This application details a proposed drug abuse treatment development study, submitted under the NIDA RFA #DA-94-02. Behavioral Therapies Development Program. The primary aim of this study is to articulate, standardize, and pilot test a comprehensive, intensive outpatient treatment for adolescent drug abusers -Multicomponent intervention for Adolescent Drug Abuse (CRADA). The proposed project will revise our empirically-established family-based treatment. Multidimensional Family Therapy (MDFT). And this reformulated MDFT intervention will be the core part of the new approach we will develop and pilot. This study has six objectives. First, we will identify individual and family processes that are related to success and non-success in the treatment of adolescent drug abuse. To accomplish this, we propose intensive analyses of archival videotape data from past and current adolescent drug abuse treatment research in the PI's lab and the Center's other sites. Three areas are investigated: (a) therapeutic alliance of the therapist and adolescent, (b) in-treatment changes in parenting practices that are related to adolescent development generally, and adolescent drug use, in particular, and (c) culturally-related responses to treatment for adolescent drug abuse. Our new knowledge in these areas will be used to reformulate and enhance our current version of MDFT. The second objective aims to specify the content and methods of two new treatment components-modules. The new modules were chosen from the basis of research about risk and protective factors for adolescent drug abuse, as well as our knowledge of particular domains of functioning not adequately addressed in the current version of MDFT. The first module aims to alter the ecology of the treatment delivery system by having the intervention be primarily a home-based treatment and offering case management services. The second module adds a skills training component (parent and adolescent skills training in groups) to the intervention. The parent groups focus on parent management techniques and social support. The adolescent groups focus on interpersonal and social situation appraisal and alternative generation. The groups, along with the other modules are offered concurrently. We will conduct a trial implementation of these modules. The project's third objective, emanating from the first two, is to create an enhanced, comprehensive, integrative, multicomponent intervention for adolescent drug abusers. The new intervention, MIADA, consists of the two new modules plus our reformulated MDFT model. All components are offered concurrently. Fourth, we will test the preliminary efficacy and feasibility of MIADA by comparing it to the MDFT approach in a small scale pilot study. Subjects will be randomly assigned and an abbreviated battery of measures will be given. Fifth, we will create a state of the science treatment manual and corresponding videotape training aids. And, sixth, we will develop therapist adherence and competence measures. These are central to this study's scientific integrity as well as to our long term aim: to crete a viable, community-based treatment with sufficient feasibility and efficacy data to warrant the conduct of a randomized clinical trial.
| Diamond, G; Liddle, H A (1996) Resolving a therapeutic impasse between parents and adolescents in multidimensional family therapy. J Consult Clin Psychol 64:481-8 |
