Family Therapy Development for Incarcerated Mothers with Substance Use Disorders

患有药物滥用障碍的被监禁母亲的家庭治疗发展

• 批准号: 7908678
• 负责人: Sydney L. Hans
• 金额: $ 3.86万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7908678
• 关键词: Address; Adult; Affect; African American; Aftercare; Alcohol or Other Drugs use; Alcohols; Area; Award; Behavior Therapy; Behavioral; Berry; Biological Markers; Caregivers; Caring; Chicago; Child; Child Care; Clinical; Collection; Complex; County; Data; Daughter; Development; Drug Courts; Evidence based practice; Family; Family Relationship; Family psychotherapy; Focus Groups; Fostering; Foundations; Funding; Future; Grant; HIV; Health; High Prevalence; Human; Imprisonment; Individual; Intervention; Intervention Studies; Jail; Knowledge; Latina; Letters; Life; Light; Manuals; Measurement; Measures; Minor; Modeling; Modification; Mothers; National Institute of Drug Abuse; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Pilot Projects; Play; Poverty; Preparation; Principal Investigator; Process; Process Measure; Public Health; Public Policy; Randomized; Randomized Clinical Trials; Recruitment Activity; Request for Applications; Research; Research Personnel; Research Project Grants; Research Proposals; Residential Treatment; Risk; Risk Behaviors; Role; Sample Size; Sampling; Science; Services; Social Workers; Staging; Stress; Substance Use Disorder; Substance abuse problem; Testing; Toxicology; Training; United States; United States National Institutes of Health; Universities; Urine; Woman; Work; addiction; arm; biopsychosocial; caregiving; cognitive system; community based participatory research; comparison group; coping; design; experience; grandchild; grandparent; health administration; high risk; high risk behavior; improved; innovation; meetings; novel; preference; psychosocial; public health relevance; response; sex risk; socioeconomics; theories; therapy development; treatment as usual; trend

DESCRIPTION (provided by applicant): This SOAR proposal is submitted to expand and strengthen a study that is currently underway with John A. Hartford Foundation funding awarded to the principal investigator, who meets the NIH early stage investigator criteria. This research addresses the alarming increase in the rate of incarceration among women in the United States, its intersection with substance abuse, and its disproportionate impact upon African American and Latina women. The majority of women who are incarcerated resided with their minor children prior to their incarceration and more than half of their children are cared for by a grandparent, disproportionately a grandmother, during their incarceration. A growing body of research suggests that family treatments yield improved treatment engagement and retention, reduced substance use, and improved individual and family functioning in comparison to individual treatment or waitlist conditions for adults with alcohol and substance use disorders. Research has also begun to demonstrate that interventions with incarcerated mothers and their children yield positive psychosocial outcomes, including reduced re-incarceration, but only one known intervention study has included caregiving grandmothers, despite their key familial roles and the potential for their involvement to enhance treatment retention and gains for incarcerated mothers with substance use disorders. This stage Ia/Ib therapy development study draws upon a multigenerational stress-process theoretical framework and principles of community-based participatory research to pursue the following aims: 1)conduct separate focus groups with incarcerated mothers with substance use disorders and grandmothers who are caring for their daughters' children during their incarceration to identify the psychosocial strengths, needs, and service preferences of the mothers, grandmothers and children; 2)draw upon gathered focus group data and family systems, cognitive and behavioral theories to design and pilot-test an innovative, culturally- relevant family therapy model; 3)recruit 30 incarcerated women who are participating in drug court-referred residential treatment in a county jail to be randomly assigned to treatment as usual (n=15) or to treatment as usual plus the novel family therapy component (n=15) and recruit the mothers of the women participating in the novel family therapy arm to participate in the family therapy component (n=15); 4)conduct baseline and post- treatment measurement of family relationships, coping, substance use, incarceration status and HIV risk behaviors among mothers; family relationships, coping, substance use, and psychosocial strain among grandmothers; and behavioral functioning among children; and 5)evaluate the acceptability of the novel family treatment component to the participants. In light of the significant potential for family treatment to reduce mothers' substance use, re-incarceration, and involvement in HIV drug and sexual risk behaviors; to reduce caregiving grandmothers' psychosocial strain and substance use risk, and to strengthen children's behavioral functioning, this study addresses a critical gap in both science and evidence-based practice in this area. PUBLIC HEALTH RELEVANCE: In light of the high prevalence of substance use disorders among women who are incarcerated, the multigenerational effects of maternal incarceration and substance abuse, and the limited family treatment research in this area, this study addresses a critically important gap in science and practice. This study's development of a novel family treatment for incarcerated mothers with substance use disorders and their mothers who are caring for their children during their incarceration holds potential to positively affect several serious public health concerns, including substance abuse, re-incarceration, and HIV drug and sexual risk behaviors among the mothers; biopsychosocial strain and substance use risk among the grandmothers; and behavioral functioning among the children.

描述(由申请人提供)：这份SOAR提案是为了扩大和加强目前正在进行的一项研究，该研究由约翰·A·哈特福德基金会资助，授予符合NIH早期研究员标准的首席研究员。这项研究探讨了美国女性监禁率的惊人增长，它与药物滥用的交集，以及它对非裔美国人和拉美裔女性的不成比例的影响。大多数被监禁的妇女在被监禁前与其未成年子女同住，她们一半以上的子女在被监禁期间由祖父母照顾，其中祖母照顾的比例不成比例。越来越多的研究表明，与患有酒精和物质使用障碍的成年人的个人治疗或等待名单相比，家庭治疗可以改善治疗的参与度和保留率，减少物质使用，并改善个人和家庭的功能。研究还开始表明，对被监禁母亲及其子女的干预措施产生了积极的心理社会结果，包括减少再次监禁，但只有一项已知的干预研究包括照顾祖母，尽管她们在家庭中发挥了关键作用，而且她们的参与有可能提高患有药物使用障碍的被监禁母亲的治疗保留率和收益。这一阶段的Ia/Ib治疗发展研究借鉴了以社区为基础的参与性研究的多代应激过程理论框架和原则，以追求以下目标：1)与患有药物使用障碍的被监禁母亲和在狱中照顾女儿子女的祖母进行单独的焦点小组，以确定母亲、祖母和孩子的心理社会力量、需求和服务偏好；2)利用收集的焦点小组数据和家庭系统、认知和行为理论来设计和试点测试创新的、与文化相关的家庭治疗模式；3)招募30名在县监狱参加毒品法庭转介住院治疗的被监禁妇女，随机分配到照常治疗(n=15)或照常治疗加新型家庭治疗部分(n=15)，并招募参与新型家庭治疗的妇女的母亲参加家庭治疗部分(n=15)；4)对母亲的家庭关系、应对、药物使用、监禁状况和艾滋病毒危险行为进行基线和治疗后的测量；祖母的家庭关系、应对、物质使用和心理社会压力；以及儿童的行为功能；5)评估新的家庭治疗成分对参与者的接受度。鉴于家庭治疗在减少母亲使用药物、再次监禁和参与艾滋病毒药物和性危险行为方面的巨大潜力，减少照顾祖母的心理社会压力和药物使用风险，以及加强儿童的行为功能，本研究解决了这一领域科学和循证实践中的一个关键差距。 公共卫生相关性：鉴于被监禁妇女中药物使用障碍的高流行率，监禁产妇和药物滥用的多代影响，以及这一领域有限的家庭治疗研究，本研究解决了科学和实践中的一个至关重要的差距。这项研究为患有药物使用障碍的被监禁母亲及其在监禁期间照顾孩子的母亲开发了一种新的家庭治疗方法，这可能会对几个严重的公共卫生问题产生积极影响，包括母亲中的药物滥用、再次监禁、艾滋病毒药物和性危险行为；祖母中的生物心理社会压力和物质使用风险；以及儿童的行为功能。