Assessment of the Adolescent Therapeutic Community Treatment Process

描述(由申请人提供)：治疗社区(TC)是适应最近青少年住院治疗计划激增的主要治疗方式之一。尽管这种方法已被证明对青少年有效，但对TC治疗如何产生结果的了解有限。青少年TC方案中护理质量的改善最好通过对治疗过程的直接评估来了解；然而，治疗过程的衡量标准很少，特别是用于青少年TC治疗的措施。鉴于青少年在药物滥用治疗方面的不同需求，对成人和青少年治疗服务脱钩的重视，以及认识到青少年药物滥用治疗最理想地应针对青少年的具体问题而量身定做，因此越来越重要的是，针对这一日益增长的药物滥用治疗消费者群体，制定可靠和有效的治疗过程措施。这项拟议的研究旨在通过完成以下具体目标来改进青少年TC治疗过程的测量：1)通过使用共识小组、焦点小组、认知访谈和小规模试点，完善青少年TC治疗过程的两个测量工具，即改变维度自我报告工具(DCI-A)和顾问-报告治疗投入顾问评估(CATE)；以及2)检查心理测量学特性，并使用横断面初步研究的数据收集这两个改进措施的初步有效性证据，该研究涉及全国7个TC治疗项目点的280名青少年客户和60名咨询师。

DESCRIPTION (provided by applicant): The therapeutic community (TC) is one of the major treatment modalities that has accommodated the recent surge in adolescent admissions to residential treatment programs. Although this modality has proven effective for adolescents, there is limited understanding of how TC treatment produces outcomes. Quality of care improvements within adolescent TC programs are best informed by direct assessment of the treatment process; yet few measures of treatment process exist, especially for use with adolescents in TC treatment. In light of the distinct needs of adolescents in substance abuse treatment, the emphasis on decoupling adult and adolescent treatment services, and the recognition that adolescent substance abuse treatment should ideally be tailored to address adolescents' particular issues, it is increasingly important to have reliable and valid measures of treatment process that are specific to this growing population of substance abuse treatment consumers. The proposed study will seek to improve measurement of adolescent TC treatment process through completion of the following specific aims: 1) To refine two measures of adolescent TC treatment process, the self-report Dimensions of Change Instrument (DCI-A) and counselor-report Counselor Assessment of Treatment Engagement (CATE), through the use of consensus panels, focus groups, cognitive interviewing, and small-scale piloting; and 2) To examine the psychometric properties and gather preliminary validity evidence for these two refined measures using data from a cross-sectional pilot study involving 280 adolescent clients and 60 counselors at 7 TC treatment program sites across the nation.