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Substance Use Disorder (SUD)DICONCT07588516

Dynamic Multilevel Processes of Recovery in Therapeutic Communities in Mexico (DICO Model)

An observational study of Substance Use Disorder (SUD) and Treatment Adherence, run by Under The Tree Therapeutic Community at 1 site in Mexico.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study aims to develop and empirically evaluate the Dinámica Integral Conductual Comunitaria (DICO) model, a multilevel framework that conceptualizes recovery from substance use disorders as a dynamic process emerging from the interaction between individual behavioral variables, social contingencies, and… Read more about this study

Who is it for?
Ages 18 years and older, men only
What is being tested?
Ecological Momentary Assessment (EMA)
How many people
60 participants
Where
1 siteMexico
Study dates
15 May 2026to 2 Oct 2026
How long will I take part?
12 Weeks
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult individuals undergoing residential treatment for substance use disorders in therapeutic communities in Mexico. The population is characterized by varying levels of substance dependence severity, psychosocial vulnerability, and exposure to structured community-based treatment environments that emphasize behavioral regulation, peer support, and institutional norms. Participants are embedded in a communal living setting where daily routines, social interactions, and reinforcement contingencies are structured by the therapeutic model, providing a naturalistic context for observing multilevel behavioral and recovery processes.

Who may be able to join

  • Adults aged 18 years or older
  • Currently enrolled in a residential therapeutic community for substance use treatment
  • Minimum stay of at least 7 days prior to baseline assessment
  • Ability to understand and provide informed consent
  • Expected availability for participation during the 8-12 week follow-up period

Who cannot join

  • Acute psychotic symptoms or severe psychiatric decompensation that interferes with participation
  • Severe cognitive impairment limiting comprehension of study procedures
  • Current medical instability requiring immediate external intervention
  • Refusal to participate in any component of the study

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Lauro Gutiérrez Castro, Mtro. contact

+523314696107

saraqael_sefer@hotmail.com

Ricardo Fernandez contact

+52 1 33 1544 5474

Mexico1 site
  • Comunidad Terapéutica Under The Tree

    Ajijic, Jalisco, 45920

    Ricardo Fernandez, +52 1 33 1544 5474, saraqael_sefer@hotmail.com

Other trials in Mexico

About this study

Official title: Comprehensive Behavioral Community Dynamics (DICO): A Prospective Longitudinal Study of Multilevel Community Processes in Therapeutic Communities for Substance Use Treatment in Mexico

This study aims to develop and empirically evaluate the Dinámica Integral Conductual Comunitaria (DICO) model, a multilevel framework that conceptualizes recovery from substance use disorders as a dynamic process emerging from the interaction between individual behavioral variables, social contingencies, and community-level factors within therapeutic communities in Mexico.

A prospective longitudinal design with intensive repeated measures will be implemented over 8 to 12 weeks. Data will be collected using ecological momentary assessment (EMA), psychometric instruments, behavioral records, and semi-structured interviews.

The study seeks to model recovery trajectories as nonlinear dynamic systems, identifying critical transitions, instability patterns, and contextual moderators associated with treatment adherence and relapse risk.

Read the detailed description

The study integrates three analytical levels:

  1. Individual behavioral processes (e.g., craving, psychological flexibility)
  2. Community-level dynamics (e.g., cohesion, reinforcement contingencies)
  3. Cultural-contextual factors relevant to Mexican therapeutic communities

Quantitative data will be collected through high-frequency EMA and longitudinal assessments, enabling the estimation of dynamic parameters using nonlinear modeling techniques (e.g., differential equations, network analysis).

Qualitative data from semi-structured interviews will provide contextual interpretation of observed behavioral trajectories and system transitions.

The study does not involve manipulation or assignment to interventions; it is designed to observe naturally occurring processes within residential treatment settings.

Being tested
Ecological Momentary Assessment (EMA)
Keywords
Therapeutic Communities, Ecological Momentary Assessment (EMA), Psychological Flexibility, Craving, Community Reinforcement, Acceptance and Commitment Therapy, Multilevel Modeling, Dynamic Systems
Medical subject headings
Substance-Related Disorders, Treatment Adherence and Compliance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ecological Momentary Assessment (EMA)Other

    Real-time data collection method using mobile devices to assess momentary fluctuations in craving, psychological flexibility, and social context multiple times per day. This procedure is used for observational measurement only and does not constitute a therapeutic intervention.

Study groups in NCT07588516
Study groupRoleWhat they receive
Therapeutic Community ResidentsAdult residents undergoing residential treatment for substance use in therapeutic communities in Mexico. Participants are followed prospectively for 8-12 weeks using intensive longitudinal assessment, including ecological momentary assessment (EMA), psychometric measures, behavioral logs, and qualitative interviews. No experimental manipulation or assignment to interventions is performed.
Receives: Other: Ecological Momentary Assessment (EMA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Treatment Adherence - Length of Stay

    Length of stay in treatment (number of days from admission to discharge), obtained from clinical records.

    Measured: From admission to discharge (up to 12 weeks)

  2. Disengagement - Total Score on Brief Disengagement Scale

    Total score on the Brief Disengagement Scale (3 items, each scored from 0 to 10; total range: 0 to 30). Higher scores indicate greater disengagement from treatment.

    Measured: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)

  3. Craving Intensity - Single-Item Scale

    Self-reported craving intensity using a single-item scale (0 to 10; 0 = no craving, 10 = extreme craving).

    Measured: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)

  4. Contextual Rumination - Total Score on the Brief Contextual Rumination Scale (BCRS-10)

    Total score on the Brief Contextual Rumination Scale (EBRC-10). Range: 0 to 40. Higher scores indicate greater rumination associated with substance use.

    Measured: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)

  5. Temporal Variability of Craving

    Within-participant temporal variance of craving scores derived from repeated measurements. Higher values indicate greater instability.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  6. Autocorrelation of Craving (Lag-1)

    Lag-1 autocorrelation coefficient of craving time series. Higher values indicate greater temporal persistence of craving states.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

Secondary outcomes (12)
  1. Psychological Flexibility - Total Score on the Acceptance and Action Questionnaire-II (AAQ-II)

    Total score on the Acceptance and Action Questionnaire-II (AAQ-II). Range: 7 to 49 points. A higher score indicates a worse outcome (greater experiential avoidance, lower psychological flexibility).

    Measured: Week 1 (baseline) and Week 12 (discharge).

  2. Community Cohesion - Mean Score on the Brief Cohesion Scale (RBDC-2D)

    Mean score of two items (each scored 0 to 10): perceived group belonging and trust in peers, derived from the Brief Community Dynamics Record (RBDC-2D). Range: 0 to 10. Higher scores indicate greater cohesion.

    Measured: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)

  3. Perceived Social Support - Single-Item Score

    Single-item score (0 to 10): perceived support from peers or staff. Higher scores indicate greater perceived support.

    Measured: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)

  4. Prosocial Behavior - Participation and Cooperation Index (RBDC-2D)

    Composite index calculated as the sum of three items (each scored 0 to 3): participation in activities, cooperation with peers, and mutual help. Total range: 0 to 9. Higher scores indicate greater prosocial behavior.

    Measured: Every 48 hours from Day 1 through Week 12 (up to 12 weeks).

  5. Perceived Institutional Punitiveness - Single Item from RBDC-2D

    Single-item score (0 to 10): perceived harshness or unfairness of rules or sanctions. Higher scores indicate greater perceived punitiveness.

    Measured: Every 48 hours from Week 1 through Week 12 (up to 12 weeks)

  6. Global Network Strength derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Time Series

    Global strength (sum of absolute edge weights) estimated using graphical vector autoregression (gVAR). Unit: standardized Z-score. Higher values indicate greater overall connectivity among behavioral variables.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  7. Node Centrality of Craving derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Data

    Standardized Z-score representing node centrality (expected influence) of craving within the temporal network. Higher values indicate greater influence on other variables.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  8. Node Centrality of Contextual Rumination derived from Temporal Network Analysis (graphical VAR) of RBDC-2D and EBRC-10 Data

    Standardized Z-score representing node centrality (expected influence) of contextual rumination (EBRC-10) within the temporal network.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  9. Node Centrality of Disengagement - Temporal Network Analysis (gVAR Model)

    Standardized Z-score representing node centrality (expected influence) of impulse/urgency within the temporal network

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  10. Node Centrality of Disengagement - Temporal Network Analysis (gVAR Model)

    Standardized Z-score representing node centrality (expected influence) of disengagement within the temporal network.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  11. Node Centrality of Perceived Institutional Punitiveness - Temporal Network Analysis (gVAR Model)

    Standardized Z-score representing node centrality (expected influence) of perceived institutional punitiveness within the temporal network.

    Measured: Derived from repeated measurements collected every 48 hours from Week 1 through Week 12

  12. Perceived Social Support - Total Score on Multidimensional Scale of Perceived Social Support (MSPSS)

    Total score on the Multidimensional Scale of Perceived Social Support (MSPSS). Range: 12 to 84. Higher scores indicate greater perceived social support.

    Measured: Week 1 (baseline), Week 4, Week 8, and Week 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 May 2026
  2. Study start15 May 2026 (estimated)
  3. Primary completion26 Sep 2026 (estimated)
  4. Study completion2 Oct 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
60 participants (estimated)
Target duration
12 Weeks
IDs, dates and publications
ClinicalTrials.gov ID
NCT07588516
Sponsor's protocol ID
DICO-CT-MX-01
Acronym
DICO
Status last verified
May 2026
First submitted
20 Apr 2026
Last updated
14 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data (IPD) underlying the results reported in this study will be available, including ecological momentary assessment (EMA) data, psychometric measures, and behavioral records. Data will be provided in a secure, encrypted format along with associated metadata, codebooks, and documentation necessary to reproduce the dynamic and network-based analyses.

Publications

  • Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1-32. doi: 10.1146/annurev.clinpsy.3.022806.091415.

    PubMed 18509902
  • Borsboom D, Cramer AO. Network analysis: an integrative approach to the structure of psychopathology. Annu Rev Clin Psychol. 2013;9:91-121. doi: 10.1146/annurev-clinpsy-050212-185608.

    PubMed 23537483
  • Scheffer M, Bascompte J, Brock WA, Brovkin V, Carpenter SR, Dakos V, Held H, van Nes EH, Rietkerk M, Sugihara G. Early-warning signals for critical transitions. Nature. 2009 Sep 3;461(7260):53-9. doi: 10.1038/nature08227.

    PubMed 19727193
  • Hofmann SG, Hayes SC. The Future of Intervention Science: Process-Based Therapy. Clin Psychol Sci. 2019 Jan;7(1):37-50. doi: 10.1177/2167702618772296. Epub 2018 May 29.

    PubMed 30713811
  • Korecki JR, Schwebel FJ, Votaw VR, Witkiewitz K. Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments. Subst Abuse Treat Prev Policy. 2020 Jul 29;15(1):51. doi: 10.1186/s13011-020-00293-3.

    PubMed 32727559
  • Society for Community Research and Action-Community Psychology, Division 27 of the American Psychological Association. The role of recovery residences in promoting long-term addiction recovery. Am J Community Psychol. 2013 Dec;52(3-4):406-11. doi: 10.1007/s10464-013-9602-6. No abstract available.

    PubMed 24081318

Questions about this trial

What is this clinical trial studying?

An observational study of Substance Use Disorder (SUD) and Treatment Adherence, run by Under The Tree Therapeutic Community at 1 site in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 14 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Lauro Gutiérrez Castro, Mtro. (+523314696107, saraqael_sefer@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Treatment Adherence - Length of Stay (time frame: From admission to discharge (up to 12 weeks)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07588516, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2026.

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