Adolescent Treatment and 12-step Mutual-help Involvement

描述(由申请者提供)：大多数针对青少年的治疗方案都是以“12步”模式为基础的，其核心目标是促进参与12步互助小组，例如戒酒互助会(AA)和戒毒互助会(NA)。研究表明，参加AA/NA会议的年轻人有明显更好的治疗结果。此外，由于AA和NA社区网络广泛可用且足够灵活，可以在高风险时期(例如，晚上、周末)提供针对戒酒的“紧急”支持(例如，通过赞助商)，并作为免费的持续支持系统发挥作用，因此它们有望在成本日益紧张的管理式护理环境中成为专业服务的有用辅助工具。 然而，总的来说，人们对青年AA/NA的参与知之甚少，所知的仅来自住院环境，这可能不能反映当前的治疗现实，因为该系统已过渡到主要是门诊护理。此外，对影响AA/NA参与的因素或青年在专业12步治疗期间经历的具体变化过程知之甚少。一项前瞻性的、面向过程的设计将被用来评估：1)12个月门诊治疗招募的青年(N=162；14-18岁)在多大程度上参加、参与和受益于AA/NA；2)影响青少年AA/NA参与和相关好处的因素；3)治疗介入对12步(如疾病模式信念)和常见(如自我效能、应对)、改变过程的影响，以及这些过程又如何与近端(即AA/NA介入)和远端(即物质使用)结果相关联。第二个目标是调查工作人员12步转介做法以及工作人员和家长对青少年参加AA/NA的态度。结果将提供关于在当前治疗背景下向青年提供的治疗有效性的新信息，并提供针对发展的具体情况 将为针对青年的12步促进工作提供信息的知识。

DESCRIPTION (provided by applicant): The majority of treatment programs targeting youth are based on a "12-step" model, a central aim of which, is to facilitate involvement in 12-step mutual-help groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Research indicates that youth who attend AA/NA meetings have significantly better treatment outcomes. Furthermore, because AA and NA community networks are widely available and flexible enough to provide "acute" abstinence-specific support (e.g., through a sponsor) at times of high risk (e.g., evenings, weekends) as well as function as ongoing support systems at no cost, they hold promise as a useful adjunct to professional services in an increasingly cost-constricting, managed-care environment. However, little is known about youth AA/NA participation, in general, and what is known is derived solely from inpatient settings, which may not reflect current treatment reality as the system has transitioned to mostly outpatient care. Further, little is known about factors that influence AA/NA participation, or the specific change processes youth undergo during professional 12-step treatment. A prospective, process-oriented, design will be utilized to assess: 1) the extent to which youth (N=162; 14-18 yrs) recruited from 12-steporiented outpatient treatment, attend, become involved in, and benefit from, AA/NA during a 12-month follow-up period; 2) factors that influence adolescent AA/NA participation and related benefits; and, 3) the influence of treatment involvement on 12-step (e.g., disease-model beliefs), and common (e.g., self-efficacy, coping), processes of change and how these, in turn, relate to proximal (i.e., AA/NA involvement) and distal (i.e., substance use) outcomes. A secondary aim is to investigate staff 12-step referral practices and staff and parent attitudes toward AA/NA attendance for youth. Results will provide new information about the effectiveness of treatment as delivered to youth in current treatment contexts and supply developmentallyspecific knowledge that will inform 12-step facilitation efforts targeting youth.