MENTORED PATIENT-ORIENTED RESEARCH CAREER DEVELOPMENT

描述（由申请人提供）： 本申请概述了一个广泛的培训和研究计划，在整个五年的奖励延伸。培训平原包括三个首要的学习目标：（1）熟悉有效的青少年药物滥用门诊治疗;（2）发展知识和经验进行随机临床试验;（3）学习和利用国家的最先进的统计方法来评估治疗结果。培训计划详细说明了候选人将用于实现这些目标的具体目标。 申请中描述的研究计划将适应和评估多系统治疗（MST），这是一种针对行为和情感障碍的青少年的强化家庭和家庭治疗计划，具有即将面临的风险，用于治疗患有合并症的青少年SUD和在门诊环境中内化心理健康诊断。研究计划将分四个阶段进行。在第一阶段，申请人将调整MST治疗手册，监督手册，质量保证协议和治疗师培训协议，用于门诊设置，以治疗双重诊断的青年。在第二阶段，申请人将在社区青少年门诊诊所对10名青少年进行改编手册、质量保证系统和治疗师培训协议的试点测试。根据接受治疗的青少年和家庭成员、诊所管理人员、治疗师和MST专家监督员的反馈，将在第三阶段对手册和质量保证系统进行完善和修订。最后，第四阶段将包括对40名双重诊断的青年进行试点研究，随机分配到治疗条件下，其中20人接受门诊MST，20人接受常规门诊服务。将在治疗前、入组后6个月和入组后12个月进行全面的多方法、多系统评估，以评价治疗有效性。 研究计划包括三个具体目标： 具体目标1 本研究的主要目的是适应和测试多系统治疗用于门诊设置，以治疗诊断为物质使用障碍和共病内化障碍的青年。 具体目标2 除了改进的心理学，目前的研究旨在测试门诊MST的有效性，以改善青年在其他领域的功能，成功的青少年发展。 具体目标3 建议研究的最终目的，是提供较一般社会服务更能为消费者接受的服务。

DESCRIPTION (provided by applicant): The present application outlines an extensive training and research program that extends throughout the five years of the award. The training plain includes three overarching learning objectives: (1) Gain familiarity with validated outpatient treatments for adolescent substance abuse; (2) Develop knowledge of and experience with conducting randomized clinical trials; and (3) Learn and utilize state-of-the-art statistical methods for evaluating treatment outcomes. The Training Plan details the specific goals the candidate will use to meet these objectives. The Research Plan described in the application will adapt and evaluate Multisystemic Therapy (MST), an intensive family- and home-based treatment program for behaviorally and emotionally disordered youth at imminent risk for out-of-home placement, for use in treating youth with comorbid SUDs and internalizing mental health diagnoses in an outpatient setting. The Research Plan will be conducted in four phases. In Phase I the applicant will adapt the MST treatment manual, supervision manual, quality assurance protocol, and therapist training protocol for use in outpatient settings to treat dually diagnosed youth. In Phase II, the applicant will pilot test the adapted manuals, quality assurance system, and therapist training protocol with 10 adolescents in a community-based youth outpatient clinic. Based on feedback from youth and family members receiving the treatment, clinic administrators, therapists, and expert MST supervisors, the manuals and quality assurance system will be refined and revised during Phase III. Finally, Phase IV will include a pilot study of 40 dually diagnosed youth, randomly assigned to treatment conditions, with 20 receiving Outpatient MST and 20 receiving usual outpatient services. Comprehensive multimethod, multisource assessments will be conducted pretreatment, 6 months post entry, and 12 months post entry to evaluate treatment effectiveness. The Research Plan includes three specific aims: Specific Aim 1 The primary aim of the present research is to adapt and test Multisystemic Therapy for use in outpatient settings to treat youth diagnosed with a substance use disorder and comorbid internalizing disorder. Specific Aim 2 Besides improved symptomatology, the current research aims to test the effectiveness of Outpatient MST to improve youth functioning in other domains pertinent to successful adolescent development. Specific Aim 3 The final aim of the proposed research is to provide services that are more acceptable to consumers than are usual services provided in the community.