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Trial registered on ANZCTR
Registration number
ACTRN12618000866202
Ethics application status
Approved
Date submitted
21/03/2018
Date registered
22/05/2018
Date last updated
25/11/2021
Date data sharing statement initially provided
15/09/2020
Date results provided
25/11/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluating the effectiveness of a modified dialectical behaviour therapy (DBT) group program in treating adolescents and young adults experiencing substance misuse
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Scientific title
Evaluating the effectiveness of a modified dialectical behaviour therapy (DBT) group program in treating adolescents and young adults experiencing substance misuse
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Secondary ID [1]
294416
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
Nil
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Linked study record
Nil
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Health condition
Health condition(s) or problem(s) studied:
Substance addiction
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Condition category
Condition code
Mental Health
306271
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0
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Addiction
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study will evaluate the effectiveness of dialectical behaviour therapy (DBT) in treating young people with co-morbid substance abuse and mental health concerns. This DBT group program is embedded within Mission Australia Triple Care Farm (TCF), a residential rehabilitation program for young people aged 16-24 years.
The intervention is a skills-based therapeutic group program delivered over the course of 12 weeks plus residential milieu. The group program integrates drug and alcohol treatment with DBT principles, developing emotional regulation, interpersonal effectiveness, mindfulness, distress tolerance, drug refusal, and relapse prevention. It is designed to address the complex needs of this population including high levels of poly substance use, comorbid mental illness, service access including acute hospital services, and risk taking behaviour including suicide and violence. The DBT component consists of a group therapy program, accompanied by a facilitator manual, participant workbook, and website (www.dbtregulator.com.au).
The residential milieu setting is an 18-bed program which incorporates the general principles of milieu treatment. The treatment model is a 12-week holistic psychosocial rehabilitation
program based on harm minimisation and health promotion. This 12-week program is followed up with community aftercare. The DBT treatment program is embedded within the overall residential milieu. Within the milieu there were general worker-resident activities throughout the day and evening designed to provide therapeutic containment and safety whilst seeking to generalise the use of skills learnt in the DBT program. The wider residential milieu also included individual counselling, principles from psychoeducation, motivational interviewing for substance use and criminality, relapse prevention, strengths-based work, and drug education.
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Intervention code [1]
301280
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Behaviour
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Comparator / control treatment
We compared two cohorts from the same 12-week residential substance use disorder (SUD) facility over a ten year period: Cohort A (2008-2009) and Cohort B (2018-2020). Data for Cohort A were routinely collected and archived, being made available for this study in de-identified form following ethical approval. The essential components of the program remained the same with the primary treatment being dialectical behaviour therapy (DBT) plus residential milieu.
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Control group
Historical
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Outcomes
Primary outcome [1]
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The primary outcome measure is the Brief Symptom Inventory (BSI) (Derogatis, 1975). The BSI total score, most indicative of general psychopathological symptom severity, will be computed as the mean score of all individual items (range 0-4). Lower BSI scores correspond to less symptoms and a more beneficial outcome, and treatment success is defined as a 50% reduction in BSI score on follow-up compared to baseline BSI score.
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Assessment method [1]
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Timepoint [1]
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Post- intervention: 3 months from program entry
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Secondary outcome [1]
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Secondary outcomes are severity of dependence and drug use - Severity of Dependence Scale (SDS)
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Assessment method [1]
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Timepoint [1]
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Post- intervention: 3 months from program entry
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Eligibility
Key inclusion criteria
Triple Care Farm is a youth rehabilitation facility for young people between the ages of 16-24 years, with substance abuse, mental illness, homelessness and family breakdown. TCF specialises in treating young people who also are suffering with mental health issues, however, this is not a requirement of entry. The inclusion/exclusion criteria are outlined below:
The young person must:
1) Be aged between 16 and 24
2) Have problematic drug and alcohol use; problematic drug and alcohol use is daily or near daily use and use of multiple types of drugs
3) Be able to participate in all aspects of the program; participants must be physically, developmentally and mentally capable of participating in all activities
4) Demonstrate commitment to undertake the program, as assessed at interview; TCF is voluntary – participants cannot be forced to attend or participate
5) Must be an Australian resident, currently residing in Australia
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Minimum age
16
Years
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Maximum age
24
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) Not aged between 16 and 24; Participants can’t enter before their 16th birthday and must complete the program before their 25th birthday
2) Not able to participate in all aspects of the program; participants that are not physically, developmentally and mentally capable of participating in all activities
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
N/A
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
Nil
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistics will be used to describe the demographic and clinical characteristics of the two groups and the outcome variables at the five measurements points. Data will be analysed as intention-to-treat (ITT), with time as a repeated measure, to analyse the short and long-terms effects between and within the control group and the Modified DBT program- group over time. Differences are considered statistically significant at p < 0.05. Missing values will be imputed with regression imputation techniques.
Regression models and survival analyses will be used to understand all aspects of treatment and outcomes over time. Effectiveness of each treatment condition will be evaluated using a Multi-level linear modelling approach (SPSS-21 Linear Mixed Models).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
5/06/2018
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Actual
25/01/2018
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Date of last participant enrolment
Anticipated
11/02/2020
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Actual
25/10/2019
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Date of last data collection
Anticipated
20/04/2020
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Actual
26/03/2020
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Sample size
Target
100
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
22149
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2577 - Knights Hill
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NSW Health - Non-Government Organisation (NGO) Evaluation Grants Round 1
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Address [1]
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Locked Mail Bag 961
NORTH SYDNEY
NSW 2059
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Country [1]
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
Triple Care Farm, Mission Australia
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Address
Triple Care Farm – Mission Australia
188 Knights Hill Rd, Knights Hill NSW 2577
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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University of Wollongong
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Address [1]
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Northfields Ave, Wollongong NSW 2522
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Country [1]
298277
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Wollongong and Illawarra Shoalhaven LHD Health and Medical HREC
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Ethics committee address [1]
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Research Services Office, University of Wollongong, Northfields Avenue, Wollongong NSW 2522
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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06/06/2017
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Approval date [1]
299977
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01/08/2017
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Ethics approval number [1]
299977
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2017/233
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Ethics committee name [2]
299978
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Aboriginal Health & Medical Research Council (AH&MRC) Ethics Committee
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Ethics committee address [2]
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3/66 Wentworth Ave, Surry Hills NSW 2010
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
299978
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31/08/2017
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Approval date [2]
299978
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30/01/2018
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Ethics approval number [2]
299978
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1319/17
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Summary
Brief summary
Dialectical Behaviour Therapy (DBT) has been proven to be an efficacious treatment for borderline personality disorder (BPD) (Linehan, 1993; McMain et al., 2009). However, generalisability of this outcome within adolescents and young adults with co-morbid substance abuse and mental health concerns within a residential care setting in Australia has not been investigated. The primary aim of this study is to evaluate the clinical effectiveness of a Modified Dialectical Behaviour Therapy (DBT) Group Program embedded within a residential program in treating adolescents and young adults aged 16 to 24 years, experiencing substance misuse over time compared to a control group that did not receive the DBT Group Program. The secondary aim is to identify the factors that predict who is most likely to benefit from such treatment, particularly in terms of improved vocational outcomes (employment and education). Additionally, the cost-effectiveness of this modified DBT program will be evaluated. Finally, client and therapist satisfaction will also be explored through the study. Evaluation of the effectiveness of the DBT program in treating young people with co-morbid substance abuse and mental health concerns – one of the most difficult cohorts to treat – is an important first step in improving mental health care for this population. This research will advance the knowledge in the field by providing evidence for the importance of continuously improving service and quality person-centred care, taking into account factors that could contribute to positive treatment outcomes. This project will be conducted at Triple Care Farm (TCF, Mission Australia in partnership with the University of Wollongong (UOW).
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Trial website
N/A
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Brin Grenyer
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Address
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University of Wollongong
Project Air Strategy
Building 22, Room G20A | Northfields Avenue | NSW 2522 | Wollongong | Australia
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Country
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Australia
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Phone
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+61 2 4221 3474
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Brin Grenyer
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Address
82147
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University of Wollongong
Project Air Strategy
Building 22, Room G20A | Northfields Avenue | NSW 2522 | Wollongong | Australia
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Country
82147
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Australia
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Phone
82147
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+61 2 4221 3474
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Fax
82147
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Email
82147
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[email protected]
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Contact person for scientific queries
Name
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Brin Grenyer
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Address
82148
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University of Wollongong
Project Air Strategy
Building 22, Room G20A | Northfields Avenue | NSW 2522 | Wollongong | Australia
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Country
82148
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Australia
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Phone
82148
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+61 2 4221 3474
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Fax
82148
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Now and then: a ten-year comparison of young people in residential substance use disorder treatment receiving group dialectical behaviour therapy.
2021
https://dx.doi.org/10.1186/s12888-021-03372-2
N.B. These documents automatically identified may not have been verified by the study sponsor.
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