Adolescent Treatment and 12-step Mutual-help Involvement

描述（由申请人提供）： 大多数针对青少年的治疗方案都基于“12步”模式，其中心目标是促进参与12步互助小组，如匿名戒酒会和匿名戒毒会。研究表明，参加AA/NA会议的青年有更好的治疗结果。此外，由于AA和NA社区网络广泛可用且足够灵活，可以提供“急性”禁欲特定支持（例如，通过赞助商）在高风险的时候（例如，在一个成本日益紧缩的管理式护理环境中，它们有望成为专业服务的有益辅助手段。 然而，很少有人知道青少年AA/NA的参与，一般来说，什么是已知的是完全来自住院设置，这可能不反映当前的治疗现实，因为该系统已过渡到主要是门诊治疗。此外，很少有人知道影响AA/NA参与的因素，或青年在专业12步治疗过程中经历的具体变化过程。一个前瞻性的、面向过程的设计将被用来评估：1）青年在多大程度上（N=162; 14-18岁）在12个月的随访期内从12个定向门诊治疗中招募，参加，参与并受益于AA/NA; 2）影响青少年AA/NA参与和相关益处的因素;以及，3）治疗参与对12步的影响（例如，疾病模型信念），和共同（例如，自我效能，应对），变化的过程以及这些，反过来，如何与近端（即，AA/NA受累）和远端（即，物质使用）的结果。第二个目的是调查工作人员12步转介的做法和工作人员和家长对AA/NA出席青年的态度。结果将提供新的信息，说明在目前的治疗环境中向青年提供的治疗的有效性，并提供针对发展的 将为针对青年的12步促进工作提供信息的知识。

DESCRIPTION (provided by applicant): The majority of treatment programs targeting youth are based on a "12-step" model, a central aim of which, is to facilitate involvement in 12-step mutual-help groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Research indicates that youth who attend AA/NA meetings have significantly better treatment outcomes. Furthermore, because AA and NA community networks are widely available and flexible enough to provide "acute" abstinence-specific support (e.g., through a sponsor) at times of high risk (e.g., evenings, weekends) as well as function as ongoing support systems at no cost, they hold promise as a useful adjunct to professional services in an increasingly cost-constricting, managed-care environment. However, little is known about youth AA/NA participation, in general, and what is known is derived solely from inpatient settings, which may not reflect current treatment reality as the system has transitioned to mostly outpatient care. Further, little is known about factors that influence AA/NA participation, or the specific change processes youth undergo during professional 12-step treatment. A prospective, process-oriented, design will be utilized to assess: 1) the extent to which youth (N=162; 14-18 yrs) recruited from 12-steporiented outpatient treatment, attend, become involved in, and benefit from, AA/NA during a 12-month follow-up period; 2) factors that influence adolescent AA/NA participation and related benefits; and, 3) the influence of treatment involvement on 12-step (e.g., disease-model beliefs), and common (e.g., self-efficacy, coping), processes of change and how these, in turn, relate to proximal (i.e., AA/NA involvement) and distal (i.e., substance use) outcomes. A secondary aim is to investigate staff 12-step referral practices and staff and parent attitudes toward AA/NA attendance for youth. Results will provide new information about the effectiveness of treatment as delivered to youth in current treatment contexts and supply developmentallyspecific knowledge that will inform 12-step facilitation efforts targeting youth.