A randomized trial of Volunteer Recovery Support for Adolescents (VRSA) following residential treatment discharge

Abstract

Research on continuing care treatment for adolescents following discharge from primary treatment has demonstrated benefit, yet treatment providers encounter multiple barriers in its implementation. Less formal recovery support following treatment is promising, but controlled trials of effectiveness are lacking. This study reports results of a randomized trial of recovery support provided by student volunteers via telephone to youth discharged from residential treatment. Both direct and indirect effects were predicted for proximal (pro-recovery peers, recovery management activities) and distal (AOD use and problems, AOD remission) outcomes. MethodPrior to treatment discharge, participants were randomized to either 9 months of post-treatment Volunteer Recovery Support for Adolescents (VRSA; n = 201) or continuing care services as usual (SAU; n = 201) and assessed over 12 months post- discharge. ResultsThere were significant direct effects for VRSA to have more involvement with pro-recovery peers and recovery management activities than SAU. VRSA also had significant indirect effects on reducing AOD use and problems and increasing remission via increases in pro-recovery peers and recovery management activities at 9- and 12-month assessments. Dose-response analyses demonstrated significant increments of improvement in proximal and distal outcomes as VRSA session completion rate increased, but effectiveness attenuated at the post-VRSA (12- month) follow-up assessment. ConclusionFindings suggest that VRSA is a promising option for post-treatment recovery support, especially in the higher dose range. Additional research is needed to test the feasibility of providing VRSA in the higher dose range to a larger proportion of intent to treat samples and extending VRSA duration.