<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02233738</url>
  </required_header>
  <id_info>
    <org_study_id>IIR 13-317</org_study_id>
    <nct_id>NCT02233738</nct_id>
  </id_info>
  <brief_title>Group Motivational Interviewing (GMI) For Homeless Veterans In VA Services</brief_title>
  <official_title>Group Motivational Interviewing (GMI) For Homeless Veterans In VA Services</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>VA Office of Research and Development</agency>
      <agency_class>U.S. Fed</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>VA Office of Research and Development</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      Homeless Veterans with substance use disorders (SUDs) are a major group served by VA and are&#xD;
      heavily represented in VA housing. VA recently adopted a 'Housing First' approach emphasizing&#xD;
      rapid housing placement to initiate recovery without requiring sobriety and will necessitate&#xD;
      SUD interventions that are efficient and easily layered onto existing services. The proposed&#xD;
      study will investigate the effectiveness, implementation process, and cost estimate of Group&#xD;
      Motivational Interviewing (GMI) for Veterans with SUDs in VA housing (Housing Urban&#xD;
      Development-VA Support Housing [HUD-VASH] and Grant and per Diem [GPD]). Outcomes will be&#xD;
      assessed at multiple time points using a multi-modal approach. The ultimate goal of this&#xD;
      research is to establish the basis of a GMI dissemination and implementation course of action&#xD;
      for highly vulnerable homeless Veterans in VA housing for achieving their greatest success in&#xD;
      attaining housing stability.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Anticipated Impacts on Veterans Health Care:&#xD;
&#xD;
      VA set an ambitious goal for ending homelessness among Veterans by 2015. Housing Urban&#xD;
      Development-VA Support Housing [HUD-VASH] and Grant and per Diem [GPD] are two primary VA&#xD;
      housing programs to help Veterans exit homelessness. Substance abuse among Veterans in VA&#xD;
      housing is a major risk factor for worsening psychopathology and housing instability. Despite&#xD;
      recent adoption of a Housing First approach, many VA housing programs lack the staff&#xD;
      infrastructure to manage substance use disorders (SUDs). This is a significant problem as 60%&#xD;
      (conservative estimate) of Veterans in VA housing have SUDs and these Veterans show greater&#xD;
      psychopathology compared to their counterparts without SUDs. These issues warrant substantial&#xD;
      need for SUD programs in VA housing that are efficient to deploy, easily layered onto&#xD;
      existing services, and require minimal staff to operate. The current study addresses this&#xD;
      current void in VA treatment services in that it investigates the effectiveness,&#xD;
      implementation process, and cost estimate of treatment of an adaptation of motivational&#xD;
      interviewing, an empirically supported intervention with strong impact on reducing substance&#xD;
      use and enhancing treatment engagement, in a group format, referred to as Group Motivational&#xD;
      Interviewing (GMI) for Veterans with SUDs in VA housing. Data from this project, if shown to&#xD;
      be promising, will establish the basis of a GMI dissemination and implementation course of&#xD;
      action for highly vulnerable homeless Veterans in VA housing for achieving their greatest&#xD;
      success in attaining housing stability.&#xD;
&#xD;
      Background:&#xD;
&#xD;
      There is a significant need for 'wraparound' treatment services in VA housing for addressing&#xD;
      SUDs. Homeless Veterans with SUDs are vulnerable to treatment dropout, rendering them&#xD;
      susceptible to relapse, while their continuation in outpatient care during their&#xD;
      participation in VA housing leads to improved clinical outcomes. According to systematic&#xD;
      reviews, individual motivational interviewing reduces the incidence of substance use&#xD;
      disorders, when compared to no treatment, but is labor intensive. As VA moves toward a&#xD;
      'Housing First' paradigm where greater numbers of homeless Veterans will continue to use&#xD;
      substances while in VA housing, delivery of GMI (which may be less labor intensive) to these&#xD;
      patients will be important for initiating and maintaining their recovery as well as enhancing&#xD;
      their psychosocial integration and quality of life. In a prior controlled trial conducted by&#xD;
      the Principal Investigator, GMI resulted in significantly higher outpatient treatment&#xD;
      engagement and lower substance use compared to treatment-as-usual among dually diagnosed&#xD;
      Veterans.&#xD;
&#xD;
      Objectives:&#xD;
&#xD;
      Study objectives are consistent with VA housing recommendations focusing on patient recovery,&#xD;
      health services promotion, and treatment implementation evaluation. GMI will be compared to a&#xD;
      control treatment condition (CT) on (Specific Aim I; Five outcomes: (Primary Hypothesis 1):&#xD;
      treatment engagement; (Primary Hypothesis 1): substance use; (Secondary H2): psychosocial&#xD;
      integration (e.g., social support, community participation); (Secondary H3) quality of&#xD;
      life/psychiatric indices; and (Secondary H4): number of days engaging in&#xD;
      structured/productive work activities in the 6-month follow up. Specific Aim II involves a&#xD;
      process evaluation for documenting (A) formative (e.g., developmental), (B) process, and (C)&#xD;
      summative outcomes; and Specific Aim III involves estimation of cost of intervention in terms&#xD;
      of direct costs, indirect costs of staff, costs of capital and workload measures for future&#xD;
      implementation and dissemination research.&#xD;
&#xD;
      Methods:&#xD;
&#xD;
      Randomized controlled trial comparing GMI to control treatment (CT) across five critical&#xD;
      outcomes. 186 Veterans in VA housing services (93 per treatment arm) will be enrolled with a&#xD;
      diagnosis of alcohol or drug abuse/dependence. Recruitment will take place in Charleston VA&#xD;
      Medical Center HUD-VASH &amp; GPD. Participants will be randomly assigned to (1) GMI or (2) CT,&#xD;
      each consisting of 4 sessions, and will be evaluated at 1, 3, and 6 months. Participants with&#xD;
      a non-substance related DSM-V disorder (e.g., major depressive disorder, PTSD) will be&#xD;
      eligible for the study. Analyses will be conducted using generalized linear mixed models&#xD;
      (GLMM) approach.&#xD;
&#xD;
      Significance to Veterans:&#xD;
&#xD;
      Homeless Veterans with SUDs represent one of the largest and most chronic groups of&#xD;
      psychiatric patients treated in the VA Healthcare System. With the ongoing execution of VA's&#xD;
      &quot;Plan to End Veteran Homelessness,&quot; Veterans entering housing require interventions that can&#xD;
      be feasibly implemented with minimal reorganization of existing services. GMI is based on&#xD;
      motivational interviewing, an empirically valid treatment that aligns with Veteran-centered&#xD;
      recovery models including Harm Reduction and more traditional treatment philosophies. The&#xD;
      investment in GMI for VA housing may be minimal as it requires only a few staff to operate in&#xD;
      relatively short time (e.g., 4 sessions, 90-min each) with modest (20 hours) staff training.&#xD;
      It can be layered onto existing services with little interruption or reorganization of staff,&#xD;
      and it has potential to be offered to larger numbers of Veterans with SUDs in VA housing who&#xD;
      would otherwise not receive this intervention.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">September 30, 2015</start_date>
  <completion_date type="Actual">July 17, 2018</completion_date>
  <primary_completion_date type="Actual">July 17, 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Factorial Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Standard Ethanol Content Units (SECs) Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Standard Ethanol Content Units (SECs) at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Standard Ethanol Content Units (SECs) at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Standard Ethanol Content Units (SECs) at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Peak SEC at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed in a single day within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Peak SEC at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Peak SEC at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Peak SEC at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Alcohol Drink Days at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Alcohol Drink Days at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days after day 1 of the treatment group. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Alcohol Drink Days at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Alcohol Drink Days at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Binge Drink Days at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Binge Drink Days at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Binge Drink Days at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Binge Drink Days at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Illicit Drug Use Days at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of drug use in the 30 days prior to Baseline. This measure represents the number of illicit drug use days within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Illicit Drug Use Days at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Illicit Drug Use Days at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Illicit Drug Use Days at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Substance Use Disorder Treatment Sessions at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Substance Use Disorder Treatment Sessions at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Substance Use Disorder Treatment Sessions at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Substance Use Disorder Treatment Sessions at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 6-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Twelve-Step Sessions Attended at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to Baseline.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Twelve-Step Sessions Attended at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to 1-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Twelve-Step Sessions Attended at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 60 days prior to 3-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Twelve-Step Sessions Attended at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended in the 90 days prior to 6-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Times Involved in Community Participation Activities at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to Baseline.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Times Involved in Community Participation Activities at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to 1-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Times Involved in Community Participation Activities at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 60 days prior to 3-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Times Involved in Community Participation Activities at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 90 days prior to 6-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Days Involved in Productive Work Activities at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to Baseline.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Days Involved in Productive Work Activities at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to 1-month follow-up.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Days Involved in Productive Work Activities at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 60 days prior to 3-month follow-up</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Days Involved in Productive Work Activities at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 90 days prior to 6-month follow-up.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Mental Health Treatment Sessions at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included individual sessions with outpatient mental health staff.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Mental Health Treatment Sessions at 1 Month</measure>
    <time_frame>1 Month</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Mental Health Treatment Sessions at 3 Months</measure>
    <time_frame>3 Months</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Mental Health Treatment Sessions at 6 Months</measure>
    <time_frame>6 Months</time_frame>
    <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 90 days prior to 6-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Substance Use Disorder and Mental Health Treatment Sessions at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to Baseline.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Substance Use Disorder and Mental Health Treatment Sessions at 1 Month</measure>
    <time_frame>1 Month</time_frame>
    <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to 1-month follow-up.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Substance Use Disorder and Mental Health Treatment Sessions at 3 Months</measure>
    <time_frame>3 Months</time_frame>
    <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 60 days prior to 3-month follow-up.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Substance Use Disorder and Mental Health Treatment Sessions at 6 Months</measure>
    <time_frame>6 Months</time_frame>
    <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 90 days prior to 6-month follow-up.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at Baseline for Alcohol Use</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Alcohol Use</measure>
    <time_frame>1 month</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at 3 Months for Alcohol Use</measure>
    <time_frame>3 months</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Alcohol Use</measure>
    <time_frame>6 months</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at Baseline for Psychiatric Status</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Psychiatric Status</measure>
    <time_frame>30 days</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at 3 Month for Psychiatric Status</measure>
    <time_frame>3 months</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Psychiatric Status</measure>
    <time_frame>6 months</time_frame>
    <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Short Inventory of Problems (SIP) at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Short Inventory of Problems at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Short Inventory of Problems at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Short Inventory of Problems at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Social Support Survey Total Score at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Min value:19 Max value:95 Higher score indicates higher support</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Social Support Survey Total Score at 1 Month</measure>
    <time_frame>30 days prior to 1-month follow-up</time_frame>
    <description>Min value:19 Max value:95 Higher score indicates higher support</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Social Support Survey Total Score at 3 Months</measure>
    <time_frame>60 days prior to 3-month follow-up</time_frame>
    <description>Min value:19 Max value:95 Higher score indicates higher support</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Social Support Survey Total Score at 6 Months</measure>
    <time_frame>90 days prior to 6-month follow-up</time_frame>
    <description>Min value:19 Max value:95 Higher score indicates higher support</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life Survey (QOLS) at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life Survey (QOLS) at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life Survey (QOLS) at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life Survey (QOLS) at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Brief Symptom Inventory (BSI-18) at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Brief Symptom Inventory(BSI-18) at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Brief Symptom Inventory (BSI-18) at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Brief Symptom Inventory (BSI-18) at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Physical Summary Score at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Physical Summary Score at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Physical Summary Score at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Physical Summary Score at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Mental Summary Score at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Mental Summary Score at 1 Month</measure>
    <time_frame>1 month</time_frame>
    <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Mental Summary Score at 3 Months</measure>
    <time_frame>3 months</time_frame>
    <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>SF-12 Health Survey Mental Summary Score at 6 Months</measure>
    <time_frame>6 months</time_frame>
    <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Treatment Motivation Questionnaire (TMQ) at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Treatment Motivation Questionnaire (TMQ) at 1-month</measure>
    <time_frame>30 days prior to 1-month follow-up</time_frame>
    <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Treatment Motivation Questionnaire (TMQ) at 3-month</measure>
    <time_frame>60 days prior to 3-month follow-up</time_frame>
    <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Treatment Motivation Questionnaire (TMQ) at 6-months</measure>
    <time_frame>90 days prior to 6-month follow-up</time_frame>
    <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Fagerstrom Test for Nicotine Dependence at Baseline</measure>
    <time_frame>30 days prior to Baseline</time_frame>
    <description>Min:0 Max:10 Higher score indicates higher level of nicotine dependence</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Psychiatric Outpatient Satisfaction Scale - Total Score</measure>
    <time_frame>1 month</time_frame>
    <description>Min:13 Max:65 Higher score indicates better satisfaction</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Helping Alliance Questionnaire - Total Score</measure>
    <time_frame>Completed during session 4 of treatment group (i.e. the final treatment session)</time_frame>
    <description>Participant completed assessment on the final day of group and rated therapist based on their interactions over the 4 days.&#xD;
Min:19 Max:114 Higher score indicates stronger alliance with therapist</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">185</enrollment>
  <condition>Alcoholism</condition>
  <condition>Substance-related Disorders</condition>
  <condition>Dual Diagnosis</condition>
  <arm_group>
    <arm_group_label>Group Motivational Interviewing (GMI)</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Group Motivational Interviewing (GMI) participants will receive four structured, back-to-back, 90-min sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Control Treatment Condition (CT)</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to Group Motivational Interviewing (GMI) (i.e., 90 minutes) and will involve the following topics: A popular 'box activity': participants will anonymously write evocative questions on slips of paper involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion (e.g., &quot;How do I talk to my family about my alcohol problem?&quot;), money management with feedback (2 sessions), and cooking-home maintenance.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Group Motivational Interviewing (GMI)</intervention_name>
    <description>Participants randomized to Group Motivational Interviewing (GMI) will receive four structured, back-to-back, 90-minute sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.</description>
    <arm_group_label>Group Motivational Interviewing (GMI)</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Control Treatment Condition (CT)</intervention_name>
    <description>Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to GMI (i.e., 90 minutes) and will involve the following topics: A popular 'box activity': participants will anonymously write evocative questions on slips of paper involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion (e.g., &quot;How do I talk to my family about my alcohol problem?&quot;), money management with feedback (2 sessions), and cooking-home maintenance.</description>
    <arm_group_label>Control Treatment Condition (CT)</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Men and women Veterans currently in Housing Urban Development-VA Support Housing&#xD;
             [HUD-VASH] and Grant and per Diem [GPD]), newly entering the program but not yet&#xD;
             housed, or Veterans on the HUD-VASH interest (wait) list.&#xD;
&#xD;
          -  Able to comprehend English.&#xD;
&#xD;
          -  Meets DSM-V criteria for a current substance use disorder and have used substances in&#xD;
             the 30 days prior to treatment entry. Participants on medications targeting their&#xD;
             substance use must be stabilized on medications for at least 2 weeks before therapy&#xD;
             initiation.&#xD;
&#xD;
          -  May meet criteria a mood, anxiety or other psychiatric disorder. Participants on&#xD;
             maintenance medications for a mood or anxiety disorder must be stabilized on&#xD;
             medications for at least 2 weeks before therapy initiation.&#xD;
&#xD;
          -  Able to adequately provide informed consent and function at an intellectual level&#xD;
             sufficient to allow accurate completion of all assessment instruments.&#xD;
&#xD;
          -  Willing to commit to 4 group therapy sessions, baseline, 1, 3, and 6 month follow-up&#xD;
             assessments.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Active suicidal or homicidal ideation with a plan as this is likely to require&#xD;
             hospitalization or other interventions that could interfere with study participation.&#xD;
&#xD;
          -  Unstable psychiatric condition that is likely to require hospitalization or other&#xD;
             interventions that would interfere with study participation.&#xD;
&#xD;
          -  Unstable medical condition or one that may require hospitalization during the course&#xD;
             of the study.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>75 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Elizabeth J. Santa Ana, PhD MA BA</last_name>
    <role>Principal Investigator</role>
    <affiliation>Ralph H. Johnson VA Medical Center, Charleston, SC</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Ralph H. Johnson VA Medical Center, Charleston, SC</name>
      <address>
        <city>Charleston</city>
        <state>South Carolina</state>
        <zip>29401-5703</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <results_reference>
    <citation>Jaconis M, Santa Ana EJ, Killeen TK, Badour CL, Back SE. Concurrent treatment of PTSD and alcohol use disorder via telehealth in a female Iraq veteran. Am J Addict. 2017 Mar;26(2):112-114. doi: 10.1111/ajad.12481. Epub 2017 Jan 24.</citation>
    <PMID>28118514</PMID>
  </results_reference>
  <results_reference>
    <citation>Gebregziabher M, Voronca D, Teklehaimanot A, Santa Ana EJ. Weibull mixture regression for marginal inference in zero-heavy continuous outcomes. Stat Methods Med Res. 2017 Jun;26(3):1476-1499. doi: 10.1177/0962280215583402. Epub 2015 Apr 22.</citation>
    <PMID>25902801</PMID>
  </results_reference>
  <results_reference>
    <citation>Shorey RC, Martino S, Lamb KE, LaRowe SD, Santa Ana EJ. Change talk and relatedness in group motivational interviewing: a pilot study. J Subst Abuse Treat. 2015 Apr;51:75-81. doi: 10.1016/j.jsat.2014.11.003. Epub 2014 Nov 20.</citation>
    <PMID>25488505</PMID>
  </results_reference>
  <results_reference>
    <citation>Santa Ana EJ, LaRowe SD, Armeson K, Lamb KE, Hartwell K. Impact of group motivational interviewing on enhancing treatment engagement for homeless Veterans with nicotine dependence and other substance use disorders: A pilot investigation. Am J Addict. 2016 Oct;25(7):533-41. doi: 10.1111/ajad.12426. Epub 2016 Sep 2.</citation>
    <PMID>27589072</PMID>
  </results_reference>
  <verification_date>July 2023</verification_date>
  <study_first_submitted>August 21, 2014</study_first_submitted>
  <study_first_submitted_qc>September 2, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">September 8, 2014</study_first_posted>
  <results_first_submitted>October 17, 2019</results_first_submitted>
  <results_first_submitted_qc>November 26, 2019</results_first_submitted_qc>
  <results_first_posted type="Actual">December 16, 2019</results_first_posted>
  <last_update_submitted>July 19, 2023</last_update_submitted>
  <last_update_submitted_qc>July 19, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">July 27, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Alcoholism</keyword>
  <keyword>Substance-related disorders</keyword>
  <keyword>Dual Diagnosis</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Alcoholism</mesh_term>
    <mesh_term>Substance-Related Disorders</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol and Statistical Analysis Plan</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>January 8, 2019</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/38/NCT02233738/Prot_SAP_000.pdf</document_url>
    </provided_document>
  </provided_document_section>

  <clinical_results>

    <participant_flow>
      <pre_assignment_details>Of the 481 patients screened between September 2015 and January 2018, 38% (n=185) were consented and enrolled. However, only 184 participants were randomized because 1 withdrew during baseline assessments.</pre_assignment_details>
      <group_list>
        <group group_id="P1">
          <title>Group Motivational Interviewing (GMI)</title>
          <description>Group Motivational Interviewing (GMI) participants will receive four structured, back-to-back, 90-min sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.</description>
        </group>
        <group group_id="P2">
          <title>Control Treatment Condition (CT)</title>
          <description>Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to GMI (i.e., 90 minutes) and will involve the following topics: A popular 'box activity', participants will anonymously submit questions on involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion money management with feedback (2 sessions), cooking-home maintenance, and psycho-education about substance use.</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Overall Study</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="93"/>
                <participants group_id="P2" count="91"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>1 Month Follow-Up</title>
              <participants_list>
                <participants group_id="P1" count="89"/>
                <participants group_id="P2" count="82"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>3 Month Follow-Up</title>
              <participants_list>
                <participants group_id="P1" count="87"/>
                <participants group_id="P2" count="77"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>6 Month Follow-Up</title>
              <participants_list>
                <participants group_id="P1" count="85"/>
                <participants group_id="P2" count="75"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="85"/>
                <participants group_id="P2" count="75"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="8"/>
                <participants group_id="P2" count="16"/>
              </participants_list>
            </milestone>
          </milestone_list>
          <drop_withdraw_reason_list>
            <drop_withdraw_reason>
              <title>Lost to Follow-up</title>
              <participants_list>
                <participants group_id="P1" count="5"/>
                <participants group_id="P2" count="12"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Death</title>
              <participants_list>
                <participants group_id="P1" count="0"/>
                <participants group_id="P2" count="1"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Withdrawal by Subject</title>
              <participants_list>
                <participants group_id="P1" count="0"/>
                <participants group_id="P2" count="1"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Did not return after Baseline</title>
              <participants_list>
                <participants group_id="P1" count="3"/>
                <participants group_id="P2" count="2"/>
              </participants_list>
            </drop_withdraw_reason>
          </drop_withdraw_reason_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <group_list>
        <group group_id="B1">
          <title>Group Motivational Interviewing (GMI)</title>
          <description>Group Motivational Interviewing (GMI) participants will receive four structured, back-to-back, 90-min sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.</description>
        </group>
        <group group_id="B2">
          <title>Control Treatment Condition (CT)</title>
          <description>Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to GMI (i.e., 90 minutes) and will involve the following topics: A popular 'box activity', participants will anonymously submit questions on involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion money management with feedback (2 sessions), cooking-home maintenance, and psycho-education about substance use.</description>
        </group>
        <group group_id="B3">
          <title>Total</title>
          <description>Total of all reporting groups</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="93"/>
            <count group_id="B2" value="91"/>
            <count group_id="B3" value="184"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="50.8" spread="10.6"/>
                    <measurement group_id="B2" value="51.4" spread="9.5"/>
                    <measurement group_id="B3" value="51.2" spread="9.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex: Female, Male</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="6"/>
                    <measurement group_id="B2" value="4"/>
                    <measurement group_id="B3" value="10"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="87"/>
                    <measurement group_id="B2" value="87"/>
                    <measurement group_id="B3" value="174"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race/Ethnicity, Customized</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <title>African American</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="49"/>
                    <measurement group_id="B2" value="69"/>
                    <measurement group_id="B3" value="118"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Caucasian</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="42"/>
                    <measurement group_id="B2" value="22"/>
                    <measurement group_id="B3" value="64"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Hispanic or Latino</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Other</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Region of Enrollment</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <title>United States</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="93"/>
                    <measurement group_id="B2" value="91"/>
                    <measurement group_id="B3" value="184"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Standard Ethanol Content Units (SECs) Baseline</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Standard Ethanol Content Units (SECs) at Baseline</title>
            <description>GMI - Standard Ethanol Content Units (SECs) at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Standard Ethanol Content Units (SECs) at Baseline</title>
            <description>LSEG - Standard Ethanol Content Units (SECs) at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Standard Ethanol Content Units (SECs) Baseline</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
          <units>Standard Ethanol Content Unit</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="179.9" lower_limit="57.4" upper_limit="240.6"/>
                    <measurement group_id="O2" value="190.1" lower_limit="68.5" upper_limit="244.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Standard Ethanol Content Units (SECs) at 1 Month</title>
        <description>The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Standard Ethanol Content Units (SECs) at 1 Month</title>
            <description>GMI - Standard Ethanol Content Units (SECs) at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Standard Ethanol Content Units (SECs) at 1 Month</title>
            <description>LSEG - Standard Ethanol Content Units (SECs) at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Standard Ethanol Content Units (SECs) at 1 Month</title>
          <description>The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="44.9" lower_limit="0.0" upper_limit="28.2"/>
                    <measurement group_id="O2" value="36.9" lower_limit="0.0" upper_limit="51.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Standard Ethanol Content Units (SECs) at 3 Months</title>
        <description>The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Standard Ethanol Content Units (SECs) at 3 Months</title>
            <description>GMI - Standard Ethanol Content Units (SECs) at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Standard Ethanol Content Units (SECs) at 3 Months</title>
            <description>LSEG - Standard Ethanol Content Units (SECs) at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Standard Ethanol Content Units (SECs) at 3 Months</title>
          <description>The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="50.1" lower_limit="0.0" upper_limit="54.4"/>
                    <measurement group_id="O2" value="37.7" lower_limit="0.0" upper_limit="44.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Standard Ethanol Content Units (SECs) at 6 Months</title>
        <description>The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Standard Ethanol Content Units (SECs) at 6 Months</title>
            <description>GMI -Standard Ethanol Content Units (SECs) at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Standard Ethanol Content Units (SECs) at 6 Months</title>
            <description>LSEG - Standard Ethanol Content Units (SECs) at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Standard Ethanol Content Units (SECs) at 6 Months</title>
          <description>The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="96.5" lower_limit="0.0" upper_limit="89.7"/>
                    <measurement group_id="O2" value="66.9" lower_limit="0.0" upper_limit="104.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Peak SEC at Baseline</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed in a single day within the stated time period.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Peak SEC at Baseline</title>
            <description>GMI - Peak SEC at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Peak SEC at Baseline</title>
            <description>LSEG - Peak SEC at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Peak SEC at Baseline</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed in a single day within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="21.0" lower_limit="12.0" upper_limit="25.6"/>
                    <measurement group_id="O2" value="19.1" lower_limit="10.6" upper_limit="25.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Peak SEC at 1 Month</title>
        <description>The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Peak SEC at 1 Month</title>
            <description>GMI - Peak SEC at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Peak SEC at 1 Month</title>
            <description>LSEG - Peak SEC at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Peak SEC at 1 Month</title>
          <description>The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.8" lower_limit="0.0" upper_limit="6.4"/>
                    <measurement group_id="O2" value="4.5" lower_limit="0.0" upper_limit="7.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Peak SEC at 3 Months</title>
        <description>The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Peak SEC at 3 Months</title>
            <description>GMI - Peak SEC at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Peak SEC at 3 Months</title>
            <description>LSEG - Peak SEC at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Peak SEC at 3 Months</title>
          <description>The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9.8" lower_limit="0.0" upper_limit="13.0"/>
                    <measurement group_id="O2" value="5.9" lower_limit="0.0" upper_limit="8.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Peak SEC at 6 Months</title>
        <description>The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Peak SEC at 6 Months</title>
            <description>GMI - Peak SEC at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Peak SEC at 6 Months</title>
            <description>LSEG - Peak SEC at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Peak SEC at 6 Months</title>
          <description>The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.</description>
          <units>Standard Ethanol Content Units</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="10.3" lower_limit="0.0" upper_limit="15.8"/>
                    <measurement group_id="O2" value="7.2" lower_limit="0.0" upper_limit="10.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Alcohol Drink Days at Baseline</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI -Alcohol Drink Days at Baseline</title>
            <description>GMI - Alcohol Drink Days at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Alcohol Drink Days at Baseline</title>
            <description>LSEG - Alcohol Drink Days at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Alcohol Drink Days at Baseline</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
          <units>days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="13.3" lower_limit="6.0" upper_limit="21.0"/>
                    <measurement group_id="O2" value="14.8" lower_limit="8.0" upper_limit="21.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Alcohol Drink Days at 1 Month</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days after day 1 of the treatment group. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Alcohol Drink Days at 1 Month</title>
            <description>GMI - Alcohol Drink Days at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Alcohol Drink Days at 1 Month</title>
            <description>LSEG - Alcohol Drink Days at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Alcohol Drink Days at 1 Month</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days after day 1 of the treatment group. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.6" lower_limit="0.0" upper_limit="4.0"/>
                    <measurement group_id="O2" value="5.5" lower_limit="0.0" upper_limit="5.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Alcohol Drink Days at 3 Months</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Alcohol Drink Days at 3 Months</title>
            <description>GMI - Alcohol Drink Days at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Alcohol Drink Days at 3 Months</title>
            <description>LSEG - Alcohol Drink Days at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Alcohol Drink Days at 3 Months</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.2" lower_limit="0.0" upper_limit="9.5"/>
                    <measurement group_id="O2" value="6.6" lower_limit="0.0" upper_limit="12.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Alcohol Drink Days at 6 Months</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Alcohol Drink Days at 6 Months</title>
            <description>GMI - Alcohol Drink Days at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Alcohol Drink Days at 6 Months</title>
            <description>LSEG - Alcohol Drink Days at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Alcohol Drink Days at 6 Months</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="8.3" lower_limit="0.0" upper_limit="13.7"/>
                    <measurement group_id="O2" value="8.3" lower_limit="0.0" upper_limit="16.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Binge Drink Days at Baseline</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females).</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Binge Drink Days at Baseline</title>
            <description>GMI - Binge Drink Days at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Binge Drink Days at Baseline</title>
            <description>LSEG - Binge Drink Days at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Binge Drink Days at Baseline</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females).</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="11.0" lower_limit="4.0" upper_limit="19.0"/>
                    <measurement group_id="O2" value="12.0" lower_limit="5.0" upper_limit="17.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Binge Drink Days at 1 Month</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Binge Drink Days at 1 Month</title>
            <description>GMI - Binge Drink Days at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Binge Drink Days at 1 Month</title>
            <description>LSEG - Binge Drink Days at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Binge Drink Days at 1 Month</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.0" lower_limit="0.0" upper_limit="1.0"/>
                    <measurement group_id="O2" value="3.0" lower_limit="0.0" upper_limit="3.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Binge Drink Days at 3 Months</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Standard Ethanol Content Units (SECs) at 3 Months</title>
            <description>GMI - Standard Ethanol Content Units (SECs) at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Standard Ethanol Content Units (SECs) at 3 Months</title>
            <description>LSEG - Standard Ethanol Content Units (SECs) at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Binge Drink Days at 3 Months</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.1" lower_limit="0.0" upper_limit="8.5"/>
                    <measurement group_id="O2" value="4.0" lower_limit="0.0" upper_limit="3.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Binge Drink Days at 6 Months</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Binge Drink Days at 6 Months</title>
            <description>GMI - Binge Drink Days at 6 Months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Binge Drink Days at 6 Months</title>
            <description>LSEG - Binge Drink Days at 6 Months</description>
          </group>
        </group_list>
        <measure>
          <title>Binge Drink Days at 6 Months</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.2" lower_limit="0.0" upper_limit="9.0"/>
                    <measurement group_id="O2" value="5.7" lower_limit="0.0" upper_limit="9.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Illicit Drug Use Days at Baseline</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of drug use in the 30 days prior to Baseline. This measure represents the number of illicit drug use days within the stated time period.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Illicit Drug Use Days at Baseline</title>
            <description>GMI - Illicit Drug Use Days at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Illicit Drug Use Days at Baseline</title>
            <description>LSEG - Illicit Drug Use Days at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Illicit Drug Use Days at Baseline</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of drug use in the 30 days prior to Baseline. This measure represents the number of illicit drug use days within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.2" lower_limit="0.0" upper_limit="9.0"/>
                    <measurement group_id="O2" value="7.7" lower_limit="0.0" upper_limit="14.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Illicit Drug Use Days at 1 Month</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Illicit Drug Use Days at 1 Month</title>
            <description>GMI - Illicit Drug Use Days at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Illicit Drug Use Days at 1 Month</title>
            <description>LSEG - Illicit Drug Use Days at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Illicit Drug Use Days at 1 Month</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.2" lower_limit="0.0" upper_limit="1.0"/>
                    <measurement group_id="O2" value="1.7" lower_limit="0.0" upper_limit="1.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Illicit Drug Use Days at 3 Months</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Illicit Drug Use Days at 3 Months</title>
            <description>GMI - Illicit Drug Use Days at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Illicit Drug Use Days at 3 Months</title>
            <description>LSEG - Illicit Drug Use Days at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Illicit Drug Use Days at 3 Months</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.0" lower_limit="0.0" upper_limit="1.0"/>
                    <measurement group_id="O2" value="2.5" lower_limit="0.0" upper_limit="0.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Illicit Drug Use Days at 6 Months</title>
        <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Illicit Drug Use Days at 6 Months</title>
            <description>GMI - Illicit Drug Use Days at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Illicit Drug Use Days at 6 Months</title>
            <description>LSEG - Illicit Drug Use Days at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Illicit Drug Use Days at 6 Months</title>
          <description>The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of illicit drug use days within the stated time period.</description>
          <units>Days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.4" lower_limit="0.0" upper_limit="2.0"/>
                    <measurement group_id="O2" value="3.3" lower_limit="0.0" upper_limit="1.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Substance Use Disorder Treatment Sessions at Baseline</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder Treatment Sessions at Baseline</title>
            <description>GMI - Substance Use Disorder Treatment Sessions at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder Treatment Sessions at Baseline</title>
            <description>LSEG - Substance Use Disorder Treatment Sessions at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder Treatment Sessions at Baseline</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.7" lower_limit="0.0" upper_limit="5.0"/>
                    <measurement group_id="O2" value="4.7" lower_limit="0.0" upper_limit="6.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Substance Use Disorder Treatment Sessions at 1 Month</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder Treatment Sessions at 1 Month</title>
            <description>GMI - Substance Use Disorder Treatment Sessions at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder Treatment Sessions at 1 Month</title>
            <description>LSEG - Substance Use Disorder Treatment Sessions at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder Treatment Sessions at 1 Month</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="20.9" lower_limit="0.0" upper_limit="40.0"/>
                    <measurement group_id="O2" value="22.2" lower_limit="0.0" upper_limit="40.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Substance Use Disorder Treatment Sessions at 3 Months</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder Treatment Sessions at 3 Months</title>
            <description>GMI - Substance Use Disorder Treatment Sessions at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder Treatment Sessions at 3 Months</title>
            <description>LSEG - Substance Use Disorder Treatment Sessions at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder Treatment Sessions at 3 Months</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="8.1" lower_limit="0.0" upper_limit="12.5"/>
                    <measurement group_id="O2" value="6.3" lower_limit="0.0" upper_limit="8.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Substance Use Disorder Treatment Sessions at 6 Months</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 6-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder Treatment Sessions at 6 Months</title>
            <description>GMI - Substance Use Disorder Treatment Sessions at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder Treatment Sessions at 6 Months</title>
            <description>LSEG - Substance Use Disorder Treatment Sessions at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder Treatment Sessions at 6 Months</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 6-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.2" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O2" value="1.8" lower_limit="0.0" upper_limit="2.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Twelve-Step Sessions Attended at Baseline</title>
        <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to Baseline.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Twelve-Step Sessions Attended at Baseline</title>
            <description>GMI - Twelve-Step Sessions Attended at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Twelve-Step Sessions Attended at Baseline</title>
            <description>LSEG - Twelve-Step Sessions Attended at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Twelve-Step Sessions Attended at Baseline</title>
          <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to Baseline.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.2" lower_limit="0.0" upper_limit="6.0"/>
                    <measurement group_id="O2" value="3.8" lower_limit="0.0" upper_limit="6.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Twelve-Step Sessions Attended at 1 Month</title>
        <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to 1-month follow-up.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Twelve-Step Sessions Attended at 1 Month</title>
            <description>GMI - Twelve-Step Sessions Attended at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Twelve-Step Sessions Attended at 1 Month</title>
            <description>LSEG - Twelve-Step Sessions Attended at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Twelve-Step Sessions Attended at 1 Month</title>
          <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to 1-month follow-up.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="10.7" lower_limit="0.0" upper_limit="19.0"/>
                    <measurement group_id="O2" value="10.8" lower_limit="0.0" upper_limit="18.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Twelve-Step Sessions Attended at 3 Months</title>
        <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 60 days prior to 3-month follow-up.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Twelve-Step Sessions Attended at 3 Months</title>
            <description>GMI - Twelve-Step Sessions Attended at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Twelve-Step Sessions Attended at 3 Months</title>
            <description>LSEG - Twelve-Step Sessions Attended at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Twelve-Step Sessions Attended at 3 Months</title>
          <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 60 days prior to 3-month follow-up.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9.8" lower_limit="0.0" upper_limit="17.0"/>
                    <measurement group_id="O2" value="7.5" lower_limit="0.0" upper_limit="13.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Twelve-Step Sessions Attended at 6 Months</title>
        <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended in the 90 days prior to 6-month follow-up.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Twelve-Step Sessions Attended at 6 Months</title>
            <description>GMI - Twelve-Step Sessions Attended at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Twelve-Step Sessions Attended at 6 Months</title>
            <description>LSEG - Twelve-Step Sessions Attended at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Twelve-Step Sessions Attended at 6 Months</title>
          <description>A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended in the 90 days prior to 6-month follow-up.</description>
          <units>Sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.7" lower_limit="0.0" upper_limit="9.7"/>
                    <measurement group_id="O2" value="3.8" lower_limit="0.0" upper_limit="6.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Times Involved in Community Participation Activities at Baseline</title>
        <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to Baseline.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Times Involved in Community Participation Activities at</title>
            <description>GMI - Times Involved in Community Participation Activities at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Times Involved in Community Participation Activities at</title>
            <description>LSEG - Times Involved in Community Participation Activities at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Times Involved in Community Participation Activities at Baseline</title>
          <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to Baseline.</description>
          <units># of times activity completed</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="10.4" lower_limit="1.0" upper_limit="15.0"/>
                    <measurement group_id="O2" value="14" lower_limit="2.0" upper_limit="19.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Times Involved in Community Participation Activities at 1 Month</title>
        <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to 1-month follow-up.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Times Involved in Community Participation Activities at</title>
            <description>GMI - Times Involved in Community Participation Activities at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Times Involved in Community Participation Activities at</title>
            <description>LSEG - Times Involved in Community Participation Activities at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Times Involved in Community Participation Activities at 1 Month</title>
          <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to 1-month follow-up.</description>
          <units># of time activity completed</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="18.4" lower_limit="6.0" upper_limit="30.0"/>
                    <measurement group_id="O2" value="25.2" lower_limit="7.0" upper_limit="40.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Times Involved in Community Participation Activities at 3 Months</title>
        <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 60 days prior to 3-month follow-up.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Times Involved in Community Participation Activities at</title>
            <description>GMI - Times Involved in Community Participation Activities at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Times Involved in Community Participation Activities at</title>
            <description>LSEG - Times Involved in Community Participation Activities at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Times Involved in Community Participation Activities at 3 Months</title>
          <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 60 days prior to 3-month follow-up.</description>
          <units># of times activity completed</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16.7" lower_limit="3.5" upper_limit="23.5"/>
                    <measurement group_id="O2" value="19.4" lower_limit="3.0" upper_limit="29.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Times Involved in Community Participation Activities at 6 Months</title>
        <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 90 days prior to 6-month follow-up.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Times Involved in Community Participation Activities at</title>
            <description>GMI - Times Involved in Community Participation Activities at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Times Involved in Community Participation Activities at</title>
            <description>LSEG - Times Involved in Community Participation Activities at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Times Involved in Community Participation Activities at 6 Months</title>
          <description>A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 90 days prior to 6-month follow-up.</description>
          <units># of times activity completed</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16.7" lower_limit="2.0" upper_limit="25.7"/>
                    <measurement group_id="O2" value="14.5" lower_limit="2.0" upper_limit="26.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Days Involved in Productive Work Activities at Baseline</title>
        <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to Baseline.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Days Involved in Productive Work Activities at Baseline</title>
            <description>GMI - Days Involved in Productive Work Activities at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Days Involved in Productive Work Activities at Baseline</title>
            <description>LSEG - Days Involved in Productive Work Activities at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Days Involved in Productive Work Activities at Baseline</title>
          <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to Baseline.</description>
          <units># of days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.2" lower_limit="0.0" upper_limit="1.0"/>
                    <measurement group_id="O2" value="3.0" lower_limit="0.0" upper_limit="2.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Days Involved in Productive Work Activities at 1 Month</title>
        <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to 1-month follow-up.</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Days Involved in Productive Work Activities at 1 Month</title>
            <description>GMI - Days Involved in Productive Work Activities at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Days Involved in Productive Work Activities at 1 Month</title>
            <description>LSEG - Days Involved in Productive Work Activities at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Days Involved in Productive Work Activities at 1 Month</title>
          <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to 1-month follow-up.</description>
          <units># of days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.6" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O2" value="3.5" lower_limit="0.0" upper_limit="3.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Days Involved in Productive Work Activities at 3 Months</title>
        <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 60 days prior to 3-month follow-up</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Days Involved in Productive Work Activities at 3 Months</title>
            <description>GMI - Days Involved in Productive Work Activities at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Days Involved in Productive Work Activities at 3 Months</title>
            <description>LSEG - Days Involved in Productive Work Activities at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Days Involved in Productive Work Activities at 3 Months</title>
          <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 60 days prior to 3-month follow-up</description>
          <units># of days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7.0" lower_limit="0.0" upper_limit="13.5"/>
                    <measurement group_id="O2" value="7.0" lower_limit="0.0" upper_limit="14.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Days Involved in Productive Work Activities at 6 Months</title>
        <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 90 days prior to 6-month follow-up.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Days Involved in Productive Work Activities at 6 Months</title>
            <description>GMI - Days Involved in Productive Work Activities at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Days Involved in Productive Work Activities at 6 Months</title>
            <description>LSEG - Days Involved in Productive Work Activities at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Days Involved in Productive Work Activities at 6 Months</title>
          <description>A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 90 days prior to 6-month follow-up.</description>
          <units># of days</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="8.0" lower_limit="0.0" upper_limit="16.7"/>
                    <measurement group_id="O2" value="9.8" lower_limit="0.0" upper_limit="22.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Mental Health Treatment Sessions at Baseline</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included individual sessions with outpatient mental health staff.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Mental Health Treatment Sessions at Baseline</title>
            <description>For those receiving GMI - Mental Health Treatment Sessions</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Mental Health Treatment Sessions at Baseline</title>
            <description>For those receiving LSEG - Mental Health Treatment Sessions</description>
          </group>
        </group_list>
        <measure>
          <title>Mental Health Treatment Sessions at Baseline</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included individual sessions with outpatient mental health staff.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.36" lower_limit="0" upper_limit="0"/>
                    <measurement group_id="O2" value="0.20" lower_limit="0" upper_limit="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Mental Health Treatment Sessions at 1 Month</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
        <time_frame>1 Month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Mental Health Treatment Sessions at 1 Month</title>
            <description>For those receiving GMI - Mental Health Treatment Sessions at 1 Month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Mental Health Treatment Sessions at 1 Month</title>
            <description>For those receiving LSEG - Mental Health Treatment Sessions at 1 Month</description>
          </group>
        </group_list>
        <measure>
          <title>Mental Health Treatment Sessions at 1 Month</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.79" lower_limit="0" upper_limit="1"/>
                    <measurement group_id="O2" value="0.39" lower_limit="0" upper_limit="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Mental Health Treatment Sessions at 3 Months</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
        <time_frame>3 Months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Mental Health Treatment Sessions at 3 Months</title>
            <description>For those receiving GMI - Mental Health Treatment Sessions at 3 Months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Mental Health Treatment Sessions at 3 Months</title>
            <description>For those receiving LSEG - Mental Health Treatment Sessions at 3 Months</description>
          </group>
        </group_list>
        <measure>
          <title>Mental Health Treatment Sessions at 3 Months</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.0" lower_limit="0" upper_limit="1"/>
                    <measurement group_id="O2" value="0.25" lower_limit="0" upper_limit="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Mental Health Treatment Sessions at 6 Months</title>
        <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 90 days prior to 6-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
        <time_frame>6 Months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Mental Health Treatment Sessions at 6 Months</title>
            <description>For those receiving GMI - Mental Health Treatment Sessions at 6 Months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Mental Health Treatment Sessions at 6 Months</title>
            <description>For those receiving LSEG - Mental Health Treatment Sessions at 6 Months</description>
          </group>
        </group_list>
        <measure>
          <title>Mental Health Treatment Sessions at 6 Months</title>
          <description>A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 90 days prior to 6-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.78" lower_limit="0" upper_limit="0.70"/>
                    <measurement group_id="O2" value="0.27" lower_limit="0" upper_limit="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Substance Use Disorder and Mental Health Treatment Sessions at Baseline</title>
        <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to Baseline.</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI -Substance Use Disorder and Mental Health Treatment Sessio</title>
            <description>For those receiving GMI - Substance Use Disorder and Mental Health Treatment Sessions at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder and Mental Health Treatment Sess</title>
            <description>For those receiving LSEG - Substance Use Disorder and Mental Health Treatment Sessions at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder and Mental Health Treatment Sessions at Baseline</title>
          <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to Baseline.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.0" lower_limit="0" upper_limit="5"/>
                    <measurement group_id="O2" value="4.9" lower_limit="0" upper_limit="6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Substance Use Disorder and Mental Health Treatment Sessions at 1 Month</title>
        <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to 1-month follow-up.</description>
        <time_frame>1 Month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder and Mental Health Treatment Sessi</title>
            <description>For those receiving GMI - Substance Use Disorder and Mental Health Treatment Sessions at 1 Month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder and Mental Health Treatment Sess</title>
            <description>For those receiving LSEG - Substance Use Disorder and Mental Health Treatment Sessions at 1 Month</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder and Mental Health Treatment Sessions at 1 Month</title>
          <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to 1-month follow-up.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="21.7" lower_limit="1" upper_limit="42"/>
                    <measurement group_id="O2" value="22.6" lower_limit="1" upper_limit="41"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Substance Use Disorder and Mental Health Treatment Sessions at 3 Months</title>
        <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 60 days prior to 3-month follow-up.</description>
        <time_frame>3 Months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder and Mental Health Treatment Sessi</title>
            <description>For those receiving GMI - Substance Use Disorder and Mental Health Treatment Sessions at 3 Months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder and Mental Health Treatment Sess</title>
            <description>For those receiving LSEG - Substance Use Disorder and Mental Health Treatment Sessions at 3 Months</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder and Mental Health Treatment Sessions at 3 Months</title>
          <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 60 days prior to 3-month follow-up.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9.1" lower_limit="0.5" upper_limit="13"/>
                    <measurement group_id="O2" value="6.5" lower_limit="0" upper_limit="9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Substance Use Disorder and Mental Health Treatment Sessions at 6 Months</title>
        <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 90 days prior to 6-month follow-up.</description>
        <time_frame>6 Months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Substance Use Disorder and Mental Health Treatment Sessi</title>
            <description>For those receiving GMI - Substance Use Disorder and Mental Health Treatment Sessions at 6 Months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Substance Use Disorder and Mental Health Treatment Sess</title>
            <description>For those receiving LSEG - Substance Use Disorder and Mental Health Treatment Sessions at 6 Months</description>
          </group>
        </group_list>
        <measure>
          <title>Substance Use Disorder and Mental Health Treatment Sessions at 6 Months</title>
          <description>This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 90 days prior to 6-month follow-up.</description>
          <units>sessions</units>
          <param>Mean</param>
          <dispersion>Inter-Quartile Range</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.0" lower_limit="0" upper_limit="3.67"/>
                    <measurement group_id="O2" value="2.0" lower_limit="0" upper_limit="2.67"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at Baseline for Alcohol Use</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <population>The ASI-Lite measures addiction severity</population>
        <group_list>
          <group group_id="O1">
            <title>GMI - Addiction Severity Index-Lite (ASI-Lite) at Baseline for</title>
            <description>GMI - Addiction Severity Index-Lite (ASI-Lite) at Baseline for Alcohol Use</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Addiction Severity Index-Lite (ASI-Lite) at Baseline fo</title>
            <description>LSEG - Addiction Severity Index-Lite (ASI-Lite) at Baseline for Alcohol Use</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at Baseline for Alcohol Use</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <population>The ASI-Lite measures addiction severity</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="90"/>
                <count group_id="O2" value="88"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.50" spread=".22"/>
                    <measurement group_id="O2" value="0.50" spread=".22"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Alcohol Use</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - ASI -- 1 Month Composite Score for Alcohol Use</title>
            <description>GMI - ASI -- 1 month Composite Score for Alcohol Use</description>
          </group>
          <group group_id="O2">
            <title>LSEG - ASI -- 1 Month Composite Score for Alcohol Use</title>
            <description>LSEG - ASI -- 1 month Composite Score for Alcohol Use</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Alcohol Use</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="84"/>
                <count group_id="O2" value="67"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.18" spread="0.23"/>
                    <measurement group_id="O2" value="0.19" spread="0.25"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at 3 Months for Alcohol Use</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - ASI -- 3 Months Composite Score for Alcohol Use</title>
            <description>GMI - ASI -- 3 months Composite Score for Alcohol Use</description>
          </group>
          <group group_id="O2">
            <title>LSEG - ASI -- 3 Months Composite Score for Alcohol Use</title>
            <description>LSEG - ASI -- 3 months Composite Score for Alcohol Use</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at 3 Months for Alcohol Use</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="81"/>
                <count group_id="O2" value="66"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.31" spread="0.35"/>
                    <measurement group_id="O2" value="0.27" spread="0.40"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Alcohol Use</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - ASI -- 6 Months Composite Score for Alcohol Use</title>
            <description>GMI - ASI -- 6 months Composite Score for Alcohol Use</description>
          </group>
          <group group_id="O2">
            <title>LSEG - ASI -- 6 Months Composite Score for Alcohol Use</title>
            <description>LSEG - ASI -- 6 months Composite Score for Alcohol Use</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Alcohol Use</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="76"/>
                <count group_id="O2" value="72"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.49" spread="0.57"/>
                    <measurement group_id="O2" value="0.41" spread="0.56"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at Baseline for Psychiatric Status</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Addiction Severity Index-Lite (ASI-Lite) at Baseline for</title>
            <description>GMI - Addiction Severity Index-Lite (ASI-Lite) at Baseline for Psychiatric Status</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Addiction Severity Index-Lite (ASI-Lite) at Baseline fo</title>
            <description>LSEG - Addiction Severity Index-Lite (ASI-Lite) at Baseline for Psychiatric Status</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at Baseline for Psychiatric Status</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="86"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.47" spread="0.21"/>
                    <measurement group_id="O2" value="0.40" spread="0.23"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Psychiatric Status</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>30 days</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Addiction Severity Index-Lite (ASI-Lite) at 1 Month for</title>
            <description>GMI - Addiction Severity Index-Lite (ASI-Lite) at 1 month for Psychiatric Status</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Addiction Severity Index-Lite (ASI-Lite) at 1 Month for</title>
            <description>LSEG - Addiction Severity Index-Lite (ASI-Lite) at 1 month for Psychiatric Status</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Psychiatric Status</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="71"/>
                <count group_id="O2" value="71"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.28" spread="0.26"/>
                    <measurement group_id="O2" value="0.26" spread="0.24"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at 3 Month for Psychiatric Status</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Addiction Severity Index-Lite (ASI-Lite) at 3 Months for</title>
            <description>GMI - Addiction Severity Index-Lite (ASI-Lite) at 3 months for Psychiatric Status</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Addiction Severity Index-Lite (ASI-Lite) at 3 Month for</title>
            <description>LSEG - Addiction Severity Index-Lite (ASI-Lite) at 3 months for Psychiatric Status</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at 3 Month for Psychiatric Status</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="79"/>
                <count group_id="O2" value="60"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.30" spread="0.28"/>
                    <measurement group_id="O2" value="0.26" spread="0.25"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Psychiatric Status</title>
        <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Addiction Severity Index-Lite (ASI-Lite) at 6 Months for</title>
            <description>GMI - Addiction Severity Index-Lite (ASI-Lite) at 6 months for Psychiatric Status</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Addiction Severity Index-Lite (ASI-Lite) at 6 Months fo</title>
            <description>LSEG - Addiction Severity Index-Lite (ASI-Lite) at 6 months for Psychiatric Status</description>
          </group>
        </group_list>
        <measure>
          <title>Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Psychiatric Status</title>
          <description>The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="70"/>
                <count group_id="O2" value="59"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.38" spread="0.28"/>
                    <measurement group_id="O2" value="0.30" spread="0.26"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Short Inventory of Problems (SIP) at Baseline</title>
        <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <population>Short Inventory of Problems - Total Score at Baseline</population>
        <group_list>
          <group group_id="O1">
            <title>GMI - Short Inventory of Problems at Baseline - Total Score</title>
            <description>GMI - Short Inventory of Problems Revised (SIP-R) at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Short Inventory of Problems Revised (SIP-R) at Baseline</title>
            <description>LSEG - Short Inventory of Problems Revised (SIP-R) at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Short Inventory of Problems (SIP) at Baseline</title>
          <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
          <population>Short Inventory of Problems - Total Score at Baseline</population>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="27.0" spread="12.6"/>
                    <measurement group_id="O2" value="26.1" spread="12.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Short Inventory of Problems at 1 Month</title>
        <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Short Inventory of Problems Revised (SIP-R) at 1 Month</title>
            <description>GMI - Short Inventory of Problems Revised (SIP-R) at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Short Inventory of Problems Revised (SIP-R) at 1 Month</title>
            <description>LSEG - Short Inventory of Problems Revised (SIP-R) at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Short Inventory of Problems at 1 Month</title>
          <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="82"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.5" spread="10.6"/>
                    <measurement group_id="O2" value="6.9" spread="10.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Short Inventory of Problems at 3 Months</title>
        <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Short Inventory of Problems Revised (SIP-R) at 3 Months</title>
            <description>GMI - Short Inventory of Problems Revised (SIP-R) at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Short Inventory of Problems Revised (SIP-R) at 3 Months</title>
            <description>LSEG - Short Inventory of Problems Revised (SIP-R) at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Short Inventory of Problems at 3 Months</title>
          <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9.8" spread="12.2"/>
                    <measurement group_id="O2" value="7.6" spread="10.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Short Inventory of Problems at 6 Months</title>
        <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Short Inventory of Problems Revised (SIP-R) at 6 Months</title>
            <description>GMI - Short Inventory of Problems Revised (SIP-R) at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Short Inventory of Problems Revised (SIP-R) at 6 Months</title>
            <description>LSEG - Short Inventory of Problems Revised (SIP-R) at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Short Inventory of Problems at 6 Months</title>
          <description>Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="11.1" spread="12.4"/>
                    <measurement group_id="O2" value="10.8" spread="12.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Social Support Survey Total Score at Baseline</title>
        <description>Min value:19 Max value:95 Higher score indicates higher support</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Social Support Survey Total Score at Baseline</title>
            <description>GMI - Social Support Survey Total Score at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Social Support Survey Total Score at Baseline</title>
            <description>LSEG - Social Support Survey Total Score at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Social Support Survey Total Score at Baseline</title>
          <description>Min value:19 Max value:95 Higher score indicates higher support</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="61.1" spread="18.6"/>
                    <measurement group_id="O2" value="60.3" spread="21.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Social Support Survey Total Score at 1 Month</title>
        <description>Min value:19 Max value:95 Higher score indicates higher support</description>
        <time_frame>30 days prior to 1-month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Social Support Survey Total Score at 1-month Follow-up</title>
            <description>GMI - Social Support Survey Total Score at 1-month follow-up</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Social Support Survey Total Score at 1-month Follow-up</title>
            <description>LSEG - Social Support Survey Total Score at 1-month follow-up</description>
          </group>
        </group_list>
        <measure>
          <title>Social Support Survey Total Score at 1 Month</title>
          <description>Min value:19 Max value:95 Higher score indicates higher support</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="81"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="63.3" spread="21"/>
                    <measurement group_id="O2" value="68.2" spread="20"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Social Support Survey Total Score at 3 Months</title>
        <description>Min value:19 Max value:95 Higher score indicates higher support</description>
        <time_frame>60 days prior to 3-month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Social Support Survey Total Score at 3 Months</title>
            <description>GMI - Social Support Survey Total Score at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Social Support Survey Total Score at 3 Months</title>
            <description>LSEG - Social Support Survey Total Score at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Social Support Survey Total Score at 3 Months</title>
          <description>Min value:19 Max value:95 Higher score indicates higher support</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="76"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="63.1" spread="21.4"/>
                    <measurement group_id="O2" value="66.8" spread="19"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Social Support Survey Total Score at 6 Months</title>
        <description>Min value:19 Max value:95 Higher score indicates higher support</description>
        <time_frame>90 days prior to 6-month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Social Support Survey Total Score at 6 Months</title>
            <description>GMI - Social Support Survey Total Score at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Social Support Survey Total Score at 6 Months</title>
            <description>LSEG - Social Support Survey Total Score at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Social Support Survey Total Score at 6 Months</title>
          <description>Min value:19 Max value:95 Higher score indicates higher support</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="74"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="61.2" spread="22"/>
                    <measurement group_id="O2" value="65.7" spread="19.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life Survey (QOLS) at Baseline</title>
        <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Quality of Life Survey (QOLS) at Baseline</title>
            <description>GMI - Quality of Life Survey (QOLS) at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Quality of Life Survey (QOLS) at Baseline</title>
            <description>LSEG - Quality of Life Survey (QOLS) at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life Survey (QOLS) at Baseline</title>
          <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="61.6" spread="18.4"/>
                    <measurement group_id="O2" value="68.8" spread="17.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life Survey (QOLS) at 1 Month</title>
        <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Quality of Life Survey (QOLS) at 1 Month</title>
            <description>GMI - Quality of Life Survey (QOLS) at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Quality of Life Survey (QOLS) at 1 Month</title>
            <description>LSEG - Quality of Life Survey (QOLS) at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life Survey (QOLS) at 1 Month</title>
          <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="81"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="71.2" spread="15.3"/>
                    <measurement group_id="O2" value="73.5" spread="15.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life Survey (QOLS) at 3 Months</title>
        <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Quality of Life Survey (QOLS) at 3 Months</title>
            <description>GMI - Quality of Life Survey (QOLS) at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Quality of Life Survey (QOLS) at 3 Months</title>
            <description>LSEG - Quality of Life Survey (QOLS) at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life Survey (QOLS) at 3 Months</title>
          <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="76"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="72.4" spread="16.5"/>
                    <measurement group_id="O2" value="75.1" spread="17.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life Survey (QOLS) at 6 Months</title>
        <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Quality of Life Survey (QOLS) at 6 Months</title>
            <description>GMI - Quality of Life Survey (QOLS) at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Quality of Life Survey (QOLS) at 6 Months</title>
            <description>LSEG - Quality of Life Survey (QOLS) at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life Survey (QOLS) at 6 Months</title>
          <description>Min value:16 Max value:112 Higher score indicates higher quality of life</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="71.3" spread="18.3"/>
                    <measurement group_id="O2" value="72.6" spread="18.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Brief Symptom Inventory (BSI-18) at Baseline</title>
        <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Brief Symptom Inventory (BSI) at Baseline</title>
            <description>GMI - Brief Symptom Inventory (BSI) at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Brief Symptom Inventory (BSI) at Baseline</title>
            <description>LSEG - Brief Symptom Inventory (BSI) at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Brief Symptom Inventory (BSI-18) at Baseline</title>
          <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="93"/>
                <count group_id="O2" value="91"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="21.4" spread="14.0"/>
                    <measurement group_id="O2" value="19.3" spread="14.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Brief Symptom Inventory(BSI-18) at 1 Month</title>
        <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Brief Symptom Inventory (BSI) at 1 Month</title>
            <description>GMI - Brief Symptom Inventory (BSI) at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Brief Symptom Inventory (BSI) at 1 Month</title>
            <description>LSEG - Brief Symptom Inventory (BSI) at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>Brief Symptom Inventory(BSI-18) at 1 Month</title>
          <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="81"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="15.9" spread="12.4"/>
                    <measurement group_id="O2" value="14.2" spread="12.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Brief Symptom Inventory (BSI-18) at 3 Months</title>
        <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Brief Symptom Inventory (BSI) at 3 Months</title>
            <description>GMI - Brief Symptom Inventory (BSI) at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Brief Symptom Inventory (BSI) at 3 Months</title>
            <description>LSEG - Brief Symptom Inventory (BSI) at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>Brief Symptom Inventory (BSI-18) at 3 Months</title>
          <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="87"/>
                <count group_id="O2" value="76"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16.1" spread="13.8"/>
                    <measurement group_id="O2" value="13.1" spread="11.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Brief Symptom Inventory (BSI-18) at 6 Months</title>
        <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Brief Symptom Inventory (BSI) at 6 Months</title>
            <description>GMI - Brief Symptom Inventory (BSI) at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Brief Symptom Inventory (BSI) at 6 Months</title>
            <description>LSEG - Brief Symptom Inventory (BSI) at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>Brief Symptom Inventory (BSI-18) at 6 Months</title>
          <description>Min value:0 Max value:72 Higher score indicates higher psychological distress</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="83"/>
                <count group_id="O2" value="75"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="17.2" spread="14.6"/>
                    <measurement group_id="O2" value="15.9" spread="13.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Physical Summary Score at Baseline</title>
        <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Health Survey Physical Summary Score at Baseline</title>
            <description>GMI - Health Survey Physical Summary Score at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Health Survey Physical Summary Score at Baseline</title>
            <description>LSEG - Health Survey Physical Summary Score at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Physical Summary Score at Baseline</title>
          <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="88"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="41.6" spread="11.8"/>
                    <measurement group_id="O2" value="41.6" spread="11.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Physical Summary Score at 1 Month</title>
        <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Physical Summary Score at 1 Month</title>
            <description>GMI - SF-12 Health Survey Physical Summary Score at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Physical Summary Score at 1 Month</title>
            <description>LSEG - SF-12 Health Survey Physical Summary Score at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Physical Summary Score at 1 Month</title>
          <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="86"/>
                <count group_id="O2" value="78"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="40.2" spread="11.4"/>
                    <measurement group_id="O2" value="43.6" spread="11.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Physical Summary Score at 3 Months</title>
        <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Physical Summary Score at 3 Months</title>
            <description>GMI - SF-12 Health Survey Physical Summary Score at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Physical Summary Score at 3 Months</title>
            <description>LSEG - SF-12 Health Survey Physical Summary Score at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Physical Summary Score at 3 Months</title>
          <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="71"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="41.0" spread="10.5"/>
                    <measurement group_id="O2" value="42.2" spread="11.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Physical Summary Score at 6 Months</title>
        <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Physical Summary Score at 6 Months</title>
            <description>GMI - SF-12 Health Survey Physical Summary Score at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Physical Summary Score at 6 Months</title>
            <description>LSEG - SF-12 Health Survey Physical Summary Score at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Physical Summary Score at 6 Months</title>
          <description>Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="80"/>
                <count group_id="O2" value="74"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="40.4" spread="11.1"/>
                    <measurement group_id="O2" value="40.8" spread="11.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Mental Summary Score at Baseline</title>
        <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Mental Summary Score at Baseline</title>
            <description>GMI - SF-12 Health Survey Mental Summary Score at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Mental Summary Score at Baseline</title>
            <description>LSEG - SF-12 Health Survey Mental Summary Score at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Mental Summary Score at Baseline</title>
          <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="89"/>
                <count group_id="O2" value="88"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="35.9" spread="11.4"/>
                    <measurement group_id="O2" value="39.0" spread="11.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Mental Summary Score at 1 Month</title>
        <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Mental Summary Score at 1 Month</title>
            <description>GMI - SF-12 Health Survey Mental Summary Score at 1 month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Mental Summary Score at 1 Month</title>
            <description>LSEG - SF-12 Health Survey Mental Summary Score at 1 month</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Mental Summary Score at 1 Month</title>
          <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="86"/>
                <count group_id="O2" value="78"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="43.9" spread="11.3"/>
                    <measurement group_id="O2" value="44.5" spread="10.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Mental Summary Score at 3 Months</title>
        <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Mental Summary Score at 3 Months</title>
            <description>GMI - SF-12 Health Survey Mental Summary Score at 3 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Mental Summary Score at 3 Months</title>
            <description>LSEG - SF-12 Health Survey Mental Summary Score at 3 months</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Mental Summary Score at 3 Months</title>
          <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="85"/>
                <count group_id="O2" value="71"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="43.0" spread="11.5"/>
                    <measurement group_id="O2" value="44.7" spread="10.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>SF-12 Health Survey Mental Summary Score at 6 Months</title>
        <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - SF-12 Health Survey Mental Summary Score at 6 Months</title>
            <description>GMI - SF-12 Health Survey Mental Summary Score at 6 months</description>
          </group>
          <group group_id="O2">
            <title>LSEG - SF-12 Health Survey Mental Summary Score at 6 Months</title>
            <description>LSEG - SF-12 Health Survey Mental Summary Score at 6 months</description>
          </group>
        </group_list>
        <measure>
          <title>SF-12 Health Survey Mental Summary Score at 6 Months</title>
          <description>Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="80"/>
                <count group_id="O2" value="74"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="42.7" spread="11.8"/>
                    <measurement group_id="O2" value="44.6" spread="11.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Treatment Motivation Questionnaire (TMQ) at Baseline</title>
        <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Treatment Motivation Questionnaire (TMQ) at Baseline</title>
            <description>For those receiving GMI - The TMQ was used to assess self-reported interest in treatment at Baseline based on external reasons, internal reasons, help seeking and confidence.</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Treatment Motivation Questionnaire (TMQ) at Baseline</title>
            <description>For those receiving GMI - The TMQ was used to assess self-reported interest in treatment at Baseline based on external reasons, internal reasons, help seeking and confidence.</description>
          </group>
        </group_list>
        <measure>
          <title>Treatment Motivation Questionnaire (TMQ) at Baseline</title>
          <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="75"/>
                <count group_id="O2" value="70"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>External Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.4" spread="1.2"/>
                    <measurement group_id="O2" value="2.6" spread="1.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Internal Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.1" spread="1.0"/>
                    <measurement group_id="O2" value="6.0" spread="0.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Treatment Motivation Questionnaire (TMQ) at 1-month</title>
        <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
        <time_frame>30 days prior to 1-month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Treatment Motivation Questionnaire (TMQ) at 1-month</title>
            <description>Treatment Motivation Questionnaire (TMQ) at 1-month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Treatment Motivation Questionnaire (TMQ) at 1-month</title>
            <description>LSEG - Treatment Motivation Questionnaire (TMQ) at 1-month</description>
          </group>
        </group_list>
        <measure>
          <title>Treatment Motivation Questionnaire (TMQ) at 1-month</title>
          <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="76"/>
                <count group_id="O2" value="68"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>External Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.2" spread="1.2"/>
                    <measurement group_id="O2" value="2.6" spread="1.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Internal Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.8" spread="1.1"/>
                    <measurement group_id="O2" value="5.8" spread="1.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Treatment Motivation Questionnaire (TMQ) at 3-month</title>
        <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
        <time_frame>60 days prior to 3-month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Treatment Motivation Questionnaire (TMQ) at 3-month</title>
            <description>GMI - Treatment Motivation Questionnaire (TMQ) at 3-month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Treatment Motivation Questionnaire (TMQ) at 3-month</title>
            <description>LSEG - Treatment Motivation Questionnaire (TMQ) at 3-month</description>
          </group>
        </group_list>
        <measure>
          <title>Treatment Motivation Questionnaire (TMQ) at 3-month</title>
          <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="74"/>
                <count group_id="O2" value="60"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>External Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2" spread="1.2"/>
                    <measurement group_id="O2" value="2.5" spread="1.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Internal Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.4" spread="1.3"/>
                    <measurement group_id="O2" value="5.6" spread="1.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Treatment Motivation Questionnaire (TMQ) at 6-months</title>
        <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
        <time_frame>90 days prior to 6-month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Treatment Motivation Questionnaire (TMQ) at 6-month</title>
            <description>GMI - Treatment Motivation Questionnaire (TMQ) at 6-month</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Treatment Motivation Questionnaire (TMQ) at 6-month</title>
            <description>LSEG - Treatment Motivation Questionnaire (TMQ) at 6-month</description>
          </group>
        </group_list>
        <measure>
          <title>Treatment Motivation Questionnaire (TMQ) at 6-months</title>
          <description>The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged&#xD;
External:&#xD;
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)&#xD;
Internal:&#xD;
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="68"/>
                <count group_id="O2" value="52"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>External Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.2" spread="1.2"/>
                    <measurement group_id="O2" value="2.5" spread="1.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Internal Reasons</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.5" spread="1.2"/>
                    <measurement group_id="O2" value="5.3" spread="1.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Fagerstrom Test for Nicotine Dependence at Baseline</title>
        <description>Min:0 Max:10 Higher score indicates higher level of nicotine dependence</description>
        <time_frame>30 days prior to Baseline</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Fagerstrom Test for Nicotine Dependence at Baseline</title>
            <description>GMI - Fagerstrom Test for Nicotine Dependence at Baseline</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Fagerstrom Test for Nicotine Dependence at Baseline</title>
            <description>LSEG - Fagerstrom Test for Nicotine Dependence at Baseline</description>
          </group>
        </group_list>
        <measure>
          <title>Fagerstrom Test for Nicotine Dependence at Baseline</title>
          <description>Min:0 Max:10 Higher score indicates higher level of nicotine dependence</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="74"/>
                <count group_id="O2" value="78"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.5" spread="2.4"/>
                    <measurement group_id="O2" value="4.0" spread="2.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Psychiatric Outpatient Satisfaction Scale - Total Score</title>
        <description>Min:13 Max:65 Higher score indicates better satisfaction</description>
        <time_frame>1 month</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - GMI - Psychiatric Outpatient Satisfaction Scale - Total</title>
            <description>GMI - Psychiatric Outpatient Satisfaction Scale - Total Score</description>
          </group>
          <group group_id="O2">
            <title>LSEG - GMI - Psychiatric Outpatient Satisfaction Scale - Total</title>
            <description>LSEG - GMI - Psychiatric Outpatient Satisfaction Scale - Total Score</description>
          </group>
        </group_list>
        <measure>
          <title>Psychiatric Outpatient Satisfaction Scale - Total Score</title>
          <description>Min:13 Max:65 Higher score indicates better satisfaction</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="88"/>
                <count group_id="O2" value="80"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="61.1" spread="9.4"/>
                    <measurement group_id="O2" value="60.1" spread="9.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Helping Alliance Questionnaire - Total Score</title>
        <description>Participant completed assessment on the final day of group and rated therapist based on their interactions over the 4 days.&#xD;
Min:19 Max:114 Higher score indicates stronger alliance with therapist</description>
        <time_frame>Completed during session 4 of treatment group (i.e. the final treatment session)</time_frame>
        <group_list>
          <group group_id="O1">
            <title>GMI - Helping Alliance Questionnaire - Total Score</title>
            <description>GMI - Helping Alliance Questionnaire - Total Score</description>
          </group>
          <group group_id="O2">
            <title>LSEG - Helping Alliance Questionnaire - Total Score</title>
            <description>LSEG - Psychiatric Outpatient Satisfaction Scale - Total Score</description>
          </group>
        </group_list>
        <measure>
          <title>Helping Alliance Questionnaire - Total Score</title>
          <description>Participant completed assessment on the final day of group and rated therapist based on their interactions over the 4 days.&#xD;
Min:19 Max:114 Higher score indicates stronger alliance with therapist</description>
          <units>score on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="78"/>
                <count group_id="O2" value="77"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="100.1" spread="10.9"/>
                    <measurement group_id="O2" value="101.6" spread="9.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>For each participant, adverse event data was collected through study completion, an average of 6 months.</time_frame>
      <group_list>
        <group group_id="E1">
          <title>Group Motivational Interviewing (GMI)</title>
          <description>Group Motivational Interviewing (GMI) participants will receive four structured, back-to-back, 90-min sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.</description>
        </group>
        <group group_id="E2">
          <title>Control Treatment Condition (CT)</title>
          <description>Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to GMI (i.e., 90 minutes) and will involve the following topics: A popular 'box activity', participants will anonymously submit questions on involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion money management with feedback (2 sessions), cooking-home maintenance, and psycho-education about substance use.</description>
        </group>
      </group_list>
      <serious_events>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="3" subjects_at_risk="93"/>
                <counts group_id="E2" subjects_affected="5" subjects_at_risk="91"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="93"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="91"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>0</frequency_threshold>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="93"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="91"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>Principal Investigators are NOT employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. </restrictive_agreement>
    </certain_agreements>
    <point_of_contact>
      <name_or_title>Dr. Elizabeth Santa Ana</name_or_title>
      <organization>Ralph H. Johnson VA Medical Cneter</organization>
      <phone>843-789-7168</phone>
      <email>Elizabeth.Santaana2@va.gov</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02233738
org study id: IIR 13-317
nct id: NCT02233738
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
is us export: No
Homeless Veterans with substance use disorders (SUDs) are a major group served by VA and are
      heavily represented in VA housing. VA recently adopted a 'Housing First' approach emphasizing
      rapid housing placement to initiate recovery without requiring sobriety and will necessitate
      SUD interventions that are efficient and easily layered onto existing services. The proposed
      study will investigate the effectiveness, implementation process, and cost estimate of Group
      Motivational Interviewing (GMI) for Veterans with SUDs in VA housing (Housing Urban
      Development-VA Support Housing [HUD-VASH] and Grant and per Diem [GPD]). Outcomes will be
      assessed at multiple time points using a multi-modal approach. The ultimate goal of this
      research is to establish the basis of a GMI dissemination and implementation course of action
      for highly vulnerable homeless Veterans in VA housing for achieving their greatest success in
      attaining housing stability.
Anticipated Impacts on Veterans Health Care:

      VA set an ambitious goal for ending homelessness among Veterans by 2015. Housing Urban
      Development-VA Support Housing [HUD-VASH] and Grant and per Diem [GPD] are two primary VA
      housing programs to help Veterans exit homelessness. Substance abuse among Veterans in VA
      housing is a major risk factor for worsening psychopathology and housing instability. Despite
      recent adoption of a Housing First approach, many VA housing programs lack the staff
      infrastructure to manage substance use disorders (SUDs). This is a significant problem as 60%
      (conservative estimate) of Veterans in VA housing have SUDs and these Veterans show greater
      psychopathology compared to their counterparts without SUDs. These issues warrant substantial
      need for SUD programs in VA housing that are efficient to deploy, easily layered onto
      existing services, and require minimal staff to operate. The current study addresses this
      current void in VA treatment services in that it investigates the effectiveness,
      implementation process, and cost estimate of treatment of an adaptation of motivational
      interviewing, an empirically supported intervention with strong impact on reducing substance
      use and enhancing treatment engagement, in a group format, referred to as Group Motivational
      Interviewing (GMI) for Veterans with SUDs in VA housing. Data from this project, if shown to
      be promising, will establish the basis of a GMI dissemination and implementation course of
      action for highly vulnerable homeless Veterans in VA housing for achieving their greatest
      success in attaining housing stability.

      Background:

      There is a significant need for 'wraparound' treatment services in VA housing for addressing
      SUDs. Homeless Veterans with SUDs are vulnerable to treatment dropout, rendering them
      susceptible to relapse, while their continuation in outpatient care during their
      participation in VA housing leads to improved clinical outcomes. According to systematic
      reviews, individual motivational interviewing reduces the incidence of substance use
      disorders, when compared to no treatment, but is labor intensive. As VA moves toward a
      'Housing First' paradigm where greater numbers of homeless Veterans will continue to use
      substances while in VA housing, delivery of GMI (which may be less labor intensive) to these
      patients will be important for initiating and maintaining their recovery as well as enhancing
      their psychosocial integration and quality of life. In a prior controlled trial conducted by
      the Principal Investigator, GMI resulted in significantly higher outpatient treatment
      engagement and lower substance use compared to treatment-as-usual among dually diagnosed
      Veterans.

      Objectives:

      Study objectives are consistent with VA housing recommendations focusing on patient recovery,
      health services promotion, and treatment implementation evaluation. GMI will be compared to a
      control treatment condition (CT) on (Specific Aim I; Five outcomes: (Primary Hypothesis 1):
      treatment engagement; (Primary Hypothesis 1): substance use; (Secondary H2): psychosocial
      integration (e.g., social support, community participation); (Secondary H3) quality of
      life/psychiatric indices; and (Secondary H4): number of days engaging in
      structured/productive work activities in the 6-month follow up. Specific Aim II involves a
      process evaluation for documenting (A) formative (e.g., developmental), (B) process, and (C)
      summative outcomes; and Specific Aim III involves estimation of cost of intervention in terms
      of direct costs, indirect costs of staff, costs of capital and workload measures for future
      implementation and dissemination research.

      Methods:

      Randomized controlled trial comparing GMI to control treatment (CT) across five critical
      outcomes. 186 Veterans in VA housing services (93 per treatment arm) will be enrolled with a
      diagnosis of alcohol or drug abuse/dependence. Recruitment will take place in Charleston VA
      Medical Center HUD-VASH & GPD. Participants will be randomly assigned to (1) GMI or (2) CT,
      each consisting of 4 sessions, and will be evaluated at 1, 3, and 6 months. Participants with
      a non-substance related DSM-V disorder (e.g., major depressive disorder, PTSD) will be
      eligible for the study. Analyses will be conducted using generalized linear mixed models
      (GLMM) approach.

      Significance to Veterans:

      Homeless Veterans with SUDs represent one of the largest and most chronic groups of
      psychiatric patients treated in the VA Healthcare System. With the ongoing execution of VA's
      "Plan to End Veteran Homelessness," Veterans entering housing require interventions that can
      be feasibly implemented with minimal reorganization of existing services. GMI is based on
      motivational interviewing, an empirically valid treatment that aligns with Veteran-centered
      recovery models including Harm Reduction and more traditional treatment philosophies. The
      investment in GMI for VA housing may be minimal as it requires only a few staff to operate in
      relatively short time (e.g., 4 sessions, 90-min each) with modest (20 hours) staff training.
      It can be layered onto existing services with little interruption or reorganization of staff,
      and it has potential to be offered to larger numbers of Veterans with SUDs in VA housing who
      would otherwise not receive this intervention.
allocation: Randomized
intervention model: Factorial Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
measure: Standard Ethanol Content Units (SECs) Baseline
time frame: 30 days prior to Baseline
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.
measure: Standard Ethanol Content Units (SECs) at 1 Month
time frame: 1 month
description: The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.
measure: Standard Ethanol Content Units (SECs) at 3 Months
time frame: 3 months
description: The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.
measure: Standard Ethanol Content Units (SECs) at 6 Months
time frame: 6 months
description: The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents ALL standard drinks consumed within the stated time period.
measure: Peak SEC at Baseline
time frame: 30 days prior to Baseline
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to baseline. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed in a single day within the stated time period.
measure: Peak SEC at 1 Month
time frame: 1 month
description: The 1-month follow-up was conducted 30 days after day 1 of the treatment group. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.
measure: Peak SEC at 3 Months
time frame: 3 months
description: The 3-month follow-up was conducted 60 days after the 1-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.
measure: Peak SEC at 6 Months
time frame: 6 months
description: The 6-month follow-up was conducted 90 days after the 3-month follow-up. The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. Amount of alcohol consumption was converted to standard ethanol content units (SECs; or standard drinks) equivalent to 0.5 oz. of ethanol. This measure represents the most standard drinks consumed on a single day within the stated time period.
measure: Alcohol Drink Days at Baseline
time frame: 30 days prior to Baseline
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days any alcohol was consumed within the stated time period.
measure: Alcohol Drink Days at 1 Month
time frame: 1 month
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days after day 1 of the treatment group. This measure represents the number of days any alcohol was consumed within the stated time period.
measure: Alcohol Drink Days at 3 Months
time frame: 3 months
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.
measure: Alcohol Drink Days at 6 Months
time frame: 6 months
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days any alcohol was consumed within the stated time period.
measure: Binge Drink Days at Baseline
time frame: 30 days prior to Baseline
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to Baseline. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females).
measure: Binge Drink Days at 1 Month
time frame: 1 month
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.
measure: Binge Drink Days at 3 Months
time frame: 3 months
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.
measure: Binge Drink Days at 6 Months
time frame: 6 months
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of days the participant binge drank (5 or more standard drinks on a single day for males; 4 or more standard drinks on a single day for females) within the stated time period.
measure: Illicit Drug Use Days at Baseline
time frame: 30 days prior to Baseline
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of drug use in the 30 days prior to Baseline. This measure represents the number of illicit drug use days within the stated time period.
measure: Illicit Drug Use Days at 1 Month
time frame: 1 month
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 30 days prior to 1-month follow-up. This measure represents the number of illicit drug use days within the stated time period.
measure: Illicit Drug Use Days at 3 Months
time frame: 3 months
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 60 days prior to 3-month follow-up. This measure represents the number of illicit drug use days within the stated time period.
measure: Illicit Drug Use Days at 6 Months
time frame: 6 months
description: The Timeline Follow-Back (TLFB) calendar was used to assess retrospective self-report of alcohol in the 90 days prior to 6-month follow-up. This measure represents the number of illicit drug use days within the stated time period.
measure: Substance Use Disorder Treatment Sessions at Baseline
time frame: 30 days prior to Baseline
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.
measure: Substance Use Disorder Treatment Sessions at 1 Month
time frame: 1 month
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.
measure: Substance Use Disorder Treatment Sessions at 3 Months
time frame: 3 months
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.
measure: Substance Use Disorder Treatment Sessions at 6 Months
time frame: 6 months
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 6-month follow-up. Treatment sessions included the outpatient substance use disorder treatment group sessions and individual sessions.
measure: Twelve-Step Sessions Attended at Baseline
time frame: 30 days prior to Baseline
description: A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to Baseline.
measure: Twelve-Step Sessions Attended at 1 Month
time frame: 1 month
description: A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 30 days prior to 1-month follow-up.
measure: Twelve-Step Sessions Attended at 3 Months
time frame: 3 months
description: A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended 60 days prior to 3-month follow-up.
measure: Twelve-Step Sessions Attended at 6 Months
time frame: 6 months
description: A Treatment Attendance Calendar was used to record the number of self-reported 12-step sessions attended in the 90 days prior to 6-month follow-up.
measure: Times Involved in Community Participation Activities at Baseline
time frame: 30 days prior to Baseline
description: A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to Baseline.
measure: Times Involved in Community Participation Activities at 1 Month
time frame: 1 month
description: A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 30 days prior to 1-month follow-up.
measure: Times Involved in Community Participation Activities at 3 Months
time frame: 3 months
description: A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 60 days prior to 3-month follow-up.
measure: Times Involved in Community Participation Activities at 6 Months
time frame: 6 months
description: A calendar was used to record the number of times a participant participated in an activity in the community (e.g. museum, library, baseball game) in the 90 days prior to 6-month follow-up.
measure: Days Involved in Productive Work Activities at Baseline
time frame: 30 days prior to Baseline
description: A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to Baseline.
measure: Days Involved in Productive Work Activities at 1 Month
time frame: 1 month
description: A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 30 days prior to 1-month follow-up.
measure: Days Involved in Productive Work Activities at 3 Months
time frame: 3 months
description: A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 60 days prior to 3-month follow-up
measure: Days Involved in Productive Work Activities at 6 Months
time frame: 6 months
description: A calendar was used to record the number of times a participant participated in a productive work activity (e.g. volunteered or worked at a job) in the 90 days prior to 6-month follow-up.
measure: Mental Health Treatment Sessions at Baseline
time frame: 30 days prior to Baseline
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to Baseline. Treatment sessions included individual sessions with outpatient mental health staff.
measure: Mental Health Treatment Sessions at 1 Month
time frame: 1 Month
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 30 days prior to 1-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.
measure: Mental Health Treatment Sessions at 3 Months
time frame: 3 Months
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 60 days prior to 3-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.
measure: Mental Health Treatment Sessions at 6 Months
time frame: 6 Months
description: A Treatment Attendance Calendar was used to record the number of objective treatment sessions documented in each participants VA Computerized Patient Record System for the 90 days prior to 6-month follow-up. Treatment sessions included individual sessions with outpatient mental health staff.
measure: Substance Use Disorder and Mental Health Treatment Sessions at Baseline
time frame: 30 days prior to Baseline
description: This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to Baseline.
measure: Substance Use Disorder and Mental Health Treatment Sessions at 1 Month
time frame: 1 Month
description: This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 30 days prior to 1-month follow-up.
measure: Substance Use Disorder and Mental Health Treatment Sessions at 3 Months
time frame: 3 Months
description: This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 60 days prior to 3-month follow-up.
measure: Substance Use Disorder and Mental Health Treatment Sessions at 6 Months
time frame: 6 Months
description: This specific measure combined the number substance use disorder treatment sessions and mental health treatment sessions attended for the 90 days prior to 6-month follow-up.
measure: Addiction Severity Index-Lite (ASI-Lite) at Baseline for Alcohol Use
time frame: 30 days prior to Baseline
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Alcohol Use
time frame: 1 month
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at 3 Months for Alcohol Use
time frame: 3 months
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Alcohol Use
time frame: 6 months
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at Baseline for Psychiatric Status
time frame: 30 days prior to Baseline
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at 1 Month for Psychiatric Status
time frame: 30 days
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at 3 Month for Psychiatric Status
time frame: 3 months
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Addiction Severity Index-Lite (ASI-Lite) at 6 Months for Psychiatric Status
time frame: 6 months
description: The ASI-Lite will be used to measure addiction severity Min value:0 Max value: 1 Higher score indicates greater problem severity
measure: Short Inventory of Problems (SIP) at Baseline
time frame: 30 days prior to Baseline
description: Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use
measure: Short Inventory of Problems at 1 Month
time frame: 1 month
description: Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use
measure: Short Inventory of Problems at 3 Months
time frame: 3 months
description: Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use
measure: Short Inventory of Problems at 6 Months
time frame: 6 months
description: Min value:0 Max value: 45 Higher score indicates higher number of consequences from alcohol and drug use
measure: Social Support Survey Total Score at Baseline
time frame: 30 days prior to Baseline
description: Min value:19 Max value:95 Higher score indicates higher support
measure: Social Support Survey Total Score at 1 Month
time frame: 30 days prior to 1-month follow-up
description: Min value:19 Max value:95 Higher score indicates higher support
measure: Social Support Survey Total Score at 3 Months
time frame: 60 days prior to 3-month follow-up
description: Min value:19 Max value:95 Higher score indicates higher support
measure: Social Support Survey Total Score at 6 Months
time frame: 90 days prior to 6-month follow-up
description: Min value:19 Max value:95 Higher score indicates higher support
measure: Quality of Life Survey (QOLS) at Baseline
time frame: 30 days prior to Baseline
description: Min value:16 Max value:112 Higher score indicates higher quality of life
measure: Quality of Life Survey (QOLS) at 1 Month
time frame: 1 month
description: Min value:16 Max value:112 Higher score indicates higher quality of life
measure: Quality of Life Survey (QOLS) at 3 Months
time frame: 3 months
description: Min value:16 Max value:112 Higher score indicates higher quality of life
measure: Quality of Life Survey (QOLS) at 6 Months
time frame: 6 months
description: Min value:16 Max value:112 Higher score indicates higher quality of life
measure: Brief Symptom Inventory (BSI-18) at Baseline
time frame: 30 days prior to Baseline
description: Min value:0 Max value:72 Higher score indicates higher psychological distress
measure: Brief Symptom Inventory(BSI-18) at 1 Month
time frame: 1 month
description: Min value:0 Max value:72 Higher score indicates higher psychological distress
measure: Brief Symptom Inventory (BSI-18) at 3 Months
time frame: 3 months
description: Min value:0 Max value:72 Higher score indicates higher psychological distress
measure: Brief Symptom Inventory (BSI-18) at 6 Months
time frame: 6 months
description: Min value:0 Max value:72 Higher score indicates higher psychological distress
measure: SF-12 Health Survey Physical Summary Score at Baseline
time frame: 30 days prior to Baseline
description: Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Physical Summary Score at 1 Month
time frame: 1 month
description: Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Physical Summary Score at 3 Months
time frame: 3 months
description: Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Physical Summary Score at 6 Months
time frame: 6 months
description: Physical summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Mental Summary Score at Baseline
time frame: 30 days prior to Baseline
description: Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Mental Summary Score at 1 Month
time frame: 1 month
description: Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Mental Summary Score at 3 Months
time frame: 3 months
description: Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: SF-12 Health Survey Mental Summary Score at 6 Months
time frame: 6 months
description: Mental summary items are summed and weighed Min value:0 Max value:100 Higher score indicates higher level of health
measure: Treatment Motivation Questionnaire (TMQ) at Baseline
time frame: 30 days prior to Baseline
description: The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged
External:
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)
Internal:
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)
measure: Treatment Motivation Questionnaire (TMQ) at 1-month
time frame: 30 days prior to 1-month follow-up
description: The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged
External:
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)
Internal:
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)
measure: Treatment Motivation Questionnaire (TMQ) at 3-month
time frame: 60 days prior to 3-month follow-up
description: The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged
External:
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)
Internal:
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)
measure: Treatment Motivation Questionnaire (TMQ) at 6-months
time frame: 90 days prior to 6-month follow-up
description: The TMQ will be used to measure self-reported interest in attending treatment Scores within each subscale are averaged
External:
Min value:1 Max value:7 External:Higher score indicates higher external reasons for attending treatment (e.g.referred to treatment by legal system)
Internal:
Min value:1 Max value:7 Internal: Higher score indicates higher internal reasons for attending treatment (e.g. personal choice to attend treatment)
measure: Fagerstrom Test for Nicotine Dependence at Baseline
time frame: 30 days prior to Baseline
description: Min:0 Max:10 Higher score indicates higher level of nicotine dependence
measure: Psychiatric Outpatient Satisfaction Scale - Total Score
time frame: 1 month
description: Min:13 Max:65 Higher score indicates better satisfaction
measure: Helping Alliance Questionnaire - Total Score
time frame: Completed during session 4 of treatment group (i.e. the final treatment session)
description: Participant completed assessment on the final day of group and rated therapist based on their interactions over the 4 days.
Min:19 Max:114 Higher score indicates stronger alliance with therapist
arm group label: Group Motivational Interviewing (GMI)
arm group type: Experimental
description: Group Motivational Interviewing (GMI) participants will receive four structured, back-to-back, 90-min sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.
arm group label: Control Treatment Condition (CT)
arm group type: Active Comparator
description: Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to Group Motivational Interviewing (GMI) (i.e., 90 minutes) and will involve the following topics: A popular 'box activity': participants will anonymously write evocative questions on slips of paper involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion (e.g., "How do I talk to my family about my alcohol problem?"), money management with feedback (2 sessions), and cooking-home maintenance.
intervention type: Behavioral
intervention name: Group Motivational Interviewing (GMI)
description: Participants randomized to Group Motivational Interviewing (GMI) will receive four structured, back-to-back, 90-minute sessions consistent with the central principles and spirit of Motivational Interviewing (MI). GMI, which is based on a manualized protocol, is specifically designed for dually diagnosed Veterans. A focus of the intervention creates awareness of the relationship between the substance use and co-existing psychiatric disorder and the importance of treating both.
arm group label: Group Motivational Interviewing (GMI)
intervention type: Behavioral
intervention name: Control Treatment Condition (CT)
description: Control Treatment Condition (CT): Participants in CT will attend four sessions equal in time and length to GMI (i.e., 90 minutes) and will involve the following topics: A popular 'box activity': participants will anonymously write evocative questions on slips of paper involving their personal concerns that are placed in a box and, when randomly selected, opened for group discussion (e.g., "How do I talk to my family about my alcohol problem?"), money management with feedback (2 sessions), and cooking-home maintenance.
arm group label: Control Treatment Condition (CT)
criteria: 
gender: All
minimum age: 18 Years
maximum age: 75 Years
healthy volunteers: No
last name: Elizabeth J. Santa Ana, PhD MA BA
role: Principal Investigator
affiliation: Ralph H. Johnson VA Medical Center, Charleston, SC
facility: 
country: United States
citation: Jaconis M, Santa Ana EJ, Killeen TK, Badour CL, Back SE. Concurrent treatment of PTSD and alcohol use disorder via telehealth in a female Iraq veteran. Am J Addict. 2017 Mar;26(2):112-114. doi: 10.1111/ajad.12481. Epub 2017 Jan 24.
PMID: 28118514
citation: Gebregziabher M, Voronca D, Teklehaimanot A, Santa Ana EJ. Weibull mixture regression for marginal inference in zero-heavy continuous outcomes. Stat Methods Med Res. 2017 Jun;26(3):1476-1499. doi: 10.1177/0962280215583402. Epub 2015 Apr 22.
PMID: 25902801
citation: Shorey RC, Martino S, Lamb KE, LaRowe SD, Santa Ana EJ. Change talk and relatedness in group motivational interviewing: a pilot study. J Subst Abuse Treat. 2015 Apr;51:75-81. doi: 10.1016/j.jsat.2014.11.003. Epub 2014 Nov 20.
PMID: 25488505
citation: Santa Ana EJ, LaRowe SD, Armeson K, Lamb KE, Hartwell K. Impact of group motivational interviewing on enhancing treatment engagement for homeless Veterans with nicotine dependence and other substance use disorders: A pilot investigation. Am J Addict. 2016 Oct;25(7):533-41. doi: 10.1111/ajad.12426. Epub 2016 Sep 2.
PMID: 27589072
responsible party type: Sponsor
mesh term: Alcoholism
mesh term: Substance-Related Disorders
sharing ipd: No
provided document: 
participant flow: 
baseline: 
outcome list: 
reported events: 
certain agreements: 
point of contact: 