Fatherhood Engagement Program for Substance Use Disorders

Recruiting at 1 trial location

Overseen By Alessandra de Marchena, LCSW

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: Montefiore Medical Center

Disqualifiers: All children in foster care

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

240 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist fathers in families at risk of substance misuse by providing enhanced support services. Participants will split into two groups: one receives regular services, while the other gets additional help, such as motivational coaching and a fatherhood program called HERO Dads. The goal is to determine if these enhanced services improve their lives. Fathers with at least one child under 18 and a family member at risk for substance use might be well-suited for this study. As an unphased trial, this study offers participants a unique opportunity to access potentially life-changing support services and contribute to valuable research.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these enhanced services are safe for families at risk of substance misuse?

Research has shown that the enhanced services in the Fatherhood Engagement Program positively affect related areas.

For example, the HERO Dads Program includes workshops to help fathers improve parenting skills and find job support. Although specific safety data for this program is unavailable, similar programs for parents usually pose minimal risk.

Contingency Management, another part of the program, has been well-researched and effectively treats substance use disorders (SUDs). It involves giving small rewards for positive behavior changes, and studies have shown it to be safe and well-tolerated.

Motivational Enhancement Therapy helps individuals explore their feelings about substance use and has proven effective and safe in many studies. It focuses on helping individuals find their own reasons to change, often leading to better outcomes.

Case Management supports individuals by organizing care and resources. This approach has been found effective and safe for people with SUDs, helping them stay in treatment and manage their recovery.

Overall, these components have been tested in various settings and are generally considered safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Fatherhood Engagement Program for Substance Use Disorders because it offers a novel approach to supporting fathers struggling with substance use. Unlike traditional treatments that focus solely on individual therapy or medication, this program integrates motivational enhancement, fatherhood engagement services, contingency management, and case management. This comprehensive method aims to not only address substance use but also improve family dynamics and paternal involvement, which could lead to more sustainable recovery outcomes. By engaging fathers in their roles within the family, the program hopes to provide a more holistic support system that enhances both personal recovery and family well-being.

What evidence suggests that this trial's treatments could be effective for substance use disorders?

Research has shown that the HERO Dads Fatherhood Program, a treatment option in this trial, helps fathers enhance their parenting skills and strengthen connections with their children, leading to better family relationships. Participants in the "Enhanced Fatherhood Services" arm will receive various services, including Contingency Management, which uses rewards to encourage positive behavior changes and has proven effective for individuals with substance use issues. Studies indicate that Motivational Enhancement Therapy, another component of this arm, can reduce substance use by boosting motivation to change. Additionally, Case Management, which organizes care and services, has demonstrated small but positive effects in managing substance use problems. Together, these components create a robust support system that could benefit fathers at risk of substance misuse. ^{1 2 4 6 7}

Who Is on the Research Team?

Scott Wetzler, PhD

Principal Investigator

Montefiore Medical Center

Are You a Good Fit for This Trial?

This trial is for fathers, whether they live with their children or not, who have at least one child under 18. They must be part of a family where someone is at risk for substance use issues. Fathers whose children are all in foster care cannot participate.

Inclusion Criteria

Is a custodial or non-custodial father

I have at least one child under 18.

Someone in the family is identified as at-risk for substance use

Exclusion Criteria

The placement of all children in the family in foster care

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive enhanced services including Motivational Enhancement, referral to HERO Dads program, Contingency Management, and Case Management

6 months

Follow-up

Participants are monitored for child well-being and behavior outcomes after receiving services

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Case Management
• Contingency Management
• HERO Dads Fatherhood Program
• Motivational Enhancement

Trial Overview The study tests if extra support services can help fathers in families at risk of substance misuse. Some dads will get usual services; others will also get motivational talks, the HERO Dads program, rewards for positive behavior (Contingency Management), and Case Management.

How Is the Trial Designed?

Group I: Enhanced Fatherhood Services through Regional Partnership Grant Round 7 (RPG7) Experimental Treatment 4 Interventions

Randomly assigned to receive enhanced RPG7 services (motivational enhancement, fatherhood engagement services, contingency management, case management)

Group II: Services as Usual Active Control 1 Intervention

Randomly assigned to receive services as usual

Who Is Running the Clinical Trial?

Montefiore Medical Center

Lead Sponsor

Trials

468

Recruited

599,000+

Albert Einstein College of Medicine

Collaborator

Trials

302

Recruited

11,690,000+

Published Research Related to This Trial

Community-based programs for low-income fathers often face challenges in achieving high attendance rates, but some programs successfully engage fathers in parenting and economic security classes.

Higher levels of participation (or dosage) in these programs are positively associated with better outcomes for fathers, including increased engagement with children, improved parenting satisfaction, and higher earnings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fathers' Dosage in Community-based Programs for Low-income Fathers. Fagan, J., Pearson, J.[2021]

In a study of 230 divorced fathers over 18 months, one third were clinically depressed, but overall, there were reductions in depression, smoking, and marijuana use, indicating potential improvements in mental health and substance use.

Fathering identity and involvement were linked to better health outcomes, as increased father involvement was associated with reduced drinking and marijuana use, highlighting the importance of supportive fathering in promoting healthier behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patterns and predictors of growth in divorced fathers' health status and substance use. DeGarmo, DS., Reid, JB., Leve, LD., et al.[2021]

In a study of 125 children with an average age of 9.8 years, it was found that greater involvement of alcohol-dependent fathers in 12-step treatment programs was linked to lower externalizing problems in their children after 12 months.

The positive impact of fathers' treatment involvement on children's behavior was mediated by the fathers' subsequent behaviors, including increased attendance at Alcoholics Anonymous and greater abstinence from alcohol, which were associated with improved child outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems. Andreas, JB., O'Farrell, TJ.[2022]

The Fathering in Recovery (FIR) intervention, a video-based program adapted for fathers in their first year of recovery from substance use disorders, significantly improved parenting knowledge and fathering efficacy among participants, based on a pilot study of 41 fathers.

FIR also showed potential in reducing ineffective parenting practices and child behavior problems, indicating that this intervention could positively impact families affected by substance use disorders, although further research is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial to improve fathering among fathers with substance use disorders: Fathering in recovery intervention. Cioffi, CC., Browning O'Hagan, AM., Halvorson, S., et al.[2023]

Substance use treatment programs often overlook the parenting status of men, despite evidence that programs focusing on gender and motherhood improve treatment outcomes for women.

The paper presents pilot outcomes from a fatherhood-focused intervention in a residential treatment program, suggesting that integrating parenting components could enhance treatment effectiveness and positively impact child welfare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Where's Dad? The Importance of Integrating Fatherhood and Parenting Programming into Substance Use Treatment for Men. Stover, CS., Carlson, M., Patel, S., et al.[2020]

The commentary emphasizes the need for the substance abuse research community to recognize and study the role of substance-abusing fathers, as their experiences and challenges are often overlooked in public policy and service delivery.

The authors outline key areas for further research, including the prevalence of substance-abusing fathers, the impact of their substance use on parenting and child development, and potential interventions to reduce harm associated with paternal substance abuse.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance abuse and fathering: adding poppa to the research agenda. McMahon, TJ., Rounsaville, BJ.[2019]

A study involving 44 fathers in a substance use disorder treatment program showed that incorporating a fatherhood-focused intervention significantly reduced anger-related thoughts and emotion regulation problems after the program.

The intervention, called Fathers for Change, had a high completion rate of 84.1% among participants, indicating strong feasibility and satisfaction with the program's content.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrating intimate partner violence and parenting intervention into residential substance use disorder treatment for fathers. Stover, CS., Carlson, M., Patel, S.[2019]

Drug-addicted fathers often struggle with feelings of inadequacy and confusion about their roles as parents, believing their children may be better off without them, regardless of their actual contact with them.

Interventions such as workshops that provide positive fathering examples and facilitate discussions about parenting experiences can help these fathers reconnect with their children and address their feelings of guilt and inadequacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Issues of fatherhood and recovery for VA substance abuse patients. Arenas, ML., Greif, GL.[2004]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC1994722/

The Development and Implementation of Case Management ... It was found that case management has been applied in various populations with substance use disorders, and distinct models have been associated with positive ...

2. library.samhsa.gov library.samhsa.gov/sites/default/files/PEP20-02-02-013.pdf

COMPREHENSIVE CASE MANAGEMENT FOR ... A 2019 meta-analysis comparing case management with treatment as usual showed a small yet statistically significant positive effect, which was greater for ...

3. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00186/full

A Meta-Analysis of the Efficacy of Case Management for ... Case management is more effective than TAU conditions for improving outcomes, but this effect is significantly larger for treatment-related tasks than for ...

4. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK73754/

Effectiveness of different models of case management ... - NCBI The authors concluded that some evidence existed for modest or small benefits of some models of case management, but that these did not significantly differ.

5. ajph.aphapublications.org ajph.aphapublications.org/doi/full/10.2105/AJPH.2005.076380

Effectiveness of Intensive Case Management for Substance ... Objective. We tested the effectiveness of a long-term coordinated care strategy—intensive case management (ICM)—compared with usual care ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10241125/

Substance Use Disorders in the Geriatric Population This review provides updated information on epidemiology, special considerations, and management of substance use disorders in older adults.

7. library.samhsa.gov library.samhsa.gov/product/advisory-comprehensive-case-management-substance-use-disorder-treatment-based-tip-27/pep20

Comprehensive Case Management for Substance Use ... This guide presents an overview of case management for substance use disorder treatment providers. It discusses models, program evaluation, ...