Process and Outcome Analysis of Group Treatment for Adolescent Substance Abuse

青少年药物滥用群体治疗的过程和结果分析

• 批准号: 8601301
• 负责人: TIMOTHY J OZECHOWSKI
• 金额: $ 19.46万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8601301
• 关键词: Address; Adolescent; Alcohol or Other Drugs use; Behavior; Behavioral; Child; Clinical; Clinical Psychology; Code; Cognitive; Data; Elements; Exhibits; Family; Group Therapy; Growth; Guidelines; Intervention; Literature; Meta-Analysis; Modeling; Motion; Outcome; Paper; Participant; Peer Group; Policies; Probability; Problem behavior; Process; Published Comment; Randomized Clinical Trials; Research; Risk; Series; Side; Source; Tobacco use; Treatment outcome; Variant; Videotape; adolescent drug use; adolescent substance abuse; base; clinical practice; contagion; group intervention; novel; peer; public health relevance; research study; substance abuse treatment

DESCRIPTION (provided by applicant): The proposed study is a secondary analysis of observed in-session clinical processes and their association with treatment outcomes among substance abusing adolescents participating in cognitive- behavioral group therapy. The specific aims of the proposed study are as follows. 1. Observe and code moment-by-moment behaviors occurring during videotaped sessions of adolescent group therapy conducted during a completed randomized clinical trial of adolescent substance abuse treatment. 2. For each adolescent participant, construct a set of two-way contingency tables summarizing critical adolescent-peer and adolescent-therapist behavioral exchanges or sequences occurring within and across group therapy sessions. 2a. Construct four contingency tables for each adolescent group therapy participant summarizing the transitional probabilities of specific observed sequences of adolescent- therapist and adolescent-peer behavioral interaction. 3. Analyze the observational sequential data using Kenny and colleagues' actor-partner independence model adapted for small groups (Kenny et al., 2002). 3a. Use the adolescent-therapist and adolescent-peer contingency table transitional probabilities as dependent variables in actor-partner independence growth curve models for small groups. 3b. Identify changes in adolescent-therapist and adolescent-peer behavioral sequences over the course of group treatment that differ between clusters of adolescents showing clinical improvement versus non-improvement controlling for adolescent- and group- specific sources of variation. The results of the proposed analysis are intended to illuminate clinical processes that characterize and distinguish between effective and ineffective adolescent treatment groups. Importantly, the actor-partner independence model can effectively tease apart adolescent-specific versus group-specific (i.e., "peer contagion") effects. This parsing of adolescent- and group-level sources of influence can directly address the questions of whether and to what extent peer contagion effects impact clinical outcomes in adolescent group interventions. Furthermore, the proposed analysis will pinpoint specific types of observed behavioral exchanges through which peer contagion effects may influence adolescent drug use outcomes. Information along these lines can inform clinical guidelines for facilitating positive clinical outcomes in adolescent group treatment.

描述（由申请人提供）：拟议的研究是对观察到的课内临床过程的次要分析，及其与参加认知行为群体治疗的滥用青少年的治疗结果的关联。拟议研究的具体目的如下。 1。观察和代码在青少年滥用治疗的完整随机临床试验期间进行的青少年群体治疗的录像过程中发生的逐一行为。 2。对于每个青少年参与者，构建一组双向应急表，总结了关键的青少年和青少年 - 治疗师行为交流或跨组治疗课程中发生的序列或序列。 2a。为每个青少年群体治疗参与者构造四个应急表，总结了青少年治疗师和青少年行为相互作用的特定观察到的过渡概率。 3。使用Kenny及其同事的Actor-Partner独立性模型分析观察性的顺序数据（Kenny等，2002）。 3a。将青少年治疗师和青少年 - 意外情况表过渡概率作为小组的参与者 - 伴侣独立生长曲线模型中的因变量。 3b。确定在小组治疗过程中青少年治疗师和青少年行为序列的变化，这些变化在青少年的群集之间有所不同，显示了临床改善与非改进的非改进控制，以控制青少年和特定的变异来源。提出的分析的结果旨在阐明表征和区分有效和无效的青少年治疗组的临床过程。重要的是，Actor-Partner独立模型可以有效地逗弄青少年特异性与特定组（即“同伴传染”）效应。青少年和群体级别的影响来源的解析可以直接解决与同伴触发效应是否影响青少年群体干预的临床结果的问题。此外，提出的分析将指出特定类型的观察到的行为交换类型，通过这些交流，同伴触发效应可能会影响青少年的药物使用结果。沿这些线索的信息可以为临床指南提供促进青少年组治疗中阳性临床结果的信息。