CRAFT for Parents of Adolescents in Outpatient Drug Treatment

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Over 3.4 million adolescents in the U.S. meet criteria for a substance use disorder, but less than 10% enter treatment each year (US DHHS, 2000a, 2000b). Data suggest that as many as 60% of parents who are aware and concerned about their adolescent's substance use are unable to get them into treatment without assistance (Szapocznik et al., 1988) and very little research has examined methods to help them. Community Reinforcement and Family Training (CRAFT) has good empirical support for helping family members foster treatment entry of treatment-resistant adults, but it has not been tested in a controlled trial with parents of substance-abusing adolescents. This project will conduct a Stage I behavior therapy pilot study to modify CRAFT (CRAFT-P) and Alanon/Naranon Facilitation (ANF) for use with parents who are concerned about an out-of-treatment adolescent. A Stage II two-group randomized controlled clinical trial will then compare CRAFT-P (n=77) vs ANF (n=77) to determine if the occurrence of adolescent treatment entry significantly differs. Mixed effects models will he used to determine if participants who are enrolled in the CRAFT-P condition report reductions in adolescent substance use and behavior problems, and improvements in parenting skills, social functioning, mood, and in parent-adolescent relationship satisfaction. Problems related to a substance abusing loved affect a wide variety of American families, in all areas of the country and at all income levels (Hudson et al., 2002; Kirby et al., 2005). Research suggests that most parents not only are motivated to help their children to address their substance abuse problems, they often are able to influence them. Unfortunately, few community-based treatment programs use empirically-based family interventions that are likely to help parents engage their child in treatment, improve treatment retention, provide effective aftercare support, and help interrupt their child's trajectory from substance use to dependence. Since parents can complete CRAFT Independent of their child, it could be disseminated to them not only through community-based adolescent substance abuse treatments, but also through private practitioners and community-based mental health programs. Moreover, preliminary data suggest that, if effective, CRAFT-P could also be disseminated directly to parents via the internet. Given that the first goal of the Parents Translation Research Center is to provide effective tools for parents of substance using adolescents, this study represents an important step In that direction. Interactions with parents on our Parent Advisory Board and elsewhere suggest that many parents feel desperate for this type of help.