TRANSPORTING FAMILY THERAPY TO ADOLESCENT DAY TREATMENT

有效的药物滥用治疗方法已经开发出来，它们在减少或消除药物使用以及影响已知形成和维持药物滥用生活方式的一系列复杂因素方面显示出相当大的希望。 然而，基于研究的疗法往往仍受研究背景的限制。 这种情况仍然存在，而行为疗法的研究进展发生在重要的药物治疗专业。 针对青少年药物滥用的基于家庭的干预措施已在定义明确的治疗手册中得到阐述，特定的治疗方法已在严格的对照试验中证明了有效性，因此，这些模式随时可以在各种临床环境中进行测试。 尽管有潜力，但这些干预措施中的大多数都是作为独立的门诊干预措施开发的，很少有人尝试在现实世界的治疗环境中测试这些治疗。 青少年药物滥用治疗研究人员几乎忽略了一个临床环境，即日间治疗。 该申请提出了此类第一批调查之一。 我们试图评估的效果和持久性运输和整合以研究为基础的，有效的，以家庭为中心的干预（多维家庭治疗[MDFT]）到一个有代表性的，门诊，吸毒青少年的日间治疗计划。 我们提出两个主要目标：（1）评价技术转让干预对ADTP临床实践和治疗/组织氛围的影响和持久性，（2）评价这些变化对临床结局的影响。 这项为期4年的研究分为4个阶段。I期：基线（10个月）不会有技术转让。 将评估日间治疗计划和客户结果的多个方面。 第二阶段：培训（4个月），日间治疗方案的工作人员将接受为期2个月的研究开发的家庭治疗模式的培训。 第三阶段：实施（10个月）方案工作人员将继续在家庭模式下接受定期监督。 将在第一阶段评估的相同计划和客户成果：基线将在实施阶段评估。 在最后阶段，阶段IV：耐久性（10个月），技术转让将完成（监督将撤销）。 我们将再次衡量在第一阶段基线和第三阶段实施中衡量的相同计划和客户成果。本研究的受试者将包括150名男性和女性青少年（13-17岁）及其家庭。 样本将主要是少数民族（大约60%的西班牙裔，30%的非洲裔美国人和10%的高加索人），几乎所有人都将有当前或过去的少年司法参与。

Efficacious drug abuse treatments have been developed, and they show considerable promise in reducing or eliminating drug use and impacting the complex set of factors known to develop and maintain drug abusing lifestyles. Too frequently, however the research-based therapies remain research-context bound. This circumstance persists while behavioral therapy research advances have occurred in important drug treatment specialties. Family- based interventions for adolescent drug abuse have been articulated in well-defined treatment manuals, particular treatments have demonstrated efficacy in rigorous controlled trials, and thus, these models stand ready to be tested in diverse clinical settings. Despite their potential, most of these interventions have been developed as stand alone outpatient interventions and very few attempts have been made to test these treatments in real-world treatment environments. One clinical setting that has been virtually ignored by adolescent drug abuse treatment researchers has been day treatment. This application proposes one of the first investigations of its kind. We seek to evaluate the effects and durability of transporting and integrating a research-based, efficacious, family-focused intervention (Multidimensional Family Therapy [MDFT]) into a representative, outpatient, day treatment program for drug abusing adolescents. We propose two major aims: (1) to evaluate the impact and durability of a technology transfer intervention on clinical practices and therapeutic/organizational climate in the ADTP, and (2) to evaluate the effects of these changes on clinical outcome. The 4-year study is divided into 4 phases. During Phase I: Baseline (10 mo.) there will be no technology transfer. Multiple aspects of the day treatment program and client outcomes will be assessed. During Phase II: Training (4 mo.), day treatment program staff will receive 2 months of training in the research-developed family therapy model. In Phase III: Implementation (10 mo.) program staff will continue to be regularly supervised in the family-based model. The same program and client outcomes that will be assessed during the Phase I: Baseline will be assessed during the Implementation Phase. In the final phase, Phase IV: Durability (10 mo.), the technology transfer will be complete (supervision will be withdrawn). Once again, we will measure the same program and client outcomes measured in Phase I Baseline and Phase III Implementation. Subjects for the study will consist of 150 male and female adolescents (ages 13-17) and their families. The sample will be primarily minority (approximately 60 percent Hispanic, 30 percent African American, and 10 percent Caucasian), and virtually all will have current or past juvenile justice involvement.