Process and Outcome Analysis of Group Treatment for Adolescent Substance Abuse

青少年药物滥用群体治疗的过程和结果分析

• 批准号: 8431207
• 负责人: TIMOTHY J OZECHOWSKI
• 金额: $ 23.36万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8431207
• 关键词: Address; Adolescent; Alcohol or Other Drugs use; Behavior; Behavioral; Child; Clinical; Clinical Psychology; Code; Cognitive; Data; Elements; Exhibits; Family; Group Therapy; Growth; Guidelines; Intervention; Literature; Meta-Analysis; Modeling; Motion; Outcome; Paper; Participant; Peer Group; Policies; Probability; Problem behavior; Process; Published Comment; Randomized Clinical Trials; Research; Risk; Series; Side; Source; Tobacco use; Treatment outcome; Variant; Videotape; adolescent drug use; adolescent substance abuse; base; clinical practice; contagion; group intervention; novel; peer; public health relevance; research study; substance abuse treatment

DESCRIPTION (provided by applicant): The proposed study is a secondary analysis of observed in-session clinical processes and their association with treatment outcomes among substance abusing adolescents participating in cognitive- behavioral group therapy. The specific aims of the proposed study are as follows. 1. Observe and code moment-by-moment behaviors occurring during videotaped sessions of adolescent group therapy conducted during a completed randomized clinical trial of adolescent substance abuse treatment. 2. For each adolescent participant, construct a set of two-way contingency tables summarizing critical adolescent-peer and adolescent-therapist behavioral exchanges or sequences occurring within and across group therapy sessions. 2a. Construct four contingency tables for each adolescent group therapy participant summarizing the transitional probabilities of specific observed sequences of adolescent- therapist and adolescent-peer behavioral interaction. 3. Analyze the observational sequential data using Kenny and colleagues' actor-partner independence model adapted for small groups (Kenny et al., 2002). 3a. Use the adolescent-therapist and adolescent-peer contingency table transitional probabilities as dependent variables in actor-partner independence growth curve models for small groups. 3b. Identify changes in adolescent-therapist and adolescent-peer behavioral sequences over the course of group treatment that differ between clusters of adolescents showing clinical improvement versus non-improvement controlling for adolescent- and group- specific sources of variation. The results of the proposed analysis are intended to illuminate clinical processes that characterize and distinguish between effective and ineffective adolescent treatment groups. Importantly, the actor-partner independence model can effectively tease apart adolescent-specific versus group-specific (i.e., "peer contagion") effects. This parsing of adolescent- and group-level sources of influence can directly address the questions of whether and to what extent peer contagion effects impact clinical outcomes in adolescent group interventions. Furthermore, the proposed analysis will pinpoint specific types of observed behavioral exchanges through which peer contagion effects may influence adolescent drug use outcomes. Information along these lines can inform clinical guidelines for facilitating positive clinical outcomes in adolescent group treatment.

描述（由申请人提供）：拟议的研究是对观察到的疗程中临床过程及其与参与认知行为团体治疗的药物滥用青少年的治疗结果的关联的二次分析。本研究的具体目标如下。 1. 在完成的青少年药物滥用治疗随机临床试验中进行的青少年团体治疗录像中，观察并记录每时每刻发生的行为。 2. 对于每个青少年参与者，构建一组双向列联表，总结在团体治疗期间和之间发生的关键青少年同伴和青少年治疗师行为交换或顺序。 2a.为每个青少年团体治疗参与者构建四个列联表，总结青少年治疗师和青少年同伴行为互动的特定观察序列的过渡概率。 3. 使用 Kenny 及其同事的适用于小组的演员-伙伴独立模型（Kenny et al., 2002）分析观察序列数据。 3a.使用青少年治疗师和青少年同侪列联表过渡概率作为小群体演员-伴侣独立增长曲线模型中的因变量。 3b.确定在团体治疗过程中青少年治疗师和青少年同伴行为序列的变化，这些变化在显示临床改善与未改善的青少年群体之间有所不同，并控制了青少年和群体特定的变异来源。拟议分析的结果旨在阐明表征和区分有效和无效青少年治疗组的临床过程。重要的是，演员-伴侣独立模型可以有效地区分青少年特定效应和群体特定效应（即“同伴传染”）。对青少年和群体层面影响源的解析可以直接解决同伴传染效应是否以及在多大程度上影响青少年群体干预的临床结果的问题。此外，拟议的分析将查明观察到的行为交流的特定类型，通过这些行为交流，同伴传染效应可能会影响青少年吸毒结果。这些信息可以为临床指南提供参考，以促进青少年团体治疗的积极临床结果。