A Pilot Test of the Functional Family Therapy Coding and Rating Scale

描述(申请人提供)：本项目的目标是进行功能性家庭治疗编码和评定量表(FFT CARS)的初步研究。FFT Cars是一种理论驱动的观察性研究工具，用于对FFT会议中基于手动的治疗师干预和技术的存在进行评级和编码。作为一种基于理论和手动的过程研究工具，FFT CARS将促进对与FFT持续治疗结果相关的临床成分、过程和机制的基本假设的直接实证测试。到目前为止，还没有这样的观测仪器可以实现这些关键的FFT过程研究目标。迫切需要这样的研究来为FFT的不断完善和机械化以及其在美国和国外的社区治疗环境的运输提供实证支持。拟议的试点研究的具体目标是：(A)培训两名新手研究生临床医生使用FFT CARS对记录的FFT课程样本进行编码和评分；(B)通过一系列分析方法建立并证明FFT CARS的评价者之间令人满意的一致性和可靠性；以及(C)通过使用从该仪器获得的一系列临床指标来评估FFT CARS的有效性，以预测治疗师-家庭联盟的形成，以及治疗前和治疗后家庭沟通和青少年治疗结果的变化。实现这些目标将使FFT CARS成为一种可信和真诚的过程研究工具。随后，FFT CARS可用于对过去十年中在众多随机临床试验过程中积累的大量存档的FFT临床录像带进行评级和编码。在这些临床试验中，存在着大量关于青少年药物使用的变化以及青少年情绪、行为和家庭功能的其他方面的评估数据。使用FFT CARS研究治疗期间的治疗师行为与FFT的持续改善、无改善或复发之间的关系，将提供有价值的临床见解，为以增强其有效性和可移植性的方式改进FFT提供信息。归根结底，将有效的治疗方法转移到以社区为基础的临床环境中，对于将青少年滥用药物的流行率降低到足以产生公共健康益处的程度是必不可少的。

DESCRIPTION (provided by applicant): The objective of this project is to conduct a pilot study of the Functional Family Therapy Coding and Rating Scale (FFT CARS). The FFT CARS is a theory-driven observational research tool for rating and coding the presence of manual-based therapist interventions and techniques in sessions of FFT. As a theory- and manual-based process research tool, the FFT CARS will facilitate direct empirical tests of fundamental hypotheses about clinical components, processes, and mechanisms associated with sustained treatment outcomes in FFT. To date, no such observational instrument exists that could accomplish these critical FFT process research objectives. Such research is urgently needed to provide empirical support for the ongoing refinement and manualization of FFT and its transportation to community-based treatment settings across the United States and abroad. The specific aims of the proposed pilot study are to: (a) train two novice graduate student clinicians to utilize the FFT CARS to code and rate a sample of recorded FFT sessions; (b) establish and demonstrate satisfactory interrater agreement and reliability for the FFT CARS through a range of analytic approaches; and (c) assess the validity of the FFT CARS by using a range of clinical indicators derived from the instrument to predict therapist-family alliance formation, and pre- to post-treatment changes in family communication and adolescent treatment outcomes. Achieving these aims would establish the FFT CARS as a credible and bona fide process research instrument. Subsequently, the FFT CARS may be used to rate and code the massive volume of archived FFT clinical videotapes that has accumulated over the course of numerous randomized clinical trials over the past decade. A wealth of assessment data exists pertaining to change in adolescent drug use and other aspects of emotional, behavioral, and family functioning for the adolescent participants in these clinical trials. Using the FFT CARS to study how therapist behavior during treatment is linked to sustained improvement, non- improvement, or relapse in FFT would provide valuable clinical insights to inform the refinement of FFT in ways that can enhance its effectiveness and transportability. Ultimately, transporting effective treatments into community-based clinical settings is indispensable for reducing the prevalence of adolescent drug abuse to a degree sufficient to produce public health benefits.