DEVELOPING A CULTURALLY ROOTED ADOLESCENT FAMILY THERAPY

描述：(申请人摘要) 这项申请建议进行第一阶段治疗开发研究， 目标是西班牙裔滥用药物的青少年和他们的家人，他们有独特的 价值观和文化适应/移民相关的生活经历 显示出直接影响参与度、保持、药物使用和 药物治疗的效果/效果。尽管文化的重要性 相关因素已被普遍承认，治疗模式失败 将特定的文化派生的干预措施与特定的治疗变化联系起来 药物滥用治疗的核心机制。建议的模式，在文化上 根深蒂固的青少年家庭治疗(CRECH)，将包括心理教育 直接解决这些区域性相关因素的模块，旨在 加强治疗联盟推进家庭治疗变革工作 机械装置。 建议的模型分为三个目标，每个目标都旨在产生结果 这为后续AIM的工作提供了信息。目标I由一项基础研究组成 调查特定移民的独立贡献和 扰乱家庭治疗机制的文化适应相关应激源 变化。目标二包括：1)编制“工作”工艺手册，2)a) 一系列旨在加强对家庭变化影响的单一案例实验 机构和工艺的可行性/可接受性，3)机械和工艺的人性化 改进的工艺模型，以及4)制定遵守清单和 治疗师选拔和培训指南。AIM III专注于试点测试 一项小型随机试验的人工干预效果 将受试者随机分为手艺治疗或家庭治疗的设计 和往常一样。 目的I对基础研究和AIM II个案进行分析 实验系列旨在提供数据，这些数据将为 精致的工艺干预。目的III对随机试验的分析 旨在确定所需分析的效果大小 在第二阶段疗效试验中，即HLM关于结果(药物滥用和其他 犯罪问题)；假设变化机制的HLM分析(家长 实践、亲子依恋、父母生态互动，以及 治疗联盟)。此外，还将使用具有临床意义的分析。 确定干预措施对哪些子组最有效，并绘制增长曲线 使用分层线性建模的分析，将用于比较 从成功到成功的行动机制的变化轨迹 不成功的案例。

DESCRIPTION: (Applicant's Abstract) This application proposes to conduct a Stage I treatment development study that targets Hispanic drug abusing adolescents and their families, who have unique values and acculturation/ immigration related life experiences that can be shown to directly impact engagement, retention, drug use, and the efficacy/effectiveness of drug treatment. Although the importance of culture related factors have been generally acknowledged, treatment models have failed to link specific culturally derived interventions to specific treatment change mechanisms central to drug abuse treatment. The proposed model, Culturally Rooted Adolescent Family Therapy (CRAFT), will include psycho-educational modules that directly address these culture related factors and are designed to enhance treatment alliance and facilitate the work of family therapy change mechanisms. The proposed model is divided into three AIMs each designed to produce findings that inform the subsequent AIM's work. AIM I consists of a basic research study that investigates the independent contribution of specific immigration and acculturation-related stressors in disrupting family therapy mechanism of change. AIM II consist of: 1) the development of a "working" CRAFT manual, 2) a set of single-case experiments designed to enhance the impact on family change mechanism and CRAFT's feasibility/acceptability, 3) the manualization of the refined CRAFT model, and 4) the development of an adherence checklist and therapist selection and training guidelines. AIM III focuses on pilot testing the efficacy of the manualized intervention using a small randomized trial design in which subjects are randomized to either CRAFT or Family Therapy as Usual. AIM I analyses of the basic research study and the AIM II single-case experiments series are intended to provide data that will inform the refinements of the CRAFT intervention. AIM III analyses of the randomized trial are designed to determine effect sizes for the analyses that would be required in a Stage II efficacy trial, viz., HLM on outcomes (drug abuse and other delinquency problems); HLM analyses of postulated change mechanisms (parent practices, parent-adolescent attachment, parent-ecology interactions, and therapeutic alliance). Moreover, analyses of clinical significance will be used to identify subgroups for whom the interventions work best, and growth curve analyses using Hierarchical Linear Modeling, will be used to compare the trajectory of change in mechanisms of action between successful and unsuccessful cases.