Integrated Continuity of Care for Adolescent Drug Users

青少年吸毒者综合连续性护理

• 批准号: 7279878
• 负责人: Nancy Jainchill
• 金额: $ 52.85万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-20 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7279878
• 关键词: Address; Admission activity; Adolescent; Aftercare; Attitude; Behavior Therapy; Behavioral; Characteristics; Client; Communities; Condition; Continuity of Patient Care; Dose; Drug usage; Drug user; Effectiveness; Equation; Failure; Family; Family Relationship; Family psychotherapy; Female; Goals; Individual; Intake; Intervention; Investigation; Lead; Measures; Mediating; Modality; Modeling; Motivation; Nature; Outcome; Outcome Measure; Performance; Pharmaceutical Preparations; Problem behavior; Process; Protocols documentation; Randomized; Randomized Controlled Clinical Trials; Rate; Recovery; Relapse; Residencies; Residential Treatment; Resistance; Resources; Risk; Risk Factors; Sampling; Services; Standards of Weights and Measures; Therapeutic; Therapeutic community technique; Treatment outcome; Truancy; Youth; anti social; base; design; dosage; experience; improved; male; programs; recidivism; service utilization; treatment program

DESCRIPTION (provided by applicant): The current application is a resubmission of a proposal submitted and reviewed by NIDA-F (1 R01DA017218-01). The overall objective of this project is to address the problem of relapse among adolescents who have been in modified residential therapeutic community (TC) treatment programs. To this end, we propose to evaluate the effectiveness of an enhanced aftercare (EA) intervention compared with standard aftercare (SA) services. The enhanced aftercare condition includes an evidence-based family therapy, Functional Family Therapy (FFT) provided along with the standard services. For many high-risk youth it has been necessary to place them in residential settings such as TCs for treatment. Heretofore these programs have been seen as a stand-alone, well-established treatment modality. The findings suggest they may be a necessary but not sufficient condition for successful treatment for many of these youth. The proposed project conceptualizes TCs not as a "stand alone" intervention, but as part of a more holistic, integrated treatment that models a continuity of care approach, which extends and enhances the therapeutic process beyond the residential context. Planned analyses address 4 specific aims to investigate the impact of the proposed Enhanced Aftercare treatment model as compared to Standard Aftercare. Aim 1 compares the impact of the EA condition to SA on post-treatment outcome measures. Aim 2 examines whether the level of goal attainment achieved during the TC residency period predicts post-treatment outcomes both across and within the aftercare conditions; analyses assess the premise that the gains achieved during TC residency are more likely to be preserved in EA. Aim 3 examines the effects of client pre-intervention moderating factors (e.g., pretreatment risk and protective status) on TC goal attainment and post-treatment outcomes in each aftercare condition using structural equations models. Aim 4 assesses the impact of participation in aftercare services (i.e., service dosage) during the aftercare period for the EA and SA conditions on 12-month post-aftercare treatment behavioral outcomes. This project reflects a core premise that a treatment model that integrates complementary strategies, i.e., modified residential TC treatment and an enhanced aftercare protocol providing Functional Family Therapy, will have an additive, if not synergistic effect on reducing or eliminating [drug use/abuse and other problem behaviors among adolescents after completing treatment.

描述（由申请人提供）： 当前申请是NIDA-F（1 R 01 DA 017218 -01）提交和审查的提案的重新提交。该项目的总体目标是解决青少年谁一直在修改住宅治疗社区（TC）治疗方案复发的问题。为此，我们建议评估加强善后（EA）干预与标准善后（SA）服务相比的有效性。加强的善后条件包括循证家庭治疗，功能性家庭治疗（FFT）与标准服务沿着提供。对于许多高危青少年来说，有必要将他们安置在诸如TC之类的住宅环境中接受治疗。因此，这些程序已被视为一个独立的，完善的治疗模式。研究结果表明，它们可能是成功治疗这些年轻人的必要条件，但不是充分条件。拟议项目的概念是，传统中医药不是一种“独立”的干预措施，而是一种更全面、综合的治疗方法的一部分，这种方法模拟了一种连续性的护理方法，这种方法将治疗过程扩展和加强到居住环境之外。计划的分析解决了4个具体目标，以调查拟议的加强善后处理模式与标准善后处理相比的影响。目的1比较EA条件SA对治疗后结局指标的影响。目的2检查是否在TC居住期间实现的目标实现水平预测治疗后的结果跨和内的善后条件;分析评估的前提下，TC居住期间实现的收益更有可能被保存在EA。目标3检查客户干预前调节因素的影响（例如，治疗前风险和保护状态）对TC目标实现和治疗后结局的影响。目标4评估参与善后服务的影响（即，服务剂量）在善后期间的EA和SA条件对12个月善后治疗后的行为结果。该项目反映了一个核心前提，即一个整合互补战略的治疗模式，即，经修改的住宅TC治疗和提供功能性家庭治疗的增强的善后方案将在完成治疗后减少或消除青少年的药物使用/滥用和其他问题行为方面具有相加作用，如果不是协同作用的话。