Adherence and Competence in Adolescent Drug Use Therapy

青少年药物使用治疗的依从性和能力

• 批准号: 6679862
• 负责人: Aaron Hogue
• 金额: $ 19.38万
• 依托单位: PARTNERSHIP TO END ADDICTION
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6679862
• 关键词: African American; adolescence (12-20); behavioral /social science research tag; caregivers; clinical research; cognitive behavior therapy; computer data analysis; drug abuse therapy; family structure /dynamics; family therapy; health care personnel performance; health care service evaluation; health services research tag; human data; longitudinal human study; mathematical model; model design /development; outcomes research; patient care personnel relations; social behavior; statistics /biometry; therapy compliance; videotape /videodisc

DESCRIPTION: (provided by applicant) The ultimate objective of the proposed study is to increase the effectiveness of two manualized treatments for adolescent drug abuse by investigating the relation of treatment adherence and therapist competence to treatment outcomes. The study will examine existing data from a randomized clinical trial comparing multidimensional family therapy (MDFT) and individual cognitive-behavioral therapy (CBT), which represent two widely practiced, empirically supported treatment approaches for adolescent substance use. Treatment adherence and therapist competence have been identified as critical elements of manualized treatment implementation and as key predictors of therapeutic gains in both adolescent and adult populations. Studies that illuminate the associations among adherence, competence, and outcome are vital for developing more effective, targeted, and transportable therapy models for dissemination in diverse clinical settings. Subjects will include 143 inner-city, primarily African American, juvenile-justice involved adolescents and their caregivers. Adolescents and caregivers completed pre- and post-treatment measures of drug use and drug involvement, externalizing and internalizing symptoms, prosocial behavior, and family functioning. Archived videotapes of therapy sessions will be reviewed to assess treatment fidelity, therapist skill, and therapeutic alliance. Study hypotheses will test both the direct and indirect effects of adherence and competence on adolescent drug use and comorbid symptomatology. Structural equation modeling will examine whether: (1) for MDFT, greater adherence and competence produce better outcomes by means of improving parenting skills and family relationships; (2) for CBT, greater adherence and competence produce better outcomes by means of increasing adolescent self-efficacy and prosocial involvement; (3) for both treatments, the effects of treatment adherence are moderated by therapist competence and therapeutic alliance. This study will be among the first to explore the relation between treatment adherence and outcome, and the very first to study therapist competence, with an adolescent drug-using sample.

描述：（由申请人提供） 拟议研究的最终目标是提高有效性 通过调查青少年药物滥用的两种手动治疗方法 治疗依从性和治疗师能力与治疗结果的关系。 该研究将检查一项随机临床试验的现有数据，比较 多维家庭治疗（MDFT）和个人认知行为 疗法（CBT），代表两种广泛实践的、有经验支持的疗法 青少年药物滥用的治疗方法。治疗依从性和 治疗师的能力已被确定为手动治疗的关键要素 治疗实施以及作为治疗效果的关键预测因素 青少年和成年人口。阐明关联的研究 坚持、能力和结果之间的关系对于发展更多 有效的、有针对性的、可移植的治疗模型，以便在 多样化的临床环境。主题将包括 143 个市中心，主要是 非裔美国人的少年司法涉及青少年及其照顾者。 青少年和照顾者完成药物治疗前和治疗后措施 使用和药物参与、外化和内化症状、亲社会 行为和家庭功能。治疗过程的存档录像将 进行审查以评估治疗保真度、治疗师技能和治疗效果 联盟。研究假设将测试直接和间接影响 青少年吸毒和共病症状的依从性和能力。 结构方程模型将检查是否： (1) 对于 MDFT，更大 坚持和能力通过改进产生更好的结果 养育技巧和家庭关系； (2) 对于CBT，更高的依从性和 能力通过增加青少年的能力产生更好的结果 自我效能和亲社会参与； (3) 两种治疗方法的效果 治疗依从性取决于治疗师的能力和治疗效果 联盟。这项研究将是第一个探索两者之间关系的研究之一。 治疗依从性和结果，以及第一个研究治疗师 能力，以及青少年吸毒样本。