This study investigating the efficacy of Strategic Structural Family Systems Engagement in bringing about entry and retention in treatment of African American drug abusing mothers. The study builds on a long history of research by the P.I. on developing family oriented interventions with minority drug abusers, and particularly on highly successful research on developing and testing the effectiveness of family-oriented strategies for improving engagement rates for drug abusers. The study proposes to test the efficacy of the experimental intervention by randomizing 132 African American women to one of two conditions: Strategic Structural Family Systems Engagement and an Engagement as Usual Control Control Condition that maximizes ecological validity. Women in both conditions receive the Engagement as Usual interventions that is the standard of care provided by the Florida Department of Health and Rehabilitative Services. Women in the study will have given birth to infants who tests positive for cocaine on a urine toxicology screen. In addition to manuals for the Experimental and condition, four different strategies are proposed for ensuring treatment fidelity including regular supervision, condition specific expert supervision, and objective blind ratings of interventions from therapists' notes and audiotaped sessions. The impact of individual (e.e., distress, stages of change) and life context (i.e., social support, stressors) factors outside the intervention on treatment entry are investigated. Theoretical mechanisms that may mediate athe efficacy of the experimental condition are explored by coding family process occuring during family interventions: supportive interactions (empathic, positive affect, positive coalition), structuring interactions (request for action, directing flow) and defensive interactions (blaming, negative coalition, attack). Analyses include Del, MANOVAs, multiple logistic regressions, structural equations modeling, and survival analyses.
| Dakof, Gayle A; Quille, Tanya J; Tejeda, Manuel J et al. (2003) Enrolling and retaining mothers of substance-exposed infants in drug abuse treatment. J Consult Clin Psychol 71:764-72 |
