Dynamic Multilevel Processes of Recovery in Therapeutic Communities in Mexico (DICO Model)
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexMale
Age18+
SponsorUnder The Tree Therapeutic Community
About this trial
This study aims to develop and empirically evaluate the Dinámica Integral Conductual Comunitaria (DICO) model, a multilevel framework that conceptualizes recovery from substance use disorders as a dynamic process emerging from the interaction between individual behavioral variables, social contingencies, and community-level factors within therapeutic communities in Mexico.
A prospective longitudinal design with intensive repeated measures will be implemented over 8 to 12 weeks. Data will be collected using ecological momentary assessment (EMA), psychometric instruments, behavioral records, and semi-structured interviews.
The study seeks to model recovery trajectories as nonlinear dynamic systems, identifying critical transitions, instability patterns, and contextual moderators associated with treatment adherence and relapse risk.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adults aged 18 years or older
Currently enrolled in a residential therapeutic community for substance use treatment
Minimum stay of at least 7 days prior to baseline assessment
Ability to understand and provide informed consent
Disqualifiers
Acute psychotic symptoms or severe psychiatric decompensation that interferes with participation
Severe cognitive impairment limiting comprehension of study procedures
Current medical instability requiring immediate external intervention
Refusal to participate in any component of the study
Trial population
Adult individuals undergoing residential treatment for substance use disorders in therapeutic communities in Mexico. The population is characterized by varying levels of substance dependence severity, psychosocial vulnerability, and exposure to structured community-based treatment environments that emphasize behavioral regulation, peer support, and institutional norms. Participants are embedded in a communal living setting where daily routines, social interactions, and reinforcement contingencies are structured by the therapeutic model, providing a naturalistic context for observing multilevel behavioral and recovery processes.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Ecological Momentary Assessment (EMA)
Other interventionReal-time data collection method using mobile devices to assess momentary fluctuations in craving, psychological flexibility, and social context multiple times per day. This procedure is used for observational measurement only and does not constitute a therapeutic intervention.
Treatment groups
60 Participants
are divided into 1 treatment groupGroup A: Therapeutic Community Residents1 intervention
Trial outcomes
Primary outcomes
1
Treatment Adherence - Length of Stay
Length of stay in treatment (number of days from admission to discharge), obtained from clinical records.
Time frame
From admission to discharge (up to 12 weeks)2
Disengagement - Total Score on Brief Disengagement Scale
Total score on the Brief Disengagement Scale (3 items, each scored from 0 to 10; total range: 0 to 30). Higher scores indicate greater disengagement from treatment.
Time frame
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)3
Craving Intensity - Single-Item Scale
Self-reported craving intensity using a single-item scale (0 to 10; 0 = no craving, 10 = extreme craving).
Time frame
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)4
Contextual Rumination - Total Score on the Brief Contextual Rumination Scale (BCRS-10)
Total score on the Brief Contextual Rumination Scale (EBRC-10). Range: 0 to 40. Higher scores indicate greater rumination associated with substance use.
Time frame
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)Secondary outcomes
1
Psychological Flexibility - Total Score on the Acceptance and Action Questionnaire-II (AAQ-II)
Total score on the Acceptance and Action Questionnaire-II (AAQ-II). Range: 7 to 49 points. A higher score indicates a worse outcome (greater experiential avoidance, lower psychological flexibility).
Time frame
Week 1 (baseline) and Week 12 (discharge).2
Community Cohesion - Mean Score on the Brief Cohesion Scale (RBDC-2D)
Mean score of two items (each scored 0 to 10): perceived group belonging and trust in peers, derived from the Brief Community Dynamics Record (RBDC-2D). Range: 0 to 10. Higher scores indicate greater cohesion.
Time frame
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)3
Perceived Social Support - Single-Item Score
Single-item score (0 to 10): perceived support from peers or staff. Higher scores indicate greater perceived support.
Time frame
Every 48 hours from Week 1 through Week 12 (up to 12 weeks)4
Prosocial Behavior - Participation and Cooperation Index (RBDC-2D)
Composite index calculated as the sum of three items (each scored 0 to 3): participation in activities, cooperation with peers, and mutual help. Total range: 0 to 9. Higher scores indicate greater prosocial behavior.
Time frame
Every 48 hours from Day 1 through Week 12 (up to 12 weeks).Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Source ClinicalTrials.gov
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