This proposal is a Mentored Patient-Oriented Research Career Development Award (K23) for Dr. Lisa Fortuna, a child and adolescent psychiatrist. Dr. Fortuna's long-term career goal is to be an independent researcher with skills in the translation of empirically supported treatments into community settings, particularly for minority adolescents with co-occurring psychiatric and substance use disorders. This proposal focuses on the treatment of substance abuse in the context of Post Traumatic Stess Disorder (PTSD) in violence exposed minority youth. PTSD is a prevalent co-occurring disorder in persons, including adolescents with substance use disorders. PTSD is associated with initiation and continuation of substance abuse, poor treatment outcomes and poor social functioning for youth. Effective therapies exist, however, the nonimplementation of efficacious therapies in community settings is a well-documented problem in the drug abuse field. Minority youth are at particular risk of not receiving services. This research proposes to 1) assess the efficacy of a cognitive behavioral treatment for Post Traumatic Stress Disorder (PTSD) with multicultural youth with substance abuse;and 2) improve access to this evidence based treatment by integrating it into the services of a community-based organization and to move beyond traditional clinical settings. Using the framework of the Onken et al (1997) Stage Model of Behavioral Therapy development, and community participatory methods, this research proposes a Stage la &1b study of CBT for PTSD with minority adolescents ages 14-18 years with substance abuse disorders and in a community based organization setting. Stage la involves the modification, procedural specification and feasibility testing for addiction, minority youth and community setting. Stage Ib involves a Pilot Trial of the modified intervention compared to waiting list comparison on three outcome measures: 1) substance use;2) PTSD symptoms; and 3) attrition. If supported by data from these studies, an efficacy study of the treatment is the next step.
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