Family Therapy via Video Teleconference for Substance-Abusing Rural Adolescents

通过视频电话会议为农村药物滥用青少年提供家庭治疗

• 批准号: 8266280
• 负责人: TIMOTHY J OZECHOWSKI
• 金额: $ 66.69万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-02-01 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8266280
• 关键词: Address; Adolescent; Adolescent Behavior; Affect; Aftercare; Alcohol or Other Drugs use; Area; Behavior Therapy; Behavioral; Child; Chronic; Clinical; Clinical effectiveness; Complex; Cost Effectiveness Analysis; County; Diagnostic; Diffusion of Innovation; Drug Formulations; Drug abuse; Evaluation; Evidence based treatment; Face; Family; Family psychotherapy; Feasibility Studies; HIV; Health Services; Health Services Accessibility; Home environment; Intervention; Investigation; Life; Lifestyle-related condition; Medicine; Modality; Modeling; Motivation; New Mexico; Online Systems; Outcome; Parents; Participant; Persons; Pilot Projects; Population; Problem behavior; Process; Psychiatry; Psychotherapy; Public Policy; Randomized; Randomized Clinical Trials; Relative (related person); Research; Risk; Risk Behaviors; Rural; Rural Community; Services; Substance Addiction; Substance Use Disorder; Substance abuse problem; Technology; Technology Transfer; Teleconferences; Testing; Therapeutic; Treatment Efficacy; Youth; adolescent drug use; adolescent substance abuse; adolescent substance use; base; community setting; cost; cost effective; follow-up; health care delivery; implementation science; improved; meetings; peer; probation; recidivism; rural area; satisfaction; substance abuse treatment; theories

DESCRIPTION (provided by applicant): It has been well documented that only about 10% of adolescents with clinically diagnosable substance use problems receive treatment in any given year. One of the major contributing factors to chronic levels of unmet need for treatment among this population is the unavailability and inaccessibility of treatment services. Service accessibilty is particularly limited in rural areas. To address problems of service availability and accessibiliy in rural areas, the use of video teleconferencing technology to provide direct services has emerged within the fields of medicine and psychiatry in particular. The use of such technology to enhance the delivery of behavioral psychotherapy is beginning to emerge as well. A handful of primarily small-scale pilot and feasibility studies indicate that psychotherapy interventions administered using video teleconferencing technology may be as effective as traditional face-to-face interventions. Few randomized clinical trials of telepsychotherapy have been conducted to date, however, and virtually none have examined video teleconferencing interventions for any type of child or adolescent behavioral problem including substance abuse. The proposed study is intended to address the need for research evaluating the application of video teleconferencing technology as a means of service delivery for substance abusing adolescents and their families living in rural areas. Specifically, the current proposal is a randomized clinical trial testing th efficacy of Functional Family Therapy (FFT) administered by video teleconference (FFT-V) in the homes of substance abusing adolescents. In the proposed investigation, FFT-V will be compared with FFT administered face-to- face in the family home as well as to a services-as-usual (SAU) condition. The overarching objective of the study is to examine the degree to which an empirically based model of substance abuse treatment such as FFT can be effectively administered via video teleconferencing to adolescents and families living in rural and remote areas who would be otherwise unlikely to access treatment. The specific aims of the proposed study are to (1) evaluate the efficacy of FFT-V compared to FFT and SAU in reducing adolescent drug use, HIV risk behavior, delinquency, and recidivism, (2) evaluate the efficacy of FFT-V compared to FFT in establishing functional levels of therapeutic alliance formation, treatment attendance, retention, and satisfaction with treatment, (3) evaluate the efficacy of FFT-V compared to FFT and SAU in impacting core mechanisms of change in adolescent behavior including improved levels of family functioning and adolescent association with substance using peers, and (4) conduct a preliminary cost-effectiveness analysis to derive initial estimates of the relative costs of each treatment modality per outcome unit. . PUBLIC HEALTH RELEVANCE: It is well known that adolescents and families in rural communities face substantial limitations in the availability and accessibility of substance abuse treatment and other health care services. This study addresses this disparity in access to services by investigating the feasibility and efficacy of providing treatment for substance abuse and associated behavioral problems such as delinquency and HIV risk behavior to adolescents in rural areas using web-based video teleconferencing technology.

描述（由申请人提供）：已充分记录在任何给定年份中只有约10％的患有临床可诊断药物使用问题的青少年接受治疗。在该人群中，慢性未满足治疗需求的主要因素之一是治疗服务的无法获得和无法访问。在农村地区，服务访问权限尤其有限。为了解决农村地区服务可用性和访问问题的问题，尤其是在医学和精神病学领域中出现了视频远程会议技术提供直接服务的问题。使用这种技术来增强行为心理治疗的传递也开始出现。少数主要的小规模试验和可行性研究表明，使用视频电信技术进行的心理治疗干预措施可能与传统的面对面干预措施一样有效。然而，迄今为止，很少有远程心理治疗的随机临床试验对任何类型的儿童或青少年行为问题（包括滥用药物滥用）进行了视频电视转让干预措施。拟议的研究旨在满足评估视频触发技术作为滥用青少年及其家人居住在农村地区的毒品的服务手段的研究的需求。具体而言，当前的建议是一项随机临床试验测试，该试验在滥用青少年的滥用药物的家庭中通过视频触发会议（FFT-V）管理的功能性家庭治疗（FFT）的疗效。在拟议的调查中，FFT-V将与家庭住宅中的FFT面对面进行比较，以及与常常的服务（SAU）条件。该研究的总体目的是研究基于经验的滥用药物治疗模型（例如FFT）的程度，可以通过视频触发会议对居住在农村和偏远地区的青少年和家庭进行视频触发会议有效地管理，而否则他们不太可能获得治疗。拟议研究的具体目的是（1）评估FFT-V与FFT和SAU相比在减少青少年药物使用，HIV风险行为，违法和累犯方面的功效，（2）评估FFT-V的疗效与FFT在确定治疗，治疗相比的效果，以及在治疗中的效果，以及（不满意）的效果，以及不满意，以及不满意的效果，以及（3与FFT和SAU相比，FFT-V在影响青少年行为变化的核心机制方面，包括使用同伴的家庭功能和青少年关联水平的提高，并且（4）进行初步成本效益分析，以得出每个结果单位每种治疗方式的相对成本的初始估计。 。 公共卫生相关性：众所周知，农村社区的青少年和家庭在药物滥用治疗和其他医疗保健服务的可用性和可及性方面面临着重大限制。这项研究通过研究滥用药物滥用的可行性和功效来解决这种访问服务的差异，并使用基于Web的视频电视节目技术为农村地区的青少年提供了违法和艾滋病毒风险行为。