Assessment of the Adolescent Therapeutic Community Treatment Process

描述（由申请人提供）：治疗社区（TC）是主要的治疗方式之一，已经适应了最近激增的青少年住院治疗计划。虽然这种方式已被证明对青少年有效，但对TC治疗如何产生结果的了解有限。青少年TC计划中的护理质量改善最好通过直接评估治疗过程来了解;但治疗过程的措施很少，特别是用于青少年TC治疗。鉴于青少年在药物滥用治疗方面的不同需求，强调成人和青少年治疗服务脱钩，并认识到青少年药物滥用治疗最好是针对青少年的特殊问题，因此，越来越重要的是，要有针对这一日益增长的药物滥用治疗消费者群体的可靠和有效的治疗过程措施。本研究将通过以下具体目标来改善青少年TC治疗过程的测量：1）通过使用共识小组、焦点小组、认知访谈和小规模试点，完善青少年TC治疗过程的两个测量方法，即自我报告的变化维度量表（DCI-A）和咨询师报告的咨询师治疗参与评估（CATE）;（2）通过对全国7个TC治疗项目点的280名青少年来访者和60名咨询师进行的一项横断面试点研究，检验这两种改进措施的心理测量学特性，并收集初步的效度证据。

DESCRIPTION (provided by applicant): The therapeutic community (TC) is one of the major treatment modalities that has accommodated the recent surge in adolescent admissions to residential treatment programs. Although this modality has proven effective for adolescents, there is limited understanding of how TC treatment produces outcomes. Quality of care improvements within adolescent TC programs are best informed by direct assessment of the treatment process; yet few measures of treatment process exist, especially for use with adolescents in TC treatment. In light of the distinct needs of adolescents in substance abuse treatment, the emphasis on decoupling adult and adolescent treatment services, and the recognition that adolescent substance abuse treatment should ideally be tailored to address adolescents' particular issues, it is increasingly important to have reliable and valid measures of treatment process that are specific to this growing population of substance abuse treatment consumers. The proposed study will seek to improve measurement of adolescent TC treatment process through completion of the following specific aims: 1) To refine two measures of adolescent TC treatment process, the self-report Dimensions of Change Instrument (DCI-A) and counselor-report Counselor Assessment of Treatment Engagement (CATE), through the use of consensus panels, focus groups, cognitive interviewing, and small-scale piloting; and 2) To examine the psychometric properties and gather preliminary validity evidence for these two refined measures using data from a cross-sectional pilot study involving 280 adolescent clients and 60 counselors at 7 TC treatment program sites across the nation.