CRAFT for Parents of Adolescents in Outpatient Drug Treatment

在美国，超过340万的青少年符合药物使用障碍的标准，但每年进入治疗的不到10%(美国国土安全部，2000a，2000b)。数据表明，在意识到并关注青少年药物使用的父母中，多达60%的人无法在没有帮助的情况下让他们接受治疗(Szapocznik等人，1988年)，而且很少有研究研究如何帮助他们。 社区强化和家庭培训(CRECH)在帮助家庭成员帮助有治疗抵抗力的成年人进入治疗方面有很好的经验支持，但它尚未在药物滥用青少年父母的对照试验中进行测试。该项目将进行第一阶段行为治疗试点研究，以改进CRATURE(CRAVATE-P)和ALANNON/Naranon Facilation(ANF)，以供关心未接受治疗的青少年的父母使用。第二阶段的两组随机对照临床试验将比较CRATURE-P(n=77)和ANF(n=77)，以确定青少年治疗进入的发生率是否有显著差异。混合效应模型将被用来确定参加CRATE-P条件的参与者是否报告青少年物质使用和行为问题的减少，以及父母养育技能、社交功能、情绪和亲子关系满意度的改善。 与滥用所爱的物质有关的问题影响着全国所有地区和所有收入水平的各种美国家庭(Hudson等人，2002年；Kirby等人，2005年)。研究表明，大多数父母不仅有动力帮助他们的孩子解决药物滥用问题，而且他们往往能够影响他们。不幸的是，很少有基于社区的治疗计划使用基于经验的家庭干预措施，这些干预措施可能会帮助父母让孩子参与治疗，提高治疗保留率，提供有效的后续护理支持，并帮助中断他们的孩子从药物使用到依赖的轨迹。由于父母可以独立于他们的孩子完成手艺，它不仅可以通过基于社区的青少年药物滥用治疗传播给他们，也可以通过私人从业者和基于社区的心理健康计划传播给他们。此外，初步数据表明，如果有效，Craft-P也可以通过互联网直接传播给父母。考虑到第一个目标是 家长翻译研究中心旨在为家长利用青少年的物质提供有效的工具，这项研究代表着朝着这个方向迈出的重要一步。在我们的家长咨询委员会和其他地方与父母的互动表明，许多父母迫切需要这种类型的帮助。

Over 3.4 million adolescents in the U.S. meet criteria for a substance use disorder, but less than 10% enter treatment each year (US DHHS, 2000a, 2000b). Data suggest that as many as 60% of parents who are aware and concerned about their adolescent's substance use are unable to get them into treatment without assistance (Szapocznik et al., 1988) and very little research has examined methods to help them. Community Reinforcement and Family Training (CRAFT) has good empirical support for helping family members foster treatment entry of treatment-resistant adults, but it has not been tested in a controlled trial with parents of substance-abusing adolescents. This project will conduct a Stage I behavior therapy pilot study to modify CRAFT (CRAFT-P) and Alanon/Naranon Facilitation (ANF) for use with parents who are concerned about an out-of-treatment adolescent. A Stage II two-group randomized controlled clinical trial will then compare CRAFT-P (n=77) vs ANF (n=77) to determine if the occurrence of adolescent treatment entry significantly differs. Mixed effects models will he used to determine if participants who are enrolled in the CRAFT-P condition report reductions in adolescent substance use and behavior problems, and improvements in parenting skills, social functioning, mood, and in parent-adolescent relationship satisfaction. Problems related to a substance abusing loved affect a wide variety of American families, in all areas of the country and at all income levels (Hudson et al., 2002; Kirby et al., 2005). Research suggests that most parents not only are motivated to help their children to address their substance abuse problems, they often are able to influence them. Unfortunately, few community-based treatment programs use empirically-based family interventions that are likely to help parents engage their child in treatment, improve treatment retention, provide effective aftercare support, and help interrupt their child's trajectory from substance use to dependence. Since parents can complete CRAFT Independent of their child, it could be disseminated to them not only through community-based adolescent substance abuse treatments, but also through private practitioners and community-based mental health programs. Moreover, preliminary data suggest that, if effective, CRAFT-P could also be disseminated directly to parents via the internet. Given that the first goal of the Parents Translation Research Center is to provide effective tools for parents of substance using adolescents, this study represents an important step In that direction. Interactions with parents on our Parent Advisory Board and elsewhere suggest that many parents feel desperate for this type of help.