DEVELOPING A CULTURALLY ROOTED ADOLESCENT FAMILY THERAPY

描述：（申请人摘要） 本申请建议进行第一阶段治疗开发研究， 目标是西班牙裔吸毒青少年及其家庭，他们有独特的 价值观和文化适应/移民相关的生活经历，可以 显示直接影响参与，保留，药物使用， 药物治疗的功效/有效性。虽然文化的重要性 相关因素已被普遍承认，治疗模式已失败 将特定的文化衍生干预与特定的治疗变化联系起来 药物滥用治疗的核心机制。文化上的模式， 扎根青少年家庭治疗（CRAFT），将包括心理教育 模块直接解决这些文化相关因素，旨在 加强治疗联盟，促进家庭治疗工作的转变 机制等 拟议的模型分为三个目标，每个目标旨在产生调查结果 为后来AIM的工作提供了信息。AIM I包括一项基础研究 调查特定移民的独立贡献， 文化适应相关的压力源在破坏家庭治疗机制的 变化AIM II包括：1）开发一个“工作”CRAFT手册，2） 一组旨在增强对家庭变化影响的单一案例实验 机制和CRAFT的可行性/可接受性，3）手动化 完善的CRAFT模型，以及4）开发依从性检查表， 治疗师选择和培训指南。AIM III侧重于试点测试 使用小型随机试验的手动干预的有效性 受试者随机接受CRAFT或家庭治疗的设计， 往常 AIM I的基础研究分析和AIM II的单个病例分析 实验系列旨在提供数据， CRAFT干预的改进。随机试验的AIM III分析 旨在确定所需分析的效应量 在II期功效试验中，即，高级别管理委员会关于成果的报告（药物滥用和其他 青少年犯罪问题）;假设的变化机制（父母）的HLM分析 实践，父母-青少年依恋，父母-生态互动， 治疗联盟）。此外，将使用临床意义分析 确定干预措施效果最好的亚组， 使用分层线性模型分析，将用于比较 成功和失败之间的作用机制的变化轨迹 不成功的案例

DESCRIPTION: (Applicant's Abstract) This application proposes to conduct a Stage I treatment development study that targets Hispanic drug abusing adolescents and their families, who have unique values and acculturation/ immigration related life experiences that can be shown to directly impact engagement, retention, drug use, and the efficacy/effectiveness of drug treatment. Although the importance of culture related factors have been generally acknowledged, treatment models have failed to link specific culturally derived interventions to specific treatment change mechanisms central to drug abuse treatment. The proposed model, Culturally Rooted Adolescent Family Therapy (CRAFT), will include psycho-educational modules that directly address these culture related factors and are designed to enhance treatment alliance and facilitate the work of family therapy change mechanisms. The proposed model is divided into three AIMs each designed to produce findings that inform the subsequent AIM's work. AIM I consists of a basic research study that investigates the independent contribution of specific immigration and acculturation-related stressors in disrupting family therapy mechanism of change. AIM II consist of: 1) the development of a "working" CRAFT manual, 2) a set of single-case experiments designed to enhance the impact on family change mechanism and CRAFT's feasibility/acceptability, 3) the manualization of the refined CRAFT model, and 4) the development of an adherence checklist and therapist selection and training guidelines. AIM III focuses on pilot testing the efficacy of the manualized intervention using a small randomized trial design in which subjects are randomized to either CRAFT or Family Therapy as Usual. AIM I analyses of the basic research study and the AIM II single-case experiments series are intended to provide data that will inform the refinements of the CRAFT intervention. AIM III analyses of the randomized trial are designed to determine effect sizes for the analyses that would be required in a Stage II efficacy trial, viz., HLM on outcomes (drug abuse and other delinquency problems); HLM analyses of postulated change mechanisms (parent practices, parent-adolescent attachment, parent-ecology interactions, and therapeutic alliance). Moreover, analyses of clinical significance will be used to identify subgroups for whom the interventions work best, and growth curve analyses using Hierarchical Linear Modeling, will be used to compare the trajectory of change in mechanisms of action between successful and unsuccessful cases.