DEVELOPING PRIME TIME PROJECT FOR DOUBLE JEOPARDY YOUTH

描述：该勘探/开发提案(R21)将进一步 开发黄金时段项目，这是一项旨在解决 贫困风险极高的青少年群体的特殊需求 结果：有药物滥用史的低收入非裔美国青年， 情绪困扰和犯罪牵连。该项目的目标是两大 社区减少暴力犯罪的障碍：青少年吸毒 以及情绪失调。 黄金时间项目首先实施了一个经过充分测试的、 基于生态的干预，多系统治疗(MST)。这一干预 已经显示出有能力减少犯罪青年的犯罪参与。 这项干预并没有显示出可以减少青少年药物的使用，也没有 它的有效性在有共生物质的罪犯身上得到了验证 虐待和精神障碍。通过进行初步研究， 调查人员了解到，这一群体尤其具有挑战性 参与和治疗。 黄金时段项目的独特组件包括嵌入到 MST框架两个单独级别的增强，以解决这些共同出现的问题 有问题。这些增强基于辩证行为疗法(DBT)，即 由心理学家玛莎·林汉博士开发的经过测试的干预方法 在华盛顿大学。第一个改进涉及前处理。 参与和激励策略，以增加治疗中的保留率。 第二个改进是使用DBT解决年轻人的情绪困扰 认知-行为技能--训练方法。 作为发展这种心理社会治疗模式的步骤，具体的 该项目的目标是开展三项活动： 1.填写《黄金时段治疗手册》，该手册将实施和 规范治疗方案。 2.制定依从性研究方案。 3.进行试点结果试验，以1)评估干预能力 产生短期收益，这反映在参与动机的增强上 干预，减少药物使用，提高调节情绪的能力， 犯罪活动减少，学校参与度增加， 成本效益，2)监察我们成功推行建议的研究 方法，以及3)计算功率估计以设计更大的随机 对照试验。 如果这些活动肯定了我们实施人工干预的能力 有了这样的目标人群和我们研究 干预，我们将继续开发黄金时段项目并进行 对其有效性的进一步试验。 该项目的创新方面之一是努力确定和 在心理健康框架内治疗少数族裔青年人口，他们 传统上，行为越来越多地被贴上标签并被制裁为 罪犯。因此，这一发展项目涉及若干优先事项 在2000年《健康人》中提出，包括改善低收入者的健康 和少数民族人口，减少年轻人使用酒精和大麻，减少 精神障碍的流行，并减少精神障碍的发生 人际暴力。

DESCRIPTION: This exploratory/development proposal (R21) will further the development of the Prime Time Project, an intervention that addresses the specific needs of a group of adolescents at extremely high risk of poor outcomes: low-income African American youth with a history of substance abuse, emotional disturbance, and criminal involvement. The Project targets two major impediments to reducing violent crime in our communities: youth substance use and emotional dysregulation. The Prime Time Project begins by implementing a manualized and well-tested, ecologically-based intervention, Multisystemic Therapy (MST). This intervention has demonstrated ability to reduce criminal involvement in delinquent youth. The intervention has not been shown to reduce adolescent substance use, nor has its effectiveness been demonstrated for delinquents with co-occurring substance abuse and psychiatric disorders. Through conducting preliminary studies, the investigators have learned that this population is particularly challenging to engage and to treat. The unique components of the Prime Time Project include embedding within the MST framework two individual-level enhancements that address these co-occurring problems. The enhancements are based on Dialectical Behavioral Therapy (DBT), a tested intervention that has been developed by psychologist Dr. Marsha Linehan at the University of Washington. The first enhancement involves pre-treatment engagement and motivational strategies to increase retention in treatment. The second enhancement addresses the youth's emotional disturbance using a DBT cognitive-behavioral skills-training approach. As steps in the development of this psychosocial treatment model, the specific aims of this project are to carry out three activities: 1. Complete the Prime Time Treatment Manual that will operationalize and standardize the treatment protocol. 2. Develop an adherence study protocol. 3. Conduct a pilot outcome trial to 1) assess the ability of the intervention to produce short-term gains as reflected in increased motivation to engage in intervention, reduced substance use, increased ability to regulate emotions, reduced criminal activity, increased school engagement and increased cost-effectiveness, 2) monitor our success in implementing the proposed study methods, and 3) Calculate power estimates for designing a larger randomized controlled trial. If these activities affirm our ability to implement a manualized intervention with this target population and our ability to study the effects of the intervention, we will continue developing the Prime Time Project and conduct further trials of its effectiveness. One of the innovative aspects of this Project is the effort to identify and treat within a mental health framework a population of minority youth whose behavior has traditionally and increasingly been labeled and sanctioned as criminal. As such, this development project addresses a number of priorities set forth in Healthy People 2000, including improving the health of low income and minority populations, reducing alcohol and marijuana use by youth, reducing the prevalence of mental disorders, and decreasing the occurrence of interpersonal violence.