Group Community Reinforcement Training for Parents of Treatment-Elusive Youth

为难以接受治疗的青少年家长提供团体社区强化培训

• 批准号: 8526163
• 负责人: Erica Miller Finstad
• 金额: $ 33.28万
• 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: 2013-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8526163
• 关键词: Address; Adolescent; Adoption; Alcohol or Other Drugs use; Behavior; Chronic; Clinical Trials; Clinical effectiveness; Communities; Cost Effectiveness Analysis; Data; Drug Addiction; Drug abuse; Drug usage; Educational process of instructing; Emotional; Family; Family member; Fostering; Group Psychotherapy; HIV; HIV risk; Health; Healthcare; Illicit Drugs; Impotence; Individual; Institution; Intervention; Investigation; Justice; Learning; Legal system; Link; Mediating; Modality; Modeling; Motivation; Outcome; Parents; Pharmaceutical Preparations; Population; Procedures; Process; Psychological reinforcement; Public Health; Randomized; Recommendation; Recruitment Activity; Relative (related person); Research; Research Training; Resistance; Resources; Risk; Risk Behaviors; Sampling; Schools; Services; Sexually Transmitted Diseases; Social isolation; Social support; Source; System; Testing; Time; Training; Treatment outcome; United States; United States Substance Abuse and Mental Health Services Administration; Work; Youth; addiction; adolescent drug abuse; adolescent drug use; base; community organizations; community setting; cost; cost effective; design; drug abuser; effective intervention; experience; financial relationship; high risk; improved; innovation; juvenile justice system; novel; parental involvement; peer; pressure; prevent; public health relevance; response; skill acquisition; sobriety; social; substance abuser; success; successful intervention

DESCRIPTION (provided by applicant): Adolescent drug abusers are particularly at high risk for a host of problems, such as HIV-related behaviors, for themselves and their families. Unfortunately, very few youth with drug abuse or dependence in the United States receive treatment. This population of untreated youth represents a massive "treatment gap" in adolescent health care that renders impotent a potentially important avenue for preventing chronic drug abuse and related difficulties. While the juvenile justice system represents a prominent path linking drug-abusing adolescents with treatment services, only one fifth of the adolescents who need treatment each year are apprehended by the legal system. As a result, large numbers of youth in need of treatment go undetected by the most typical entry way into the system. Moreover, the lack of motivation for treatment characterizing most adolescent drug abusers significantly decreases the likelihood these youth will enter treatment, barring mandates from the legal system or other social institutions. These adolescents represent a sizeable and, heretofore, overlooked population of treatment-elusive youth. Efficacy studies have demonstrated that Community Reinforcement Training (CRT), an approach that involves teaching parents how to engage their youth into treatment can work to recruit 60-80% of these treatment-elusive youth. The proposed study will improve upon our prior work by using a group format to provide a less costly procedure for engaging youth into treatment to make it more portable to treatment agencies, schools, juvenile justice, and other community organizations seeking to offer support to parents or engage youth in treatment, thus significantly increasing the adoption and sustainability of the approach. The proposed pilot research will examine the efficacy of the group format (G-CRT) for helping parents engage their unmotivated, resistant youth in treatment compared to the traditional individual format (I-CRT). Parents (n = 60) will be randomly assigned to G-CRT or to I-CRT. We will evaluate the differential efficacy of G-CRT, relative to I-CRT, on rates of adolescent engagement in treatment. We expect that G-CRT compared to I-CRT will also be associated with greater parent encouragement of adolescent sobriety, perceived social support, and family functioning. We also predict that changes on these process variables will predict increased success in engaging adolescents. We will also examine treatment outcomes for youth engaged in CBT as a function of parental involvement in G-CRT or I-CRT. We predict enhanced support received by parents in G-CRT will result in greater reductions in drug use and lower levels of HIV-risk behaviors, outcomes hypothesized to be mediated by motivation to change and session attendance. Finally, we will conduct an informal cost-effectiveness analysis to derive preliminary estimates of the relative costs of each treatment modality per outcome unit and hypothesize that G-CRT will be more cost effective than I-CRT by virtue of having higher clinical effectiveness and lower costs. Successful outcomes here will provide the basis for a full clinical trial with larger samples.

描述（由申请人提供）：青少年药物滥用者特别容易出现一系列问题，如艾滋病毒相关行为，对他们自己和他们的家庭。不幸的是，在美国，很少有滥用或依赖药物的青年接受治疗。这一未接受治疗的青少年群体是青少年保健中的一个巨大“治疗缺口”，使阳痿成为预防慢性药物滥用和相关困难的一个潜在的重要途径。虽然少年司法系统是将吸毒青少年与治疗服务联系起来的一条重要途径，但每年需要治疗的青少年中只有五分之一被法律的系统逮捕。因此，大量需要治疗的青年通过最典型的进入系统的方式没有被发现。此外，大多数青少年药物滥用者缺乏治疗的动机，这大大降低了这些青年接受治疗的可能性，除非得到法律的系统或其他社会机构的授权。这些青少年代表了一个相当大的，迄今为止，被忽视的人口治疗难以捉摸的青年。疗效研究表明，社区强化训练（CRT），一种涉及教导父母如何让他们的年轻人参与治疗的方法，可以招募60-80%的这些难以治疗的年轻人。拟议的研究将改进我们以前的工作，采用小组形式，提供一个成本较低的程序，让青少年参与治疗，使其更便于治疗机构，学校，少年司法和其他社区组织寻求为父母提供支持或让青少年参与治疗，从而显着提高采用和可持续性的方法。拟议的试点研究将检查小组格式（G-CRT）的有效性，以帮助父母吸引他们的无动力，抵抗青年的治疗相比，传统的个人格式（I-CRT）。父母（n = 60）将被随机分配至G-CRT或I-CRT组。我们将评估G-CRT相对于I-CRT在青少年参与治疗率方面的不同疗效。我们预计，G-CRT相比，I-CRT也将与更大的青少年清醒，感知社会支持和家庭功能的父母鼓励。我们还预测，这些过程变量的变化将预测参与青少年的成功率增加。我们还将研究青少年参与CBT作为父母参与G-CRT或I-CRT的功能的治疗结果。我们预测，加强支持G-CRT的父母将导致更大的减少药物使用和降低艾滋病毒风险行为的水平，结果假设是由动机改变和会议出席介导。最后，我们将进行一个非正式的成本效益分析，以得出每个结果单位的每种治疗方式的相对成本的初步估计，并假设G-CRT将比I-CRT具有更高的临床有效性和更低的成本效益。成功的结果将为更大样本的完整临床试验提供基础。