Brief Substance Abuse Treatment for Homeless Adolescents

描述（由申请人提供）： 无家可归的青年是一个青少年群体，有患药物使用障碍和相关心理社会后果的高风险，但为这一群体制定的干预措施很少。为了响应PA-99-107，NIDA行为疗法开发计划，此应用程序寻求对第一阶段开发项目的支持。这项为期四年的研究计划将开发和测试一种针对无家可归青年特殊需求的简短的激励增强和服务联系干预措施。对青少年行为有强烈影响的社会结构（如家庭和学校）通常无法进行干预。大多数青少年不寻求药物滥用治疗。青年遭受创伤、精神病并发症、贫困和受害的比率也很高。干预将以行为改变的跨理论模型为指导（Prochaska和DiClemente，1983）。我们建议制定一个简短的，动机和服务联系的干预措施，旨在促进思考的变化和使用现有的服务。干预措施将在一个月的时间内通过几次单独会议进行。辅导员将提供关于物质使用行为和社会网络关系的个性化反馈，使用非对抗性临床访谈技术（动机访谈），并提供代金券以鼓励参与。建议对不寻求治疗的青年进行干预，并在当地机构内与其他服务结合进行。干预的目标将是鼓励无家可归的青少年质疑有关物质使用的社会影响，质疑有关药物影响的假设，考虑治疗药物问题，并利用现有的社会服务。初期的资金将用于制定一项试验性干预措施，借鉴对成年人和青少年进行测试的简要干预措施，并完成对无家可归青少年利用服务的过程分析。随后，将进行随机对照试验。将100名按年龄和性别分层的青年样本随机分配到动机增强治疗（ME）或作为治疗（TAU）。TAU包括临时方案（卫生、食品、物质援助和病例管理）。治疗后一个月和三个月的随访访谈将评估物质使用、变化阶段和服务利用率。

DESCRIPTION (provided by applicant): Homeless youth constitute a group of adolescents at high risk for substance use disorders and associated psychosocial consequences, yet few interventions have been developed for this population. In response to PA-99-107, NIDA Behavioral Therapies Development Program, this application seeks support for a Stage I developmental project. The four-year research program will develop and test a brief motivational enhancement and service-linking intervention tailored to the special needs of homeless youth. Social structures that have strong influence on adolescent behavior (such as families and schools) are not typically available for intervention. Most youth are not seeking substance abuse treatment. Youth also suffer from high rates of trauma, psychiatric co-morbidity, poverty, and victimization. The intervention will be guided by the Transtheoretical Model of behavior change (Prochaska and DiClemente, 1983). We propose to develop a brief, motivational and service linking intervention aimed at facilitating contemplation of change and use of available services. The intervention will be conducted over several individual meetings over a period of one month. Counselors will provide personalized feedback on substance use behavior and social network relations, use non-confrontational clinical interviewing techniques (Motivational Interviewing), and provide vouchers to encourage participation. The intervention is proposed to be conducted with youth who are not seeking treatment, and to be conducted and integrated with additional services within a local agency. The goals of the intervention will be to encourage homeless adolescents to question social influences about substance use, question assumptions about drug effects, consider treatment for drug problems, and make use of available social services. An initial period of funding will be used to develop a pilot intervention drawing from brief interventions tested with adults and adolescents, and to complete process analyses of service utilization among homeless adolescents. Subsequently, a randomized controlled trial will be conducted. A sample of 100 youth-stratified by age and gender, will be randomly assigned to Motivational Enhancement treatment (ME) or Treatment as Usual (TAU). TAU includes drop-in programs (hygiene, food, material assistance, and case management). Follow-up interviews at one- and three-months post-treatment, will assess substance use, stage of change, and service utilization.