Efficacy of Outpatient Aftercare for Adolescents With Alcohol Use Disorders: A Randomized Controlled Study

Abstract 

Objective

Relapse rates for treated adolescents with alcohol use disorders (AUDs) amount to approximately 60% at 3 to 6 months after treatment completion. This randomized controlled study tested the hypothesis that active aftercare may maintain treatment gains better than no active aftercare (NA).

Method

A total of 177 adolescents, 13 to 18 years of age, diagnosed with DSM-IV AUD, participated in nine weekly outpatient cognitive behavioral therapy group sessions. The 144 treatment completers were randomized into a 5-session in-person, brief telephone, or NA condition. Three alcohol use variables were the main outcome measures for 130 aftercare completers.

Results

At the end of aftercare, the likelihood of relapse increased significantly compared with end of treatment outcomes. The likelihood of relapse for youths in NA, however, increased significantly more for youths in combined active aftercare (AA) conditions (p = .008). This effect was driven primarily by a significant sex × active aftercare interaction: girls showed no significant relapse under AA but relapsed significantly in NA. Youths enrolled in AA also showed significantly fewer drinking days (p = .044) and fewer heavy drinking days (p = .035) per month relative to NA.

Conclusions

In general, active aftercare interventions showed certain efficacy in slowing the expected posttreatment relapse process for alcohol use, with maintenance of treatment gains only for girls. Frequency of interventions, dose-response, duration of aftercare phase, and mediators of behavior change should be examined further to optimize aftercare for youths with AUD. J. Am. Acad. Child Adolesc. Psychiatry, 2008;47(12):1405–1412.

Key Words:  alcohol use disorders , aftercare , continued care , treatment by telephone