Adolescent Involvement in Parental Substance Abuse Treatment: Evaluation of EBFT

青少年参与父母药物滥用治疗：EBFT 评估

• 批准号: 8067897
• 负责人: NATASHA SLESNICK
• 金额: $ 59.14万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8067897
• 关键词: Address; Adolescent; Adolescent Behavior; Adult; Affect; Aftercare; Age; Alcohol consumption; Alcohol dependence; Alcohol or Other Drugs use; Alcohols; Area; Attention; Behavior; Caring; Child; Client; Clinical Trials; Cognitive; Couples; Couples Therapy; Development; Discipline; Drug abuse; Drug usage; Ecology; Effectiveness; Emotional; Evaluation; Family; Family dynamics; Family history of; Family member; Family psychotherapy; Focus Groups; Future; Gender; Health; Health education; Home environment; Illicit Drugs; Individual; Intervention; Life; Lifestyle-related condition; Maintenance; Mediating; Mediator of activation protein; Medical; Modeling; Mothers; Nature; Outcome; Parent-Child Relations; Parenting behavior; Parents; Patients; Personal Satisfaction; Pharmaceutical Preparations; Problem behavior; Process; Quality of life; Randomized; Randomized Clinical Trials; Recovery; Relapse; Relative (related person); Reporting; Research; Research Personnel; Resources; Risk; SF-36; Services; Substance Addiction; Substance abuse problem; Substance of Abuse; Supervision; System; Testing; Time; Treatment Effectiveness; Woman; Women' s Health; Youth; adolescent substance abuse; base; cost effective; cost effectiveness; drug abuser; economic cost; economic evaluation; effective therapy; emotional experience; health care service utilization; improved; prospective; psychologic; psychosocial; response; skills; social; substance abuse treatment; substance abuser; therapy development; treatment as usual; treatment center; treatment effect; treatment planning; treatment program; treatment response

DESCRIPTION (provided by applicant): Many researchers have studied the effects of parental alcohol and drug use on child outcomes. These studies conclude that parental substance use has the potential to negatively impact children's psychosocial development by depriving them of adequate care and supervision, impeding their socioemotional and cognitive development and/or influencing them to become substance users as well. Considering a bidirectional, systemic model for understanding the development, maintenance and recovery of substance use problems, it follows that the child impacts parents' behaviors as well. Family therapy has consistently shown that involvement of family members in the treatment of substance users is associated with higher levels of engagement and retention in treatment. Many studies report pre to post treatment reductions in substance use and related problems among those receiving couples and family therapy. While randomized clinical trials of family therapy have involved adult identified patients (IPs) in couples therapy and adolescent IPs in family therapy, this study will evaluate a family systems intervention involving an adolescent child in the treatment plan of the adult treatment seeker. In the current study, alcohol and drug treatment seeking adult mothers of an adolescent child (11-15) living in the home will be engaged. All clients will be randomized to (1) ecologically-based family therapy (EBFT) in the home + treatment as usual (TAU), (2) EBFT at the office + TAU, or (3) TAU + attention control. The relative efficacy of this approach will be evaluated at 3, 6, 12, and 18 months post-baseline. Proposed change mechanisms (mediators) for family therapy will be evaluated. Differential treatment response as a function of gender, family history of alcohol or drug use, and primary alcohol v. drug abuse (moderators) will be investigated to better understand the intervention. The study will also examine how, if at all, treatment engagement and retention impact parent and adolescent response to treatment. Information gained through this project will help evaluate the utility of including adolescent family members in the treatment plan of their adult parents. Finally, the study will include an economic evaluation component to estimate the economic cost of each intervention and determine which condition is most cost effective. Intervention that includes a focus on parent-child interaction has the potential to enhance substance use reductions, reduce parent relapse, and improve family and emotional health among adults. Involvement of the adolescent offers the opportunity to increase the potential protection of a positive parent-child relationship which is shown to be associated with positive developmental outcomes. Narrative Given the reciprocal nature of parent-child interaction, involvement of the adolescent in their mother's substance abuse treatment plan might be associated with reductions in adult relapse and improvements in child functioning. These findings would support the assertion that focus on family dynamics in substance abuse treatment programs is an effective use of resources and an important target of intervention efforts. PUBLIC HEALTH RELEVANCE: Given the reciprocal nature of parent-child interaction, involvement of the adolescent in their mother's substance abuse treatment plan might be associated with reductions in adult relapse and improvements in child functioning. These findings would support the assertion that focus on family dynamics in substance abuse treatment programs is an effective use of resources and an important target of intervention efforts.

描述（由申请人提供）：许多研究人员研究了父母饮酒和吸毒对儿童结局的影响。这些研究得出的结论是，父母使用药物有可能对儿童的心理社会发展产生负面影响，使他们得不到充分的照顾和监督，阻碍他们的社会情感和认知发展，并/或影响他们成为药物使用者。考虑到一个双向的、系统的模型来理解物质使用问题的发展、维持和恢复，那么孩子也会影响父母的行为。家庭治疗一直表明，家庭成员参与药物使用者的治疗与更高水平的参与和保持治疗有关。许多研究报告说，在接受夫妻和家庭治疗的患者中，治疗前后药物使用和相关问题有所减少。虽然家庭治疗的随机临床试验涉及夫妻治疗的成人识别患者（IPs）和家庭治疗的青少年IPs，但本研究将评估涉及成人治疗寻求者治疗计划中青少年儿童的家庭系统干预。在目前的研究中，将参与寻求家中有青春期儿童（11-15岁）的成年母亲的酒精和药物治疗。所有的来访者将被随机分配到(1)以生态为基础的家庭治疗(EBFT) +家庭照例治疗（TAU），(2)以生态为基础的家庭治疗(EBFT) +办公室治疗（TAU），或(3)TAU +注意力控制。该方法的相对疗效将在基线后3、6、12和18个月进行评估。建议的改变机制（中介）的家庭治疗将进行评估。将调查性别、酒精或药物使用家族史以及原发性酒精与药物滥用（调节因子）对治疗反应的影响，以更好地了解干预措施。该研究还将调查，如果有的话，治疗参与和保留如何影响父母和青少年对治疗的反应。通过该项目获得的信息将有助于评估将青少年家庭成员纳入其成年父母的治疗计划的效用。最后，该研究将包括经济评估部分，以估计每种干预措施的经济成本，并确定哪种情况最具成本效益。包括关注亲子互动在内的干预措施有可能加强减少药物使用，减少父母复发，并改善成年人的家庭和情感健康。青少年的参与提供了机会，以增加对积极的亲子关系的潜在保护，这种关系已被证明与积极的发展结果有关。鉴于亲子互动的互惠性质，青少年参与其母亲的药物滥用治疗计划可能与成人复发的减少和儿童功能的改善有关。这些发现将支持在药物滥用治疗项目中关注家庭动态是对资源的有效利用和干预努力的重要目标的断言。公共卫生相关性：鉴于亲子互动的互惠性质，青少年参与其母亲的药物滥用治疗计划可能与成人复发的减少和儿童功能的改善有关。这些发现将支持在药物滥用治疗项目中关注家庭动态是对资源的有效利用和干预努力的重要目标的断言。