Integrating Interventions for Maternal Substance Abuse and Child Neglect

描述（由申请人提供）：此K23指导患者导向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（Lisa Saldana）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儿童虐待领域的研究和临床技能上。她对开发儿童忽视干预措施特别感兴趣。母亲滥用药物是导致儿童被忽视的主要原因之一。这项建议的目标是加强萨尔达纳博士的培训，使她的知识扩展到治疗母亲滥用药物方面。在整个K23奖项中要实现的九个目标将帮助Saldana博士实现她的长期职业目标包括：1)获得在儿童福利人群中进行母亲药物滥用治疗研究的随机临床试验的技能；2)了解目前儿童福利系统内的药物滥用服务提供情况，以及从系统角度为这一人群服务的需求；3)在成人药物滥用的循证实践中获得专业知识；4)获得与被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体系，以针对同时存在物质使用障碍和疏忽育儿行为的家庭；6)制定培训方案；7)对被忽视的滥用药物人群进行综合治疗的试点试验；8)撰写R21奖助金；9)写R01授权。研究计划提出第一阶段的研究，将药物滥用治疗的强化疗法与在治疗交付的多系统治疗模式中概念化疏忽育儿的框架结合起来。Saldana博士将在治疗发展阶段进行可行性研究（n - 5），随后进行一个小型随机试验（n = 24），以检查药物滥用和忽视综合治疗与常规治疗相比的效果，其中包括通过社会服务部转诊的药物滥用和忽视母亲群体。Saldana博士将在专家指导团队的指导下进行培训和研究活动。斯科特·亨格勒，亨德利·琼斯和帕特里夏·张伯伦。她将接受医生的咨询。John Landsverk， Bradley Donohue和Kristina Jackson，分别获得服务研究、治疗中种族因素的考虑和纵向统计分析的相关问题。鉴于每天虐待儿童的费用为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，当前应用程序的目标可能会解决一个极其昂贵的公共卫生问题。由于儿童忽视是最普遍和最昂贵的虐待形式，因此发展以证据为基础的药物滥用和儿童忽视共同发生的实践至关重要。

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.