Concurrent Treatment of Substance Abuse and Child Maltreatment

描述（由申请人提供）：儿童虐待和父母药物滥用的共同发生是一个重大的公共卫生问题，对儿童，父母，家庭和整个社区造成严重后果。毫无疑问，需要有效的双重治疗的照顾者药物滥用和虐待儿童，但有一个缺乏控制的治疗结果的研究与药物滥用的父母谁从事虐待儿童。本研究探讨两种循证治疗-物质滥用的应急管理和路径三P亲职干预，以改善亲职和解决儿童虐待。主要研究是一项纵向，析因，随机对照试验，以衡量对结果变量的影响，包括父母药物滥用，父母相关功能（父母的做法，儿童虐待累犯，观察到的亲子互动），儿童适应，父母的艾滋病毒行为风险和父母的生活质量。样本包括儿童福利系统中的父母，他们正在与药物滥用问题作斗争，至少有一个2-8岁的孩子。研究设计和实施特征是严格的，并建立在足够的统计功效、保留意向治疗模型的仔细随机化程序、多个数据来源（即，毒理学样本、自我报告、观察、CPS数据、治疗记录和教师报告）、促进和验证治疗保真度的程序、以随机截距线性增长模型为中心的分析框架以及包括12个月和18个月随访评估。第二项研究借鉴了第一项研究的部分内容，重点关注双重治疗结果中个体变量的潜在相关因素或预测因素，如父母年龄和教育程度、社会经济劣势水平、心理困扰、家庭困难和法律的困难。该项目的结果将告知该领域，最先进的药物滥用和虐待儿童治疗方法的结合如何影响儿童福利系统中的家庭，并更接近于减少与这些严重的公共卫生问题相关的痛苦和社会成本。

DESCRIPTION (provided by applicant): The co-occurrence of child maltreatment and parental substance abuse is a major public health problem with serious consequences for children, parents, families, and the community at large. The need for effective dual treatment of caregiver substance abuse and child maltreatment is unquestionable, but there is a dearth of controlled treatment outcome studies with substance-abusing parents who have engaged in child maltreatment. This project examines two evidence-based treatments-Contingency Management for substance abuse and Pathways Triple P parenting intervention to improve parenting and address child maltreatment. The main study is a longitudinal, factorial, randomized controlled trial to gauge impact on outcome variables that include parental substance abuse, parenting-related functioning (parenting practices, child-maltreatment recidivism, observed parent-child interaction), child adjustment, parent's HIV behavioral risk, and parental quality of life. The sample includes parents in the child welfare system that is struggling with substance-abuse difficulties and has at least one child 2-8 years of age. The study design and implementation features are rigorous and build on adequate statistical power, careful randomization procedures preserving an intent-to-treat model, multiple sources of data (i.e., toxicology samples, self-report, observation, CPS data, treatment records, and teacher report), procedures for promoting and verifying treatment fidelity, an analytic framework centering on random-intercept linear growth models and inclusion of 12 and 18 month follow-up assessments. A second study draws on part of the first study and focuses on potential correlates or predictors of individual variabilty in outcome with the dual treatment, such as parent age and education, level of socioeconomic disadvantage, psychological distress, family difficulties, and legal difficulties. The results of tis project will inform the field about how well the combination of state-of-the-art treatments for substance abuse and child maltreatment impacts families in the child welfare system and move closer to reducing the misery and societal costs associated with these serious public health problems.