CClinicalTrials.gg
CompletedNCT01318538Updated Jun 5, 2017Results posted

Women's Recovery Group (WRG) Study - A Randomized Controlled Stage II Trial

An interventional study of The Women's Recovery Group and Group Drug Counseling in Substance-Related Disorders and Alcohol-Related Disorders, sponsored by Mclean Hospital. Completed at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-06-05.

Sponsored by Mclean Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
158
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this Stage II randomized controlled behavioral treatment development trial was to test the effectiveness of the Women's Recovery Group (WRG) relative to mixed-gender Group Drug Counseling (GDC) and demonstrate the feasibility of implementing the WRG in an open-enrollment (i.e., rolling admission) group format at two clinical sites. The Stage II trial aims were to (1) investigate effectiveness of the WRG relative to GDC in a sample of women heterogeneous with respect to substance use and co-occurring psychiatric disorders, and (2) demonstrate the feasibility of implementing WRG in an open enrollment group format characteristic of community treatment programs at two sites.

Read the detailed description

This Stage II trial builds on the Stage I trial that compared the single-gender WRG to mixed-gender GDC and demonstrated preliminary support for the WRG in treating women with substance use disorders (SUDs). It was hypothesized that women in the WRG would decrease their substance use more so than women in the GDC. The GDC was chosen as the comparison group to approximate group drug counseling that is consistent with treatment as usual within the community. The WRG is a manual-based group therapy for women heterogeneous with respect to their substance dependence, co-occurring psychiatric disorders, trauma history, and age and stage of life. The WRG is a 12-session structured relapse prevention group therapy that utilizes a cognitive-behavioral approach and includes gender-specific content and single-gender group composition. There are 14 specific session topics that can be flexibly implemented in any order for a 12-week sequence of groups. In the Stage I trial, women were randomized to WRG (n=16) or mixed-gender GDC (n =7). No significant differences in outcomes emerged between WRG and GDC during the 12 week group sequence. However, in the 6 months post-treatment, WRG participants showed a pattern of continued reductions in substance use while GDC participants did not. While the design of the Stage I trial was essential for treatment development and testing, the Stage I trial had a small sample size and used a semi-closed enrollment format. However, most treatment is delivered in an open enrollment format (i.e., rolling admission) in which patients enter at any time in the group sequence and exit the group after 12 weeks are completed. Because WRG is intended to be a manual-based treatment ready for dissemination into clinical practice if demonstrated to be effective, the Stage II trial was designed to be implemented in an open group format and to enroll a larger, more diverse sample at two clinical sites. The study was designed to investigate the effectiveness of the WRG relative to the GDC in (1) reducing days of use of any substance from baseline in a sample of women with heterogeneity with regard to their substance dependence, co-occurring psychiatric disorders, and other demographic characteristics, and (2) to demonstrate the feasibility of implementing the WRG in an open-enrollment group format.

02

Conditions studied

  • Substance-Related Disorders
  • Alcohol-Related Disorders

Keywords

  • Substance use disorders, Gender differences, women, treatment outcomes, group therapy
03

In context

Substance-Related Disorders

2,124 studies on the registry are indexed under Substance-Related Disorders; 393 are open to participants now.

This study's enrollment of 158 is above the median of 108 across 1,727 interventional studies indexed under Substance-Related Disorders.

Browse Substance-Related Disorders studies →

Lead sponsor

Mclean Hospital is the lead sponsor of 181 studies on the registry; 32 are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 10 (71%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Subjects were included in the study if they:

    • were 18 years or older
    • used substances within the past 60 days
    • met current Diagnostic and Statistical Manual (DSM)-IV criteria (American Psychiatric Association, 2000; World Health Organization, 1997) of substance dependence (in addition to any nicotine dependence)
    • planned to stay within the area during the study period
    • consented for study personnel to communicate with other mental health professionals from whom they are receiving care
    • furnished the names of two locators who can assist study personnel in locating them during the study period
    • were interested in group treatment
    • lived close enough either to McLean Hospital or SSTAR to come to group weekly
    • were able to sign informed consent.

Exclusion criteria

Exclusion Criteria:

  • Patients were excluded if they:

    • had a current medical condition that would prevent regular group attendance
    • had mental retardation or organic mental disorder
    • had certain other major Axis I psychiatric disorders according to the Composite International Diagnostic Interview (CIDI), such as psychotic disorders or bipolar I disorder
    • would be in a residential treatment setting throughout the treatment period in which substance use is monitored and restricted (e.g., a therapeutic community)
    • required medical detoxification (these patients could enter the study after being detoxified)
    • were current intravenous drug users
    • engaged in self-destructive behaviors (e.g., life-threatening bulimia or anorexia, suicide attempts and chronic suicidality) or other behaviors (e.g., violence toward others, assault behaviors)
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
158 participants (actual)

Study arms

  • Experimental
    Women's Recovery Group

    The Women's Recovery Group (WRG) is a manual-based group therapy for women heterogeneous with respect to their substance use disorder, co-occurring psychiatric disorders, trauma history, age, and stage of life. The WRG is a 12-session, structured relapse-prevention group therapy that utilizes a cognitive behavioral approach and includes gender-specific content and single-gender group composition. Individual session content was derived from research on gender-specific substance use disorder antecedents, consequences, and treatment outcomes. The overall goals of the treatment are to (1) promote abstinence from all substances including alcohol; (2) improve understanding of specific aspects of SUDs, recovery, and relapse that are relevant to women, and (3) help participants with skills and strategies useful in preventing relapse and promoting recovery.

    Behavioral: The Women's Recovery Group

  • Active comparator
    mixed-gender Group Drug Counseling

    Group Drug Counseling (GDC) is a standard 12-week, 90-minute mixed-gender group therapy. The overall goals of GDC are to 1) help patients to achieve abstinence from all substances including alcohol; 2) educate patients regarding recovery from substance use disorders; 3) increase patients' self-awareness of the problems that their substance use disorder has caused; 4) encourage patients to give mutual support; and 5) help patients learn new ways to cope with problems in order to prevent relapse. The GDC was chosen as the comparison group to approximate group drug counseling that is consistent with treatment as usual within the community.

    Behavioral: Group Drug Counseling

Interventions

  • BehavioralThe Women's Recovery Group

    The Women's Recovery Group (WRG) is a manual-based group therapy for women heterogeneous with respect to their substance use disorder, co-occurring psychiatric disorders, trauma history, age, and stage of life. The WRG is a 12-session, structured relapse-prevention group therapy that utilizes a cognitive behavioral approach and includes gender-specific content and single-gender group composition. Individual session content was derived from research on gender-specific substance use disorder antecedents, consequences, and treatment outcomes. The overall goals of the treatment are to (1) promote abstinence from all substances including alcohol; (2) improve understanding of specific aspects of SUDs, recovery, and relapse that are relevant to women, and (3) help participants with skills and strategies useful in preventing relapse and promoting recovery.

    Also known as: WRG

  • BehavioralGroup Drug Counseling

    Group Drug Counseling (GDC) is a standard 12-week, 90-minute mixed-gender group therapy. The overall goals of GDC are to 1) help patients to achieve abstinence from all substances including alcohol; 2) educate patients regarding recovery from substance use disorders; 3) increase patients' self-awareness of the problems that their substance use disorder has caused; 4) encourage patients to give mutual support; and 5) help patients learn new ways to cope with problems in order to prevent relapse. The GDC was chosen as the comparison group to approximate group drug counseling that is consistent with treatment as usual within the community.

    Also known as: GDC

06

What researchers measure

Primary outcomes

  1. Percent Change in Mean Days of Any Substance Use for Women

    This represents the percent change from baseline in the mean number of days per month of any substance use (i.e. drug and/or alcohol) for women. Days of substance use was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean days of any substance use. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

  2. Change in Mean ASI Alcohol Composite Score for Women

    This represents the change from baseline in mean ASI Alcohol composite scores. The ASI was administered at baseline, at months 1-6, and then at month 9. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline ASI data. Outcomes were analyzed using linear mixed effect models. These models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction. The ASI is a multidimensional assessment of substance-related problems which yields composite scores for alcohol use, drug use, psychiatric status, medical status, legal status, family/social relationships, and employment status. Composite scores range from 0 to 1, with higher scores indicating more significant problems.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

  3. Change in Mean ASI Drug Composite Score for Women

    This represents the change from baseline in mean ASI Drug composite scores. The ASI was administered at baseline, at months 1-6, and then at month 9. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline ASI data. Outcomes were analyzed using linear mixed effect models. These models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction. The ASI is a multidimensional assessment of substance-related problems which yields composite scores for alcohol use, drug use, psychiatric status, medical status, legal status, family/social relationships, and employment status. Composite scores range from 0 to 1, with higher scores indicating more significant problems.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

Secondary outcomes

  1. Percent Change in Mean Alcohol Use Days for Women

    This represents the percent change from baseline in the mean number of alcohol use days. Days of alcohol use was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline alcohol use data. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

  2. Percent Change in Mean Drug Use Days for Women

    This represents the percent change from baseline in the mean number of drug use days (excluding alcohol) for women. Days of drug use was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean drug use days. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

  3. Percent Change in Mean Heavy Drinking Days for Women

    This represents the percent change from baseline in the mean number of heavy drinking days for women. Number of heavy drinking days was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean heavy drinking days. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

  4. Change in Mean Drinks Per Drinking Day for Women

    This represents the change from baseline in the mean number of drinks per drinking day. Drinks per drinking day was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean drinks per drinking day. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

    Time frame: In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)

Other outcomes

  1. Therapist Adherence

    All therapists were female to eliminate any therapist-patient gender matching effects. There were eight therapists in total: 4 who led WRG groups and 4 who led GDC groups. All group sessions were videotaped each week so that we could measure therapist adherence to the treatment they were assigned to. Two independent raters completed adherence scales for a random selection of 20% of WRG and 10%of GDC sessions. For both groups, the extensiveness to which the therapist engaged in a behavior during the session was rated with a 5-point Likert scale (0 = not at all; 4 = extensively). Adherence scores were calculated by averaging all scores for each question (25 questions for WRG; 18 for GDC) on the measure. The scores reported here represent the average of all WRG therapists scores from all session, and all GDC therapist scores from all sessions. Scores range from 0 to 4.

    Time frame: In treatment (weeks 1-12)

  2. Group Attendance

    Treatment attendance was calculated by summing the number of treatment sessions attended. Therefore, numbers range from 0-12.

    Time frame: In treatment (weeks 1-12)

  3. Group Stability

    Treatment group stability was calculated using the Percentage of Group Change Index which captures change in group membership composition from session to session separately for each individual within each group (specific to the calendar period that each person was in the group). The value can range from 0 (i.e., the exact same membership from one session to the next) to 1 (i.e., complete turnover in membership). The average values across all sessions were taken to get an overall sense of the amount of turnover each person experienced in the group during the period in calendar time they were in treatment.

    Time frame: In treatment (weeks 1-12)

07

Results

Posted Mar 28, 2017
Limitations and caveats
* relatively small sample * sample was almost all white and well-educated (questionable generalizability) * therapists not blind to study

Participant flow

Subjects were recruited at McLean Hospital in Belmont, MA and SSTAR Inc. in Fall River, MA using advertisements, flyers, and clinician referrals. At both sites, subjects were recruited from inpatient, residential, partial hospital and outpatient programs. Those recruited from inpatient or residential settings started the groups after discharge.

Participant flow — Overall Study
MilestoneWomen's Recovery GroupMixed-gender Group Drug CounselingGroup Therapist
Started521068
Completed521068
Not completed000

Outcome measures

PrimaryPercent Change in Mean Days of Any Substance Use for Women

This represents the percent change from baseline in the mean number of days per month of any substance use (i.e. drug and/or alcohol) for women. Days of substance use was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean days of any substance use. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · % change in mean substance use days
Percent Change in Mean Days of Any Substance Use for Women
% change in mean substance use daysWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-76.5 (-83.9 to -65.7)-76.5 (-85.0 to -63.0)
3 Month Post-treatment Phase (months 4-6)-68.4 (-76.9 to -56.8)-73.3 (-83.0 to -58.1)
6 Month Post-Treatment Phase (months 7-9)-62.2 (-74.9 to -41.3)-70.8 (-80.5 to -56.1)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · loglinear (negative binomial) regression · p = 0.821Analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (relative changes i.e. % change)
SecondaryPercent Change in Mean Alcohol Use Days for Women

This represents the percent change from baseline in the mean number of alcohol use days. Days of alcohol use was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline alcohol use data. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · percent change in Alcohol Use Days
Percent Change in Mean Alcohol Use Days for Women
percent change in Alcohol Use DaysWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-80.6 (-87.5 to -69.9)-82.6 (-89.7 to -67.2)
3 Month Post-treatment Phase (months 4-6)-70.3 (-79.1 to -57.6)-80.5 (-88.6 to -66.6)
6 Month Post-Treatment Phase (months 7-9)-67.8 (-80.5 to -46.8)-80.4 (-87.7 to -68.5)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · loglinear (negative binomial) regression · p = 0.519We used loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE).
PrimaryChange in Mean ASI Alcohol Composite Score for Women

This represents the change from baseline in mean ASI Alcohol composite scores. The ASI was administered at baseline, at months 1-6, and then at month 9. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline ASI data. Outcomes were analyzed using linear mixed effect models. These models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction. The ASI is a multidimensional assessment of substance-related problems which yields composite scores for alcohol use, drug use, psychiatric status, medical status, legal status, family/social relationships, and employment status. Composite scores range from 0 to 1, with higher scores indicating more significant problems.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · change in ASI Alcohol composite score
Change in Mean ASI Alcohol Composite Score for Women
change in ASI Alcohol composite scoreWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-0.27 (-0.33 to -0.22)-0.33 (-0.39 to -0.28)
3 Month Post-treatment Phase (months 4-6)-0.28 (-0.34 to -0.22)-0.36 (-0.43 to -0.30)
6 Month Post-Treatment Phase (months 7-9)-0.30 (-0.39 to -0.21)-0.35 (-0.44 to -0.26)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · Linear mixed effect models · p = 0.253This measure was analyzed using using linear mixed effect models with estimation via restricted maximum likelihood (absolute changes in the mean).
PrimaryChange in Mean ASI Drug Composite Score for Women

This represents the change from baseline in mean ASI Drug composite scores. The ASI was administered at baseline, at months 1-6, and then at month 9. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline ASI data. Outcomes were analyzed using linear mixed effect models. These models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction. The ASI is a multidimensional assessment of substance-related problems which yields composite scores for alcohol use, drug use, psychiatric status, medical status, legal status, family/social relationships, and employment status. Composite scores range from 0 to 1, with higher scores indicating more significant problems.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · change in ASI Drug composite score
Change in Mean ASI Drug Composite Score for Women
change in ASI Drug composite scoreWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-0.03 (-0.05 to -0.02)-0.03 (-0.05 to -0.01)
3 Month Post-treatment Phase (months 4-6)-0.03 (-0.05 to -0.01)-0.03 (-0.05 to -0.01)
6 Month Post-Treatment Phase (months 7-9)-0.02 (-0.05 to 0.02)-0.04 (-0.07 to 0.00)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · Linear mixed effect models · p = 0.667This measure was analyzed using using linear mixed effect models with estimation via restricted maximum likelihood (absolute changes in the mean).
Other pre-specifiedTherapist Adherence

All therapists were female to eliminate any therapist-patient gender matching effects. There were eight therapists in total: 4 who led WRG groups and 4 who led GDC groups. All group sessions were videotaped each week so that we could measure therapist adherence to the treatment they were assigned to. Two independent raters completed adherence scales for a random selection of 20% of WRG and 10%of GDC sessions. For both groups, the extensiveness to which the therapist engaged in a behavior during the session was rated with a 5-point Likert scale (0 = not at all; 4 = extensively). Adherence scores were calculated by averaging all scores for each question (25 questions for WRG; 18 for GDC) on the measure. The scores reported here represent the average of all WRG therapists scores from all session, and all GDC therapist scores from all sessions. Scores range from 0 to 4.

Time frame:
In treatment (weeks 1-12)
Reported as:
Mean · units on a 0-4 adherence scale
Therapist Adherence
units on a 0-4 adherence scaleWomen's Recovery GroupMixed-gender Group Drug Counseling
Therapist Adherence3.8 ± 0.133.6 ± 0.28
Other pre-specifiedGroup Attendance

Treatment attendance was calculated by summing the number of treatment sessions attended. Therefore, numbers range from 0-12.

Time frame:
In treatment (weeks 1-12)
Reported as:
Mean · sessions attended
Group Attendance
sessions attendedWomen's Recovery GroupMixed-gender Group Drug Counseling
Group Attendance7.64 ± 1.367.69 ± 1.36
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · t-test, 2 sided · p = >0.05
Other pre-specifiedGroup Stability

Treatment group stability was calculated using the Percentage of Group Change Index which captures change in group membership composition from session to session separately for each individual within each group (specific to the calendar period that each person was in the group). The value can range from 0 (i.e., the exact same membership from one session to the next) to 1 (i.e., complete turnover in membership). The average values across all sessions were taken to get an overall sense of the amount of turnover each person experienced in the group during the period in calendar time they were in treatment.

Time frame:
In treatment (weeks 1-12)
Reported as:
Mean · units on a scale
Group Stability
units on a scaleWomen's Recovery GroupMixed-gender Group Drug Counseling
Group Stability0.39 ± 0.070.36 ± 0.07
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · t-test, 2 sided · p = >0.05
SecondaryPercent Change in Mean Drug Use Days for Women

This represents the percent change from baseline in the mean number of drug use days (excluding alcohol) for women. Days of drug use was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean drug use days. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · % change in mean drug use days
Percent Change in Mean Drug Use Days for Women
% change in mean drug use daysWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-66.3 (-85.5 to -21.8)-40.8 (-62.4 to -6.8)
3 Month Post-treatment Phase (months 4-6)-76.7 (-89.6 to -47.5)-51.1 (-71.9 to 16.3)
6 Month Post-Treatment Phase (months 7-9)-62.2 (-83.0 to -15.9)-41.9 (-71.7 to 19.2)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · loglinear (negative binomial) regression · p = 0.464We used loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE).
SecondaryPercent Change in Mean Heavy Drinking Days for Women

This represents the percent change from baseline in the mean number of heavy drinking days for women. Number of heavy drinking days was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean heavy drinking days. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · % change in mean heavy drinking days
Percent Change in Mean Heavy Drinking Days for Women
% change in mean heavy drinking daysWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-89.6 (-91.4 to -81.8)-85.7 (-92.7 to -72.0)
3 Month Post-treatment Phase (months 4-6)-82.4 (-89.5 to -70.4)-82.0 (-90.0 to -67.5)
6 Month Post-Treatment Phase (months 7-9)-83.8 (-91.2 to -70.3)-83.2 (-90.2 to -71.2)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · loglinear (negative binomial) regression · p = 0.904We used loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE).
SecondaryChange in Mean Drinks Per Drinking Day for Women

This represents the change from baseline in the mean number of drinks per drinking day. Drinks per drinking day was assessed using the Timeline Follow-Back at baseline and then monthly for 9 months. The In-Treatment phase includes months 1-3, the 3 Month Post-Treatment phase includes months 4-6, and the 6 Month Post-Treatment phase includes months 7-9. The in-treatment and 2 post-treatment phases were compared to baseline data of mean drinks per drinking day. Outcomes were analyzed using loglinear (negative binomial) regression models with estimation via generalized estimating equations (GEE). The models included the effects of treatment group, phase (3 levels), and the treatment group by phase interaction.

Time frame:
In-treatment (months 1-3), 3 Month Post-treatment (months 4-6), 6 Month Post-Treatment (months 7-9)
Reported as:
Mean · change in mean drinks per drinking day
Change in Mean Drinks Per Drinking Day for Women
change in mean drinks per drinking dayWomen's Recovery GroupMixed-gender Group Drug Counseling
In-treatment Phase (months 1-3)-1.96 (-3.77 to -0.16)-2.87 (-4.74 to -1.01)
3 Month Post-treatment Phase (months 4-6)-1.47 (-3.91 to 0.98)-1.41 (-3.99 to 1.18)
6 Month Post-treatment Phase (months 7-9)-1.22 (-4.57 to 2.13)-0.76 (-4.28 to 2.76)
Statistical analysis
  • Women's Recovery Group vs Mixed-gender Group Drug Counseling · linear mixed effect model · p = 0.799This measure was analyzed using using linear mixed effect models with estimation via restricted maximum likelihood (absolute changes in the mean).

Adverse events

Collected over Adverse events were recorded over a period of 1 year and 9 months (November 2009 to August 2011).. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Women's Recovery Group—4/52 (7.7%)13/52 (25%)
Mixed-gender Group Drug Counseling—13/106 (12.3%)8/106 (7.5%)
Most frequent serious events
Showing 10 of 14
Most frequent serious events
EventWomen's Recovery GroupMixed-gender Group Drug Counseling
Colon SurgerySurgical and medical procedures1/520/106
HospitalizationGastrointestinal disorders1/521/106
Chest PainGeneral disorders1/520/106
AbscessSkin and subcutaneous tissue disorders1/520/106
OverdoseGeneral disorders0/522/106
Death - Heart AttackCardiac disorders0/522/106
DehydrationGeneral disorders0/521/106
SeizureNervous system disorders0/521/106
Post-Surgery InfectionInfections and infestations0/521/106
StrokeNervous system disorders0/521/106
Most frequent other events
Showing 10 of 16
Most frequent other events
EventWomen's Recovery GroupMixed-gender Group Drug Counseling
Gastrointestinal DiscomfortGastrointestinal disorders2/520/106
Back PainMusculoskeletal and connective tissue disorders2/520/106
Acute Asthma EpisodeRespiratory, thoracic and mediastinal disorders1/521/106
BronchitisRespiratory, thoracic and mediastinal disorders1/520/106
Surgical Procedure - Removal of Lymph NodesSurgical and medical procedures1/520/106
Ovarian CystNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/520/106
Motor Vehicle AccidentSocial circumstances1/520/106
HospitalizationGeneral disorders1/520/106
Broken ArmMusculoskeletal and connective tissue disorders1/521/106
Animal BiteInfections and infestations1/520/106

Baseline characteristics

Age, Continuous
Age, Continuous(Years)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
Mean45.7 ± 12.647.6 ± 12.047 ± 12.2
Sex: Female, Male
Sex: Female, Male(Participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
Female5248100
Male05858
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
Hispanic or Latino011
Not Hispanic or Latino52105157
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
American Indian or Alaska Native000
Asian101
Native Hawaiian or Other Pacific Islander000
Black or African American358
White48101149
More than one race000
Unknown or Not Reported000
Marital Status
Marital Status(participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
Married194160
Divorced/Separated172744
Never married123042
Unmarried and living with partner459
Widowed033
Education
Education(participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
Did not graduate high school4711
Graduated high school72229
Some college112233
Graduated from college183452
Postgraduate122133
Household Income
Household Income(participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
$0-$20,000172643
$20,001-$50,00093140
$50,001-$100,000112839
More than $100,000152136
Current psychiatric diagnoses
Current psychiatric diagnoses(participants)Women's Recovery GroupMixed-gender Group Drug CounselingTotal
Major depressive disorder305888
Generalized anxiety disorder112031
Post-traumatic stress disorder92029
Any Axis I3779116
Any Axis II91524

3 further baseline measures are reported on the registry.

08

Study locations

2 sites
  • McLean Hospital
    Belmont, Massachusetts 02478, United States
  • Stanley Street Treatment and Resources (SSTAR)
    Fall River, Massachusetts 02720, United States
09

References and documents

Publications

  • Greenfield SF, Crisafulli MA, Kaufman JS, Freid CM, Bailey GL, Connery HS, Rapoza M, Rodolico J. Implementing substance abuse group therapy clinical trials in real-world settings: challenges and strategies for participant recruitment and therapist training in the Women's Recovery Group Study. Am J Addict. 2014 May-Jun;23(3):197-204. doi: 10.1111/j.1521-0391.2014.12099.x. PubMed 24724875 ↗
  • Greenfield SF. Treating Women with Substance Use Disorders: The Women's Recovery Group Manual. New York: Guilford Press; 2016.
  • Greenfield SF, Sugarman DE, Freid CM, Bailey GL, Crisafulli MA, Kaufman JS, Wigderson S, Connery HS, Rodolico J, Morgan-Lopez AA, Fitzmaurice GM. Group therapy for women with substance use disorders: results from the Women's Recovery Group Study. Drug Alcohol Depend. 2014 Sep 1;142:245-53. doi: 10.1016/j.drugalcdep.2014.06.035. Epub 2014 Jul 4. PubMed 25042759 ↗
  • Sugarman DE, Wigderson SB, Iles BR, Kaufman JS, Fitzmaurice GM, Hilario EY, Robbins MS, Greenfield SF. Measuring affiliation in group therapy for substance use disorders in the Women's Recovery Group study: Does it matter whether the group is all-women or mixed-gender? Am J Addict. 2016 Oct;25(7):573-80. doi: 10.1111/ajad.12443. Epub 2016 Sep 20. PubMed 27647710 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 5, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01318538
Lead sponsor
Mclean Hospital
Collaborators
National Institute on Drug Abuse (NIDA)
Responsible party
Shelly F. Greenfield (Chief Academic Officer; Chief, Division of Women's Mental Health; Kristine M Trustey Endowed Professor of Psychiatry; Director, Clinical and Health Services Research and Education, McLean Hospital; Professor of Psychiatry, Harvard Medical School, Mclean Hospital) — Principal investigator
First posted
Mar 18, 2011
Start date
Aug 2008
Primary completion
Aug 2011
Completion
Jun 2012
Results posted
Mar 28, 2017
Last update
Jun 5, 2017

Study contacts

Shelly F Greenfield, MD, MPH
principal investigator · Mclean Hospital

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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