Treatment Outcome with Runaway Adolescents II

描述(由申请人提供)： 无家可归的青少年滥用药物的人数是在校青少年的两倍。失控青年还报告说，与在校青年相比，与物质有关的问题、心理健康和家庭问题的范围更广、更严重。离家出走的收容所人满为患，大多数收容所只专注于危机干预，因此没有能力治疗青少年的毒品、酒精、家庭和相关问题。到目前为止，很少有研究检查对这一人群的治疗效果。鉴于健康和心理问题的高风险及其相关的长期社会成本，迫切需要确定有效的干预措施。PI通过第一阶段的第一次获奖试验，测试了基于生态的家庭治疗(EBFT)的有效性，其中包括在离家出走的收容所中滥用物质的离家青少年。据我们所知，这是第一次对这一人群的药物使用和精神健康治疗进行系统评估。这项拟议的研究是一项第二阶段的临床试验，考察了三种理论上不同的干预措施的结果，这些干预措施具有经验基础：社区强化方法、激励性访谈和EBFT。针对失控青少年的拟议干预措施的相对有效性和治疗变化过程将在治疗后3、6、9、12、18和24个月进行评估，并将包括药物使用、家庭关系和青少年功能的衡量标准。研究目的还将调查治疗依从性和满意度如何调节年轻人对这三种治疗的反应。该项目还将评估与每项治疗干预措施相关的成本节约潜力。

DESCRIPTION (provided by applicant): Substance abuse among homeless youth is twice that of school youth. Runaway youth also report a broader range and higher severity of substance-related, mental health and family problems relative to school youth. Shelters for runaways are overcrowded, and most shelters focus exclusively on crisis intervention, and are therefore not equipped to treat youth for drug, alcohol, family and related problems. To date, few studies have examined treatment effectiveness with this population. Given the high level of risk for health and psychological problems and their associated long-term social costs, there is a great need for identifying potent interventions. The PI examined the effectiveness of Ecologically-Based Family Therapy (EBFT) with substance abusing runaway youth in runaway shelters, through a Stage I FIRST award trial. To our knowledge, this is the first systematic evaluation of a substance use and mental health treatment with this population. The proposed study is a Stage II clinical trial examining outcome for three theoretically distinct interventions that have empirical bases: Community Reinforcement Approach, Motivational Interviewing and EBFT. The relative effectiveness and therapeutic change process of the proposed interventions for runaway youth will be evaluated 3, 6, 9, 12, 18 and 24 months after treatment, and will include measures of substance use, family relations, and adolescent functioning. Study aims also will investigate how, if at all, treatment compliance and satisfaction mediate youth response to the three treatments. This project will also evaluate the cost-savings potential associated with each treatment intervention.