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Funded Research Projects
Project Title:
Comparing
Treatments for Dual Diagnosis:
Twelve-Step and Self Management and Recovery Training
Principal
Investigator:
Patricia E. Penn, Ph.D.
Funded by:
National Institute on Drug Abuse
Funding Period:
10/1/94–3/31/00
This study evaluated the efficacy
of 12-Step and cognitive-behavioral (Self Management and Recovery
Training–SMART) approaches applied in a group intensive outpatient/partial
hospitalization modality (IOP/PHP) for persons with a dual diagnosis
of serious mental illness and substance use disorder. Participants
(n = 112) were alternately assigned to treatment conditions with 50
participants completing the 6 months of treatment. Assessments
occurred at baseline, 3 months, 6 months, and 3- and 12-month
follow-ups. Few differences in outcomes were found between the two
treatment approaches. Participants in both groups showed improvements
in quality of life and the alcohol, drug, psychiatric, legal, and
employment domains of the Addiction Severity Index. The benefits of the IOP/PHP modality and both approaches
in treating this population are discussed in the grant final report
and publications (see next section). (Supported by a grant from NIDA, R01-DA08537 to Penn, and by La Frontera Center, Inc.)
Project Title:
Evaluation of ADMIRE+ Program for
Co-Occurring Disorder
Principal Investigator:
Patricia E. Penn, Ph.D.
Co-Investigator:
Audrey Brooks, Ph.D.
Funded by:
Center for Substance Abuse Treatment
Funding Period:
9/30/2000–12/31/04
This grant evaluated and documented a publicly
funded integrated outpatient treatment model designed to improve
quality of life in persons with co-occurring substance abuse and
mental health disorders. The program goals, derived from the needs of
the population with co-occurring disorders (COD) as identified in the
literature and our experience, are to decrease substance use; improve
psychological functioning; improve overall functioning and quality of
life; improve access to and engagement in treatment services; improve
cost-effectiveness of services; address women's, cultural, lifestyle,
and other minority concerns; and to disseminate program and research
methods and materials. Measures directly related to these goals were made at client intake into the program, and after 3, 6, and 12
months. Instruments included selected items from the GAIN,
urinalyses, the Brief Symptom Inventory, Lehman Quality of Life -
Short Form, service utilization, service cost, Ways of Coping
Inventory, Self-Efficacy to resist substance abuse, the Community
Program Philosophy Scale (assesses program characteristics), and a variety of qualitative data.
Several focus groups with persons with COD were also conducted.
The program to be evaluated, ADMIRE Plus (A+), was the
result of 6 years of funded research in COD, a 5-year grant from the
National Institute on Drug Abuse, and a competitive COD demonstration
project awarded by the State of Arizona. Also included in the design
were the recommendations from the Arizona Integrated Treatment Panel
for Co-occurring Disorders, La Frontera's Clinical Practice Guidelines
for Co-occurring Disorders, and almost 20 years of experience treating
co-occurring disorders at the agency.
The population served by A+ and the comparison group
consisted of persons with COD enrolled in Tucson's community behavioral
health system. These clients typically receive low-intensity case
management services, medication-related services, and occasional group
treatment. Modest to severe functioning impairments in
many areas of life are present.
A+ provides a multidimensional continuum of care that
allows clients to easily move to different intensity levels and choose
from a variety of services as needed. This is important as this
population has multiple issues and frequent relapses. The core of A+
is an intensive outpatient/partial hospitalization program (IOP/PHP)
and intensive case management, but it also includes a wide variety of
other levels, therapy modalities, and activities. The IOP/PHP uses the following methods supported by
our research and that of others: cognitive methods (SMART), 12-Step,
Motivational Interviewing, auricular acupuncture, contingent
reinforcement, family involvement, and enhanced medication services.
Project Title:
Comparing
Smoking Cessation Treatments for Persons with Schizophrenia and
Other Psychotic Disorders
Principal
Investigator:
Patricia E. Penn, Ph.D.
Co-Investigators:
Eric Schindler, Ph.D., Sandra Gallagher, Ph.D.
Funded by:
Arizona Disease Control Research Commission and La Frontera Center,
Inc.
Funding Period:
10/1/2002–9/30/2005
This
study compared two smoking cessation interventions in persons with
schizophrenia or other serious mental illness (PSMI). We focused on
PSMI because national data suggest that (1) they smoke at 2–3 times
the rate of the general population; (2) cessation interventions for
this population are understudied; (3) most cessation studies exclude
PSMI; and (4) cessation results in public health care savings and
disposable income savings for clients. Furthermore, adults with any
DSM-IV diagnosed mental illness smoke nearly half of the cigarettes
in the U.S. (Lasser et al., 2000). PSMI (n = 181) were recruited
from three sites within a large community behavioral health center
and randomly assigned to one of three groups: contingent
reinforcement (CR), contingent reinforcement plus nicotine
replacement therapy by 21 mg patch (CR+NRT) for 16 weeks, and
self-quit control group. These participants were followed for 36
weeks. CR was accomplished with escalating financial compensation
for achieving and maintaining abstinence as verified by expired
carbon monoxide (CO). Expired CO and self-report outcomes were
discordant with saliva cotinine outcomes, which showed low quit
rates and small differences between intervention and control
participants at weeks 20 and 36. There was evidence of reduced
smoking and importantly, no evidence of psychiatric exacerbation.
Implications for intervention and research with this population are
discussed.
Project Title:
NIDA Clinical
Trials Network
La Frontera Center,
Inc., a clinical treatment provider (CTP) in the California-Arizona
Node, partnering with the University of California, San Francisco and the
University of Arizona.
Node Principal
Investigator:
James Sorensen, Ph.D.
CTP PI:
Pat Penn, Ph.D.
Funded by:
National Institute on Drug Abuse
Funding Period:
10/1/2002–9/30/2007
To date, the efficacy
of new treatments for drug addiction has been demonstrated primarily
in specialized research settings, with somewhat restricted patient
populations. To address this problem, the National Institute on Drug
Abuse (NIDA) has established the National Drug Abuse Treatment
Clinical Trials Network (CTN).
The mission of the CTN
is twofold:
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Conduct studies of behavioral, pharmacological, and
integrated behavioral and pharmacological treatment interventions of
therapeutic effect in rigorous, multi-site clinical trials to
determine effectiveness across a broad range of community-based
treatment settings and diversified patient populations.
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Transfer the research results to physicians,
providers, and their patients to improve the quality of drug abuse
treatment throughout the country using science as the vehicle.
For more information
visit http://www.nida.nih.gov/CTN/index.htm
Project Title:
Brief Strategic Family Therapy
Site Principal
Investigator: Janine d'Haven
Funded by:
Arizona Board of Regents, University of Arizona
(pass-through from the NIDA CTN grant)
Funding Period:
9/30/03–1/31/07
This nationwide
clinical trial is designed to study the efficacy of Brief Strategic
Family Therapy (BSFT), a family-focused behavioral intervention that
targets family patterns of interaction to modify adolescents’ drug
abusive behavior. The research trial will evaluate the effectiveness
of BSFT for Adolescent Drug Abuse in a community treatment setting
when compared to traditional treatment methods offered, or
treatment as usual (TAU). The study is taking place at 14
locations in the United States and Puerto Rico.
Project Title:
Tucson Coalition on
Girls and Violence (TCGV)
Project Director:
Antonietta Estrada, MC, LISAC
Funded by:
Substance Abuse and Mental Health Services Administration (SAMHSA),
Center for Mental Health Services
Funding Period: 10/1/04–3/31/07
Target Population
Jewish
Family and Children’s Service of Southern Arizona (JFCS) is the lead
organization and will initiate and coordinate the Tucson Coalition
on Girls and Violence (TCGV), a community-based collaboration. The
purpose of the collaboration is to create a coordinated community
intervention program that will provide services to girls and young
women in Pima County, Arizona, who are victims and/or perpetrators
of violence. Specifically, the population to be served in TCGV is
girls and young women in Pima County between the ages of 8 and 21
with histories of sexual and/or physical abuse.
Project Goals
Using
as a launching point JFCS’s Project Safe Place, a successful
violence intervention and prevention program in operation since
1996, the TCGV’s goals are to
1. Establish
a local coalition of agencies involved with girls and violence in
order to create and implement an action plan to broaden the scope of
gender-specific violence intervention and prevention services
available to girls and young women in Pima County, Arizona.
2. Modify
the Project Safe Place model to meet the needs of clients of
coalition organizations and the Tucson community at large.
3. Develop
strategies to enhance and incorporate cultural competency training
for all service providers working with the diverse population of
girls and young women with a history of violence in their lives, and
provide the training to interested agencies.
La
Frontera
Center (LFC)
will direct the
evaluation for the project and provide the cultural competency
training, based on LFC’s Building Bridges assessment tool.
Project Title:
Child & Adolescent
Traumatic Stress Services Center of Southern Arizona (CATSS)
Project Director:
David
Romero, MSW
Funded by:
Substance Abuse and Mental Health
Services Administration (SAMHSA): National Child Traumatic Stress
Initiative―Community Treatment and Services Center Grants
Funding Period:
10/1/06
– 9/30/10
The Child & Adolescent Traumatic Stress Services Center of Southern
Arizona (CATSS) is a collaboration of Jewish Family and Children’s
Service (JFCS), Arizona’s
Children Association (AzCA), the Pima County Attorney’s
Office/Victim Witness Program, and La Frontera Center. CATSS is
designed to expand access to trauma-informed services and enhance
the availability of evidenced-based trauma treatment resources for
children and adolescents (ages 3–18) and their families in
Tucson/Pima County.
Collaboration:
JFCS is the lead agency and is responsible for managing the grant,
providing training, delivering services, and coordinating and
expanding collaborative efforts. Our collaborative partners’ roles
are as follow: AzCA is a primary referral site for counseling
services; Victim Witness is a referral source within the community,
specifically working with first response personnel; La
Frontera Center provides the local
evaluators for the project, which includes the Cross-Site Evaluation
collaboration.
Project Goals: The CATSS program has three primary goals, as indicated below:
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Identify best practices to effectively address
child-youth trauma needs in Tucson/Pima County.
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Adapt
evidenced-based treatment and services approaches, and enhance
the delivery of such service through collaboration and training with stakeholders.
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Collaborate closely with the National Child Traumatic
Stress Network (NCTSN) and regional networks in resource development and dissemination, and share lessons learned in this process.
· National Child
Traumatic Stress Network (NCTSN):
The mission of the NCTSN is to
raise the standard of care and improve access to services for
traumatized children, their families, and communities throughout the
United States. This network consists of more than 40 centers
nationwide. As a collective group the NCTSN is able to provide
delivery of services, trauma research, product and resource
development, training, and innovation in the areas of child and
traumatic stress. For more information about NCTSN, go to http://www.nctsn.org/nccts/nav.do?pid=hom_main
Cross-Site Evaluation:
As part of the NCTSN, the CATSS
program outcomes will be entered into a national data bank. Thus,
outcomes will be evaluated locally through La Frontera, and
nationally through an independent evaluation team to both monitor
and evaluate programs and services.
For more information
about CATSS, go to http://kb.nctsn.org/SPT--FullRecord.php?ResourceId=383
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