DEVELOPING FAMILY THERAPY FOR BPD DRUG ABUSING YOUTHS

该应用程序建议进行阶段1治疗开发 针对药物滥用青少年的一种亚型的研究 临界性人格障碍(BPD)，已被证明是 尤其难以治疗。拟议的干预措施，边缘 青少年家庭治疗(BAFT)融合了两个成功的传统 干预研究：药物滥用的结构性家庭治疗 具有个人技能的青少年构建源自 Martha Linehan与BorderLine合作的作品。这项拟议的研究存在分歧 分成两个阶段。第一阶段是BAFT开发阶段，包括： 开发一本集个人和家庭于一身的“工作”BAFT手册 基于存档录像带的组件，与三个 案例以确定如何提高可接受性和可行性 方式，并加强baft干预措施的重点 BPD药物滥用家族特有的变化机制 并制定了一本精致的baft手册，一本 治疗师的选择和培训，以及遵守程度的衡量标准。第二阶段 由24个病例的随机先导研究组成，使用对照 情况包括向社区机构转介。分析是 旨在提供信息，用于确定 第二阶段疗效试验所需的分析，即 关于结果的MANOVA(药物滥用、边缘行为、行为问题、 和个人技能发展的标志)；假设的MANOVA 行动机制(家庭互动模式， 消极/积极，以及治疗联盟)。此外，分析了 具有临床意义的亚组将被用于识别其 干预效果最好，增长曲线分析将用于 将行动机制的变化过程与成功的 和不成功的案例。

This application proposes to conduct a Stage 1 treatment development study targeting a subtype of drug abusing adolescent, those with Borderline Personality Disorder (BPD), that has proved to be particularly difficult to treat. The proposed intervention, Borderline Adolescent Family Therapy (BAFT) integrates two successful traditions in intervention research: Structural Family Therapy for drug abusing adolescents with individual skills building components derived from the work of Marsha Linehan with Borderlines. The proposed study is divided into two phases. Phase I is the BAFT development phase including: developing a "working" BAFT manual integrating individual and family components based on archived videotapes, conducting BAFT with three cases to determine ways of enhancing feasibility and acceptability of the modality, and enhancing the focus of BAFT interventions on mechanisms of change specific to families of BPD drug abusing adolescents; and developing a refined BAFT manual, a manual for therapist selection and training, and a measure of adherence. Phase II consists of a randomized pilot study of 24 cases using a control condition comprised of referrals to community agencies. Analyses are intended to provide information for determining effect sizes for the analyses that will be required in a Stage II efficacy trial, viz., MANOVAs on outcomes (drug abuse, borderline behaviors, conduct problems, and markers of individuals skills development); MANOVAs on postulated mechanisms of actions (family patterns of interactions, negativity/positivity, and therapeutic alliances). Moreover, analyses of clinical significance will be used to identify subgroups for whom the intervention works best, and growth curve analyses will be used to compare the course of change in mechanisms of action between successful and unsuccessful cases.