Integrating Interventions for Maternal Substance Abuse and Child Neglect

描述（由申请人提供）：本K23指导的以患者为导向的研究职业发展奖申请正在提交给国家药物滥用研究所。候选人丽莎索尔达娜博士是一名临床心理学家，她的培训和职业生涯都集中在发展虐待儿童领域的研究和临床技能上。她对制定儿童忽视的干预措施特别感兴趣。母亲滥用药物是忽视儿童的主要原因之一。这项建议的目标将加强Saldana博士的培训，使她的知识扩展到孕产妇药物滥用的治疗。在K23奖项中，将帮助Saldana博士实现其长期职业目标的九个目标包括：1）获得进行随机临床试验的技能，以研究儿童福利人群中母亲药物滥用的治疗;（二）了解儿童福利系统内目前提供的药物滥用服务，以及从一个系统中为这一人群提供服务的需求前景; 3）获得成人药物滥用循证实践的专业知识; 4）获得对忽视人群进行临床研究的专业知识; 5）调整治疗手册和质量保证系统，以针对同时出现药物使用障碍和忽视父母行为的家庭; 6）制定培训方案; 7)对滥用药物被忽视的人群进行综合治疗的试点试验; 8）编写R21赠款;和9）编写R 01赠款。该研究计划提出了第一阶段研究，将基于强化的治疗方法用于药物滥用的治疗，并在多系统治疗模式中建立了一个概念化疏忽育儿的框架。Saldana博士将在治疗开发阶段进行一项可行性研究（n - 5），然后进行一项小型随机试验（n = 24），以检查药物滥用和新生儿综合治疗与常规治疗相比的疗效，通过社会服务部转介药物滥用疏忽的母亲。Saldana博士将在包括Scott Henggeler、Hendree Jones和Patricia Chamberlain博士在内的专家指导团队的指导下开展培训和研究活动。她将分别接受John Landsverk、布拉德利多诺霍和Kristina杰克逊博士关于服务研究、治疗提供中种族因素考虑和纵向统计分析的咨询。鉴于虐待儿童的费用每天为2.58亿美元，每年用于父母药物滥用治疗的费用超过240亿美元，目前申请的目标可能会解决一个极其昂贵的公共卫生问题。由于忽视儿童是最普遍和代价最高的虐待形式，因此，针对同时发生的药物滥用和忽视儿童问题制定循证做法至关重要。

DESCRIPTION (provided by applicant): This K23 Mentored Patient-Oriented Research Career Development Award application is being submitted to the National Institute on Drug Abuse. The candidate, Dr. Lisa Saldana, is a clinical psychologist who has focused her training and career on developing research and clinical skills in the area of child maltreatment. She has specific interest in developing interventions for child neglect. Maternal substance abuse is one of the primary drivers for child neglect. The goals of this proposal would enhance Dr. Saldana's training to extend her knowledge to the treatment of maternal substance abuse. The nine goals to be accomplished throughout this K23 award that will assist Dr. Saldana in achieving her long-term career goals include: 1) attain skills to conduct randomized clinical trials for the study of treatments of maternal substance abuse within child welfare populations; 2) gain understanding of current substance abuse service delivery within the child welfare system and the needs for serving this population from a system perspective; 3) gain expertise in evidence-based practices for adult substance abuse; 4) gain expertise in conducting clinical research with neglectful populations; 5) adapt treatment manuals and quality assurance systems to target families presenting with co-occurring substance use disorders and neglectful parenting behaviors; 6) develop a training protocol.; 7) conduct a pilot test of an integrated treatment for substance abusing neglectful populations; 8) write an R21 grant; and 9) write an R01 grant. The Research Plan proposes Stage 1 Research integrating Reinforcement Based Therapy for the treatment of substance abuse, with a framework for conceptualizing neglectful parenting, within the Multisystemic Therapy model of treatment delivery. Dr. Saldana will conduct a feasibility study (n - 5) during the treatment development stage, followed by a small randomized pilot (n = 24) to examine the efficacy of the Integrated Treatment for Substance Abuse and Neglect compared to treatment as usual, with a population of substance abusing neglectful mothers referred through the Department of Social Services. Dr. Saldana will conduct her training and research activities under the guidance of an expert mentoring team including Drs. Scott Henggeler, Hendree Jones, and Patricia Chamberlain. She will receive consulting from Drs. John Landsverk, Bradley Donohue, and Kristina Jackson for issues related to services research, consideration of ethnic factors in therapy delivery, and longitudinal statistical analyses respectively. Given that the cost of child maltreatment is $258 million per day, with over $24 billion a year being spent on parental substance abuse treatment, the goals of the current application might address an extremely costly public health problem. As child neglect is the most prevalent and costly form of maltreatment, development of evidence-based practice for co-occurring substance abuse and child neglect is critical.