymakers at the state and county levels to plan for statewide HCR implementation. For the Center on Substance Abuse Treatment, Chalk and Kemp have been designated lead consultants for the State Systems Development Program (SSDP), making their first plenary presentation (ñState-Level Planning for Health Care Reform NOWî) at the 2010 SSDP conference in Baltimore, with regional presentations to follow in 2011. Kelly Alanis-Hirsch, X 180
Mutual Assistance Program for States "MAPS"Mady Chalk, PhD; Jack KempFormed in 2006, this select group of state substance abuse directors regularly meets with TRI and other topical experts to discuss timely issues (health care reform; organizational issues including lessons learned from other industries, etc.). MAPS semi-annual meetings are also the venue where members review progress on pilot implementation/evaluation projects of the directorsÍ choosing. The goal of MAPS is advancement of quality improvement in treatment of substance use disorders.Kelly Alanis-Hirsch, X 180
Forum on IntegrationMady Chalk, PhDDr. Chalk and others from TRI are leading a SAMHSA/CSAT-funded project to accelerate integration of appropriate services for substance use conditions in health care settings. Building on findings from PRISM (see selected past projects), an April 2010 kick-off meeting showcased innovative programs in fourteen health care organizations across the country, and the following February, a second Forum addressed the issues of State, County and other payers of substance use treatment services. A white paper summarizing lessons learned from the April meeting was prepared and released by TRI in September 2010, and a second document summarizing the results of the February, 2011 meeting was issued the following May.Kelly Alanis-Hirsch, X 180
Medication Assisted TreatmentMady Chalk, PhDIn a project funded by the Center for Substance Abuse Treatment (CSAT), a blue-ribbon panel led by Mady Chalk, Ph.D. met November 2008 to discuss economic and policy impediments to medication assisted treatment (MAT) for substance use disorders. Ongoing is a project, also funded by CSAT, to develop national recommendations on health information technology (HIT) and its role in information sharing between criminal justice and substance use treatment systems.Kelly Alanis-Hirsch, X 180
Addiction Studies ProgramJack KempThis NIDA-funded project was co-founded in 1999 by the Wake Forest University School of Medicine and the National Families in Action, originally as an educational series for journalists. In 2005, a separate series for legislators was added when TRI and the National Conference of State Legislatures became project partners. Acknowledging that issues of addiction are challenging and cross-cutting at the State level, beginning in 2007 the series pairs legislators with their Executive branch counterparts in workshops covering fiscal, substance abuse treatment and prevention, health, criminal justice, child welfare, and other issues.Kelly Alanis-Hirsch, X 180
Parents as Interventionists for Mild or Moderate, Drug-Abusing AdolescentsKen Winters, PhDA project of the ParentsÍ Translational Research Center to empirically develop a brief intervention for use by parents or other caregivers who know or suspect a youth has begun using drugs or alcohol but not does not necessarily require treatment.Elena Bresani, X 151
Developing a Consumer Guide to Adolescent Drug TreatmentJohn Cacciola, PhD A project of the Parents Translational Research Center to empirically develop for parent use a comparative list of evidence-based practices used in adolescent treatment programs in the City of Philadelphia, with dissemination plans for replicating the approach in other U.S. jurisdictions.Elena Bresani, X 151
CRAFT: Helping Parents Initiate and Support their Adolescent's Drug TreatmentKimberly Kirby, PhDThis is a project of the Parents Translational Research Center to adapt the CRAFT intervention (empirically demonstrated for use with adults) for parent use with treatment-resistant adolescents.Elena Bresani, X 151
Evaluation of the Children's Program at the Betty Ford CenterAmelia Arria, PhDTRI is helping evaluate short- and long-term outcomes of the program.Bonnie Catone, X 100
A Parent's Guide to the Teen BrainKen Winters, PhDMulti-media and science based, this parent product developed by the Partnership for a Drug Free America (Partnership) with science from TRI explains adolescent brain processes and gives tips for creating (or re-creating) the essential talking connection between parents and teens.Bonnie Catone, X 100
Time to Act!Amelia Arria, PhDAnother science-based product from the Partnership and TRI, Time to Act! is a web-based helping tool for parents who know or suspect their children are drinking or taking drugs.Bonnie Catone, X 100
For Clinicians: Brief Intervention for Substance-Abusing AdolescentsKen Winters, PhDMultimedia training developed by TRI Senior Scientist Ken C. Winters, Ph.D. is a computer-delivered adaptation of the Brief Intervention (ñBIî) workshop Winters developed based on research with mild drug-abusing adolescents and their parents. The CD-based workshop topics include a detailed description of the model along with general counseling skills and a focus on motivational enhancement strategies.Bonnie Catone, X 100
Brief Intervention for Drug Use and HIV/STD Prevention Among TruantsRichard Dembo, PhD; Ken Winters, PhD; Steven Belenko, PhDIn collaboration with Dr. Richard Dembo of the University of South Florida, this NIDA-funded project is studying the effects of a Brief Intervention for truant youths with mild to moderate substance abuse problems. Effective interventions to reduce youth drug use and improve relationships with parents/guardians are needed to reduce the risk of youthful clients moving into serious drug use and delinquency patterns. The project team is evaluating the efficacy of a manualized BI among drug-involved truant youths in this Stage 2 randomized clinical trial, comparing (1) a 2-session youth only condition (BI-Y), (2) a 3-session youth (2-session) and parent (1-session) condition (BI-YP), and (3) a standard truancy services (STS) condition. Effects on drug use, school performance and attitudes toward school are being assessed through 18 months follow-up (baseline, 3 months, 6 months, 12 months, and 18 months).Thea Musselman, X 148