Adolescent Involvement in Parental Substance Abuse Treatment: Evaluation of EBFT

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 研究得出结论，父母的物质使用有可能对儿童的心理社会产生负面影响， 剥夺他们的适当照顾和监督，阻碍他们的社会情感和 认知发展和/或影响他们成为物质使用者。考虑 理解物质发展、维持和恢复的双向系统模型 使用问题，这表明孩子也会影响父母的行为。家庭治疗一直以来 家庭成员参与药物使用者的治疗与更高的 参与和保留治疗的水平。许多研究报告治疗前后 在接受夫妻和家庭治疗的人中，药物使用和相关问题。随机分组时 家庭治疗的临床试验涉及夫妻治疗和青少年治疗中的成年确定患者（IP）。 在家庭治疗的IP，这项研究将评估家庭系统的干预，涉及青少年儿童， 成人寻求治疗者的治疗计划。在目前的研究中，寻求酒精和药物治疗 在家中生活的青少年儿童（11-15岁）的成年母亲将参与。所有客户将被随机分配 （1）家庭生态家庭治疗（EBFT）+常规治疗（TAU），（2） 办公室+ TAU，或（3）TAU +注意力控制。这种方法的相对有效性将在3，6， 基线后12和18个月。建议的改变机制（调解人）的家庭治疗将是 评估。性别、酒精或药物使用家族史以及 将调查主要酗酒与药物滥用（调节者），以更好地了解干预措施。的 研究还将探讨治疗参与和保留对父母和青少年的影响（如果有的话 对治疗的反应通过该项目获得的信息将有助于评估包括 青少年家庭成员在其成年父母的治疗计划。最后，研究将包括一个 经济评价部分，以估计每项干预措施的经济成本，并确定 条件最具成本效益。包括注重亲子互动在内的干预措施有可能 加强减少物质使用，减少父母复发，改善家庭和情绪健康 在成年人中。青少年的参与提供了机会，以增加对儿童的潜在保护。 积极的亲子关系与积极的发展成果有关。叙事 鉴于父母与子女互动的相互性质，青少年参与 他们母亲的药物滥用治疗计划可能与减少 成人复发和儿童功能的改善。这些发现将支持 在药物滥用治疗计划中关注家庭动力学的主张是一种 资源的有效利用和干预工作的重要目标。

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.