The fundamental objective of this study is to compare the effectiveness of an intensive in-home family-based treatment, Multidimensional Family Therapy, with a multifaceted residential treatment, Adolescent Residential Treatment, over 4 years post-intake and to delineate the mechanisms of change for each treatment. The study targets dually- diagnosed adolescent drug abusers recommended for residential treatment.
Aim 1: To compare the effectiveness of residential treatment with outpatient, family-based treatment multiple outcomes including substance use, mental health, school functioning, family function and delinquency among dually diagnosed adolescents. Hypothesis 1. From intake to 2 months, residential treatment will show better outcomes than the family based treatment. Between 2 months and 18 months, family based treatment will show better outcomes than residential. Between 18 months and four years post intake, outpatient family based treatment will maintain its treatment gains, while the residential treatment condition will show an increase in these same symptoms and behaviors. Aim 2: To examine the relationship between predictors (family, peer, educational/vocational functioning and involvement in post-treatment services), and outcomes (drug use, co-morbid symptoms, and criminal behavior) during the four-year post intake period. Hypothesis 2a. Family functioning, educational/vocational functioning, and peer relationships measured at discharge will predict drug use, co-morbid symptoms, and criminal behaviors though the four year longer term follow up period. Hypothesis 2b. Family functioning, educational/vocational functioning, peer relationships, and involvement in post-treatment services during the post treatment period will predict drug use, co-morbid symptoms, and criminal behavior through the longer term follow up period. Research Question 1. Is the rate of change in family functioning, educational/vocational functioning, peer relationships, and involvement in post-treatment services related to the rate of change in drug use, co-morbid symptoms, and criminal behavior?
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
113
MDFT assesses and intervenes in five domains: 1) Interventions with the adolescent, 2) interventions with the parent, 3) interventions to improve the parent-adolescent relationship, 4) interventions with other family members, and 5) interventions with external systems.
The Adolescent Treatment Program targets the adolescent's abuse or dependency on chemicals while simultaneously treating the comorbid symptomatology found in dual diagnosed patients. These goals are accomplished by using four primary forms of intervention: (1) Chemical Education; (2) Group, Individual and Family Counseling; (3) Twelve Step Work; and 4) Psychotropic Medication for Clinical Symptomatology Comorbid with Substance Abuse.
University of Miami Miller School of Medicine
Miami, Florida, United States
The Village, Inc.
Miami, Florida, United States
Change in Personal Involvement with Chemicals
Scale from the Personal Experience Inventory (PEI) developed by Ken Winter.
Time frame: Baseline, 2, 4, 12, 18, 24, 36 and 48 months after baseline
Change in substance use consumption
Measure of substance use consumption as measured by the Timeline Follow-back Method.
Time frame: Baseline, 2, 4, 12,18,24,36,48 months after intake
Change in externalizing symptoms
Externalizing symptoms measured by the Youth Self Report
Time frame: Baseline, 2, 4, 12, 18, 24, 36 and 48 months
Change in delinquency
Measured by youth report on the Self Report Delinquency Scale.
Time frame: Intake, 2, 4, 12, 18, 24, 35, 48 months after intake
Change in internalzing symptoms
Measured by the Youth Self Report (YSR)
Time frame: Intake, 2, 4, 12, 18, 24, 36, 48 months after baseline
Change in family conflict
Parent and youth report on their family conflict as measured by the Family Environment Scale.
Time frame: Baseline, 2, 4, 12, 18, 24, 36, 48 months after baseline
Change in parenting practices
Measures the extent to which parents monitor, set limits, and provide affection to their teens.
Time frame: Baseline, 2, 4, 12, 18, 24,36, 48 months after baseline
Change in family cohesion
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Youth and parent reports of family closeness measured by the Family Environment Scale (FES)
Time frame: Intake, 2, 4, 12, 18, 24, 26, 48 months after intake