The R34 study will integrate existing tools for use with JJ populations and examine the feasibility, acceptability, and preliminary efficacy of a caregiver-youth intervention aimed at increasing SU treatment initiation. The adaptive intervention incorporates three evidence-based components: 1) assessment of motivation and linkage-related barriers with personalized feedback, 2) Mapping-Enhanced Counseling (MEC) for improving readiness for change and interpersonal communication, and 3) Active Linkage (AL) for addressing logistical barriers to service initiation. Youth-caregiver dyads will be randomly assigned to receive an initial dose (2, 1-hr sessions) of either MEC or AL. After 30 days, participants will be classified as Responders (1 or more services initiated) or Non-responders (no service initiation). All participants will be randomized to one of two intervening interventions: an additional dose (2, 1-hr sessions) of the initial intervention (MEC or AL) or a different dose (2, 1-hr sessions of the other). The specific aims are to 1) integrate and adapt appropriate evidence-based intervention components as a dyadic intervention approach for JJ youth and caregivers; 2) test the feasibility, acceptability, and optimal configuration of the dyadic intervention components and the protocol used to evaluate effectiveness (including feasibility of recruitment, implementation, measurement); and 3) preliminarily explore a) whether an initial dose of MEC or AL is sufficient for promoting early initiation and engagement, b) whether an additional dose of MEC or AL or a change in dose is more effective, and c) which component sequence is most effective. Primary outcomes include youth (initiation of assessment or counseling; counseling attendance) and caregiver (attendance at assessment, first counseling, and/or family sessions) measures. Secondary outcomes include youth and caregiver attitudes (problem recognition, desire for help), normative beliefs (SU norms), perceived control (stressors and obstacles), and youth SU (self-report corroborated by UA results). The study addresses the sizeable gap in service receipt among JJ youth by addressing family engagement, and focuses on improving motivation to change, linkage to services, and treatment engagement.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
150
Practitioner-led, collaborative discussion with the youth and their caregiver on co-creating guide maps for decision making around starting treatment and continuing substance use that can help users organize information and think through a series of steps, questions, and behavior choices. encountered when attempting to initiate substance use treatment services. MEC is a communication and decision-making approach that uses graphic visualization tools to train individuals to monitor and control their decision making, improve judgment and behavioral choices (self-regulation), and improve communication and mutual understanding.
Practitioner-led, collaborative discussion with the youth and their caregiver on how to overcome barriers encountered when attempting to initiate substance use treatment services. Discussion focuses around the top barriers identified through assessment and identification of 1 or more treatment agency/options that fit the family's needs. Practitioner takes a more active role in addressing barriers to treatment by helping the family find ways to access resources for payment, childcare, or other needs, and actively linking them to the treatment provider (e.g., scheduling the initial appointment with family present).
Texas Christian University
Fort Worth, Texas, United States
Youth Initiation
Youth attendance at 1 or more treatment appointment (assessment or counseling), obtained through self-report and corroborated using probation agency attendance records
Time frame: Week 4
Youth Initiation
Youth attendance at 1 or more treatment appointment (assessment or counseling), obtained through self-report and corroborated using probation agency attendance records
Time frame: Week 9
Youth Initiation
Youth attendance at 1 or more treatment appointment (assessment or counseling), obtained through self-report and corroborated using probation agency attendance records
Time frame: Week 17
Caregiver attendance with youth at 1 or more treatment appointment
Caregiver attendance with youth at 1 or more treatment appointment (assessment, counseling)
Time frame: Week 4
Caregiver attendance with youth at 1 or more treatment appointment
Caregiver attendance with youth at 1 or more treatment appointment (assessment, counseling)
Time frame: Week 9
Caregiver attendance with youth at 1 or more treatment appointment
Caregiver attendance with youth at 1 or more treatment appointment (assessment, counseling)
Time frame: Week 17
Change in Youth Treatment Motivation as measured by the TCU MOT Form
Change in motivation for treatment (problem recognition, desire for help, treatment readiness)
Time frame: Weeks 1, 9, and 17
Change in Caregiver's Perception of Youth's Treatment Motivation as measured by the TCU MOT Form
Change in motivation for treatment (recognition of youth's drug problem, desire for help, treatment readiness)
Time frame: Weeks 1, 9, and 17
Change in Youth Normative Beliefs about Substance Use as measured by the TCU THK Form
Change in beliefs about substance use (drug culture)
Time frame: Weeks 1, 9, and 17
Change in Caregiver Normative Beliefs about Substance Use as measured by the TCU THK Form
Change in beliefs about substance use (drug culture)
Time frame: Weeks 1, 9, and 17
Change in Youth Perceived Control over Substance Use as measured by the TCU THK Form
Change in perceived control over substance use
Time frame: Weeks 1, 9, and 17
Change in Youth Perceived Control over Treatment Initiation as measured by the Barriers to Treatment Participation Scale (BTPS)
Change in perceived control over treatment initiation (number of barriers to seeking and starting treatment)
Time frame: Weeks 1, 9, and 17
Change in Caregiver Perceived Control over Youth's Substance Use as measured by the Caregiver Strain Questionnaire (CGSQ-SF7):
Change in perceived control over youth's substance use (stressors and obstacles caused by youth's substance use)
Time frame: Weeks 1, 9, and 17
Change in Caregiver Perceived Control over Youth's Treatment Initiation as measured by the Barriers to Treatment Participation Scale (BTPS)
Change in perceived control over youth's treatment initiation (number of barriers to seeking and starting treatment)
Time frame: Weeks 1, 9, and 17
Change in Youth Intentions to Use Substances as measured by the TCU THK Form
Change in intention to use substances (drug resistance efficacy) and to initiate treatment
Time frame: Weeks 1, 5, 9, and 17
Change in Youth Intentions to Initiate Treatment
Change in intention to initiate treatment
Time frame: Weeks 1, 5, 9, and 17
Change in Caregiver Intentions to schedule and attend youth's treatment sessions
Change in intention to initiate youth's substance use treatment (intention to contact agency, intention to accompany child)
Time frame: Weeks 1, 5, 9, and 17
Change in Youth Substance Use as measured by the TCUDS and Opioid Supplement Forms
Self-reported use of substances (e.g., alcohol, marijuana, opioids), corroborated by urinalysis
Time frame: Weeks 1, 5, 9, and 17
Change in Family relationships as measured by the TCU FFS Scale
Change in quality of family relationships (warmth, control, conflict)
Time frame: Weeks 1, 9, and 17
Change in Family responsiveness as measured by the Family Assessment Device (FAD)
Change in quality of family affective responsiveness, affective involvement, behavior control)
Time frame: Weeks 1, 9, and 17
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