Vocational Outcomes for Youth With Substance Abuse Problems and High HIV Risk

描述(由申请人提供)：这项拟议的研究旨在测试一项有前景的战略，以改善已发现的药物滥用问题或此类问题的高危青少年的职业和就业结果。从个人和社会的角度来看，这些年轻人都有很高的长期不良结果的风险。为期6个月的就业计划，项目工艺(以社区恢复学徒为重点的培训)，旨在培训和安置高危青年在住宅建筑行业就业。重要的是，Craft由住宅建筑商协会运营，该协会是全国住宅建筑商协会的教育分支机构，与全国几乎所有地方建筑协会都有正式联系。在整个培训过程中，技工参与者与当地雇主建立了联系。CREATE的初始测试使用康涅狄格州现有的多系统治疗(MST，Henggler等人，1998)计划作为评估平台，在验证的早期阶段具有几个优势(例如，减少“噪音”，提供综合服务，治疗物质使用)。具体地说，120名15至18岁的青少年出现严重的反社会行为，并发现有药物滥用问题或有此类问题的高风险，将被随机分为手工和教育照常(EAU)条件。在这两种情况下，根据标准的MST方案，治疗师将支持职业指导员(在手艺条件下)或学校人员(在EAU条件下)为提高青年学校和职业表现所做的努力。后续将在项目完成后的两年内进行。这项研究有三个主要目的。目标1：评估手工艺提高参与者就业和收入的能力。据推测，在后处理和后续工作中，手工艺参与者的就业率(以受雇天数衡量)比其eau同行的小时工资高得多。目的2：研究手艺与物质使用的减少和心理社会功能的增加之间的关系。预计在两种治疗条件下的参与者在治疗期间都会在心理社会功能方面取得进展。由于参与就业预计将促进心理社会结果的进一步改善，因此假设手工艺参与者在治疗后经历额外的收益，而EAU参与者被假设仅保持治疗收益。目的3：评估可能影响手工艺效果的因素(如犯罪历史、症状学)。对于处于工艺条件下的参与者，还将检查剂量效应。

DESCRIPTION (provided by applicant): The proposed study aims to test a promising strategy for improving vocational and employment outcomes for adolescents with identified substance abuse problems or at high risk for such. These youths are at very high risk for poor long-term outcomes from both personal and societal perspectives. The 6- month employment program, Project CRAFT (Community Restitution Apprenticeship-Focused Training), is designed to train and place high-risk youths in employment within the residential building industry. Importantly, CRAFT is operated by the Home Builders Institute, which is the educational arm of the National Association of Home Builders and has formal linkages with virtually all local building associations across the nation. CRAFT participants are connected with local employers throughout the course of training. This initial test of CRAFT uses existing multisystemic therapy (MST, Henggeler et al., 1998) programs in Connecticut as the platform for the evaluation, which has several advantages at this early stage of validation (e.g., reducing "noise," providing integrated services, treating substance use). Specifically, 120 15- to 18-year old adolescents presenting serious antisocial behavior and with identified substance abuse problems or at high risk for such will be randomized to CRAFT versus education as usual (EAU) conditions. In both cases, the therapists, per standard MST protocols, will be supporting the efforts of the vocational instructor (in the CRAFT condition) or school personnel (in the EAU condition) at enhancing youth school and vocational performance. Follow-up will be conducted through 2 years post program completion. This study has three primary aims. Aim 1: To evaluate the capacity of CRAFT to improve participant employment and earnings. CRAFT participants are hypothesized to have considerably higher rates of employment (measured by days employed) at a higher hourly wage than their EAU counterparts at posttreatment and follow-up. Aim 2: To examine the extent to which CRAFT is associated with decreases in substance use and increases in psychosocial functioning. Participants in both treatment conditions are expected to demonstrate gains in psychosocial functioning during treatment. Because participation in employment is expected to facilitate further improvement in psychosocial outcomes, CRAFT participants are hypothesized to experience additional gains following treatment while EAU participants are hypothesized to only maintain treatment gains. Aim 3: To evaluate possible moderators (e.g., criminal history, symptomatology) of CRAFT effects. For participants in the CRAFT condition, dosage effects will also be examined.