The current proposal is a request for a K08 Mentored Clinical Scientist Development Award. The candidate, Dr. Deborah Deas-Nesmith, is a child/adolescent psychiatrist in the field of adolescent substance abuse at the Medical University of South Carolina, Center for Drug and Alcohol Programs. In order for the candidate to develop into a sophisticated, independent researcher, she must receive additional didactic and experiential research training in treatment research which is not possible in her current faculty position due to the vast amount of clinical and teaching responsibilities required. The long-term objectives of the proposal are to: acquire expertise in research-related skills as well as acquire skills in theory, development and execution of manual-guided therapies for adolescents; and to gain expertise in the delivery of an assessment battery, and cognitive behavioral (CBT) and 12-step facilitation (TSF) therapy to adolescent substance abusers in a clinical trial. The proposed research plan addresses the need for systematic exploration of the effectiveness of psychosocial interventions in the treatment of adolescent substance abusers. The project integrates the ~candidate's skills and expertise in the area of adolescent substance abuse with a training plan designed to develop skill in non-pharmacologic treatment interventions and in adolescent treatment outcome research. The proposed research is a randomized clinical trial which will compare two standard approaches used in the treatment of adult alcoholics (CBT and TSF), in treatment-seeking adolescents who abuse alcohol. The hypothesis being tested is that treatment-seeking adolescent alcohol abusers will have better treatment outcome over a six month period with cognitive behavioral therapy intervention than with a 12-step facilitation therapy intervention.
The specific aims are to modify existing CBT and TSF therapy manuals to suit adolescent alcohol abusers as well as gain training in the use of these manuals; to pilot test and revise manuals if necessary and conduct a 12-week randomized trial of weekly individual CBT or TSF in 84 (42/group) adolescents presenting for outpatient treatment of alcohol abuse/dependence. The study involves a randomized clinical trial assigning substance abusing adolescents to one of two 12-week individual psychotherapy groups. The proposed research is divided into several phases which will take place over the 5 year training period. Phase I will consist of manual development/revision for substance abusing adolescents; in Phase 2, the manual and research assessment battery will be pilot tested for feasibility and acceptability; and in Phase 3, the subjects will be randomly assigned to one of the two treatment conditions, and treatment will begin.
