Treatment Outcome with Runaway Adolescents II

描述（由申请人提供）： 无家可归青年的药物滥用是在校青年的两倍。离家出走的青年还报告说，与在校青年相比，与毒品有关的问题、心理健康问题和家庭问题的范围更广，严重程度更高。 离家出走者收容所人满为患，大多数收容所只侧重于危机干预，因此不具备治疗青年吸毒、酗酒、家庭和相关问题的设备。 到目前为止，很少有研究对这一人群的治疗效果进行了研究。 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FIRST奖励试验，检查了基于药物的家庭治疗（EBFT）对离家出走庇护所中滥用药物的离家出走青年的有效性。 据我们所知，这是第一次对这一人群的物质使用和心理健康治疗进行系统评估。 拟议的研究是一个第二阶段的临床试验，研究结果为三个理论上不同的干预措施，有经验的基础：社区强化方法，动机面试和EBFT。 将在治疗后3、6、9、12、18和24个月评估针对离家出走青少年的拟议干预措施的相对有效性和治疗变化过程，并将包括药物使用、家庭关系和青少年功能的测量。 研究的目的还将调查如何，如果有的话，治疗依从性和满意度介导青年对三种治疗的反应。 该项目还将评估与每种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.