TREATMENT FOR DEPRESSED, SUBSTANCE ABUSING ADOLESCENTS

药物滥用是一个主要的公共卫生问题，与 对青少年造成破坏性或危及生命的后果。很多物质 虐待青少年出现一种或多种共病精神障碍， 其中最常见的是抑郁症。在开发有效的 因此，有必要对心理社会物质滥用进行治疗 解决共病障碍。社会认知与家庭研究 特征、预防和治疗表明认知能力 行为干预可能对抑郁症的治疗有效， 滥用药物的青少年。这个项目的第一个具体目标是 在手册中开发和实施组合的群体认知 行为疗法(GCBT)和家庭认知行为疗法(FCBT) 抑郁、滥用药物的青少年。第二个目标是 论证实施GCBT和FCBT相结合的可行性 并为随后的受控试验提供试点数据 结果研究。第三个目标是论证 培训药物滥用咨询师和治疗人员如何使用这种药物 治疗。第四个目标是评估药物滥用的变化和 治疗过程中出现抑郁。 为了实现这些目标，十个步骤的手动开发和 提出了中试试验方案。在第一年，初始手册将是 在文献回顾和咨询的基础上开发的。在第二个 年，首席调查员和联合调查员将治疗六名 案件，有录像带监督和专家咨询。在进一步 手册修订，药物滥用顾问和治疗师将 在第二年接受培训，并将在监督下治疗12例 第三年。治疗将包括16周的GCBT和FCBT。 诊断性访谈和自我报告措施将在 并在治疗后。数据分析将解决治疗完整性问题， 患者满意度和诊断状态的变化，自我报告 药物滥用和抑郁，以及社会认知和家庭 变量。为了计划后续的结果研究，电力分析将 使用。试点数据将包括患者特征、遵从性、 出勤率和流失率。

Substance abuse is a major public health problem associated with destructive or life-threatening outcomes in adolescents. Many substance abusing adolescents present with one or more co-morbid mental disorders, of which one of the most common is depression. In developing effective psychosocial substance abuse treatments, therefore, it is necessary to address co-morbid disorders. Studies of social cognitive and family characteristics, prevention and treatment suggest that cognitive behavioral interventions may be effective in the treatment of depressed, substance abusing adolescents. The first specific aim of this project is to develop and to operationalize in manuals a combined Group Cognitive Behavior Therapy (GCBT) and Family Cognitive Behavior Therapy (FCBT) for depressed, substance abusing adolescents. The second aim is to demonstrate the feasibility of conducting combined GCBT and FCBT with these adolescents and to provide pilot data for a subsequent, controlled outcome study. The third aim is to demonstrate the feasibility of training substance abuse counselors and therapies in the use of this treatment. The forth aim is to evaluate change in substance abuse and depression during treatment. To accomplish these aims, a ten step sequence of manual development and pilot testing is proposed. In the first year, initial manuals will be developed, based on literature review and consultation. In the second year, the Principal Investigator and Co-Investigator will treat six cases, with videotape supervision and expert consultation. After further manual revision, substance abuse counselors and therapists will be trained in year two and will conduct supervised treatment of 12 cases in year three. Treatment will consist of 16 weeks of GCBT and FCBT. Diagnostic interviews and self-report measures will be completed before and after treatment. Data analyses will address treatment integrity, patient satisfaction, and changes in diagnostic status, self-reported substance abuse and depression, and social cognitive and family variables. To plan a subsequent outcome study, power analysis will be used. Pilot data will include patient characteristics, compliance, attendance, and attrition rates.