This program is for adults who have completed residential substance abuse treatment.

Contracts, Prompts, and Reinforcement of Substance Use Disorder Continuing Care (CPR), a community-based program, is designed to encourage clients to participate in aftercare therapy and self-help support groups in an effort to maintain their substance use abstinence.

Results from a randomized controlled trial indicated that a greater number of CPR participants were abstinent at 12 months, and results were better for those in the treatment group, who had co-occurring psychiatric disorders, compared to the control group.  However, there was no difference in abstinence rates at 3 or 6 months.  In addition, although CPR participants were more likely to begin aftercare and to complete at least 3 months of the program, attendance decreased over time in both groups, and there were no significant differences between groups in attendance at 7 or 12 months.  There were also no significant differences between groups in attendance of Alcoholics/ Narcotics Anonymous; average percentage of days that participants used substances; number of drinks per month; negative consequences of substance use; or self-reported problem severity associated with alcohol use, drug use, employment, family relations, or legal status.  Results from a second multi-site randomized controlled trial demonstrated no significant differences between treatment and control groups in attendance or in abstinence rates 12 months after beginning the intervention, and results did not differ between groups for those with co-occurring psychiatric disorders.

CPR intends to support participants as they enter an outpatient status after completing residential substance abuse treatment and is comprised of the following components:

• Contracts - During the last week of residential treatment, the therapist and client sign a written contract that focuses on the positive outcomes associated with aftercare and self-help attendance and establishes a commitment in which the client agrees to participate in weekly group therapy and monthly individual therapy for at least 8 weeks after completion of the treatment.  After 8 weeks, the contract is renewed for an additional 9 months;

• Prompts - Following contracting, clients receive regular letters, appointment reminders, and telephone calls following missed therapy sessions to encourage their adherence.  Prompts also include feedback on progress toward goals established in the contract; and

• Reinforcements - Congratulatory letters, certificates, and a medallion are provided to clients as reinforcements of attendance and ongoing abstinence.

The CPR program has been implemented at approximately 30 sites in 25 U.S. states since 1999 and has been evaluated in a Veterans Affairs (VA) Medical Center in Salem, Virginia.  Approximately 1,700 clients have received treatment.

This program is facilitated by therapists, and they are required to attend a 2-day, on-site training, which is available to VA medical centers for free except for the cost of trainer travel expenses.  A similar training is offered to non-VA sites for $7,000 plus travel expenses. Please use details in the Contact section for more information.

Considerations for implementing this program include acquiring participant buy-in, hiring therapists to implement the program and ensuring they receive training, and locating space for sessions.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing CPR, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

The CPR program lasts 1 year.  Implementation times for group therapy and individual therapy sessions vary and depend on clients' needs and therapists' recommendations.

A treatment manual and other required intervention materials are available at no cost.  Please use details in the Contact section for more information.

To move the CPR program to the Promising category on the Clearinghouse Continuum of Evidence, at least one evaluation should be performed demonstrating positive effects lasting at least one year from the beginning of the program or at least six months from program completion.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185  Email: Clearinghouse@psu.edu

You may also contact Steven Lash by phone 1-540-982-2463 EXT 2593, fax 1-540-983-1085, or email Steven.Lash@med.va.gov

Burden, Parker, Williams and Lash (2017) and http://legacy.nreppadmin.net/ViewIntervention.aspx?id=166 (This website no longer contains program information)