CRAFT for Parents of Adolescents in Outpatient Drug Treatment

美国有340多万青少年符合物质使用障碍的标准，但每年接受治疗的不到10%（美国卫生和公众服务部，2000年a，2000年b）。数据表明，多达60%的父母意识到并关注青少年的物质使用，但在没有帮助的情况下无法让他们接受治疗（Szapocznik等人，1988年），很少有研究探讨的方法，以帮助他们。 社区强化和家庭培训（CRAFT）在帮助家庭成员促进耐药成年人进入治疗方面有很好的经验支持，但尚未在药物滥用青少年父母的对照试验中进行测试。该项目将进行第一阶段行为治疗试点研究，以修改CRAFT（CRAFT-P）和Alanon/Naranon促进（ANF），用于关心治疗外青少年的父母。II期两组随机对照临床试验将比较CRAFT-P（n = 77）与ANF（n = 77），以确定青少年治疗进入的发生率是否存在显著差异。混合效应模型将用于确定参加CRAFT-P条件的参与者是否报告青少年物质使用和行为问题减少，以及育儿技能，社会功能，情绪和父母-青少年关系满意度的改善。 与所爱的物质滥用有关的问题影响着美国所有地区和所有收入水平的各种各样的美国家庭（哈德逊等人，2002; Kirby等人，2005年）。研究表明，大多数父母不仅有动机帮助他们的孩子解决他们的药物滥用问题，他们往往能够影响他们。不幸的是，很少有以社区为基础的治疗计划使用以家庭为基础的干预措施，这些干预措施可能有助于父母让孩子参与治疗，提高治疗保留率，提供有效的善后支持，并帮助中断孩子从药物使用到依赖的轨迹。由于父母可以独立于他们的孩子完成CRAFT，它不仅可以通过社区青少年药物滥用治疗传播给他们，还可以通过私人执业者和社区心理健康计划。此外，初步数据表明，如果有效，CRAFT-P也可以通过互联网直接传播给父母。鉴于第一个目标， 父母翻译研究中心的目的是为青少年物质使用者的父母提供有效的工具，这项研究是朝着这个方向迈出的重要一步。在我们的家长咨询委员会和其他地方与家长的互动表明，许多家长对这种类型的帮助感到绝望。

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.