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孩子结局的影响。这些 研究得出结论，父母使用药物有可能对儿童的心理社会产生负面影响 发展，剥夺他们足够的照顾和监督，阻碍他们的社会情感和 认知发展和/或影响他们也成为物质使用者。考虑到一个 理解物质发展、维持和回收的双向、系统模型 使用问题，那么孩子也会影响父母的行为。家庭治疗一直是 表明家庭成员参与药物使用者的治疗与更高的 治疗中的参与度和保留率。许多研究报告治疗前和治疗后减少了 接受夫妻和家庭治疗的人中的药物使用和相关问题。在随机化时 家庭治疗的临床试验涉及夫妇治疗中的成人识别患者(IP)和青少年 在家庭治疗中，这项研究将评估一项涉及青春期儿童的家庭系统干预 成人治疗寻求者的治疗计划。在目前的研究中，酒精和药物治疗寻求 居住在家中的青春期儿童(11-15岁)的成年母亲将被聘用。所有客户端都将随机进行 (1)以生态为基础的家庭治疗(EBFT)在家庭照常治疗(TAU)，(2)EBFT在 办公室TAU，或(3)TAU注意控制。这种方法的相对效果将在3，6， 基线后12个月和18个月。家庭治疗的拟议改变机制(调解人)将是 已评估。作为性别、酒精或药物使用家族史的不同治疗反应，以及 将对初级酒精与药物滥用(主持人)进行调查，以更好地了解干预措施。这个 研究还将考察治疗参与度和留存对父母和青少年的影响 对治疗的反应。通过该项目获得的信息将有助于评估包括 将青少年家庭成员纳入其成年父母的治疗计划。最后，这项研究将包括 经济评估部分，用于估计每次干预的经济成本并确定 条件是最具成本效益的。包括关注亲子互动的干预措施有可能 加强减少药物使用，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 积极的亲子关系，这被证明与积极的发展结果有关。叙述性 鉴于亲子互动的互惠性质，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改善。这些发现将支持 在药物滥用治疗计划中关注家庭动态的断言是一种 资源的有效利用和干预努力的一个重要目标。

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.