Despite some advances in empirically validating interventions for adolescent substance abuse, the treatment of adolescents substance use problems is severely challenged by their lack of motivation to change and difficulty with treatment engagement. For adolescents, the decision to pursue treatment is invariably prompted by the direct action of parents, school personnel, probation officers, or others; self-referral is rare. Moreover, families of substance abusing adolescents are commonly characterized by adolescents' defiance of parental rules and noncompliance with expectations, and, as a result, many parents who attempt to initiate treatment for their adolescents fail due to seemingly insurmountable lack of motivation for change and overt treatment refusal. The proposed 2-year treatment development project is designed to develop an intervention approach for counseling parents of adolescents who are resistant to treatment, using a community reinforcement and family training (CRAFT) approach in order to enhance behavior change and treatment initiation for adolescents with drug abuse and dependence. Two phases of treatment will be offered. During Phase I, parents of resistance adolescents (n=45) will receive 12 sessions of community reinforcement and family training with the goals of improving their own level of functioning, facilitating their adolescents entry into treatment, and enhancing family functioning. During Phase II, the adolescents successfully engaged in treatment (estimated n=40) will receive 12 sessions of individual therapy involving motivational and community reinforcement approach strategies with the goal of reducing substance use. Multidimensional pre-treatment and follow-up assessment will extend to 6 months for parents and to 3 months for adolescents. The overall aim of the project is to ascertain the effectiveness of these approaches for initiating and offering early treatment for unmotivated adolescent drug abusers. Principal analyses will focus on the relative efficacy of the intervention, processes underlying behavior change, and client and therapist characteristics associated with differential therapeutic response.
| Waldron, Holly Barrett; Turner, Charles W (2008) Evidence-based psychosocial treatments for adolescent substance abuse. J Clin Child Adolesc Psychol 37:238-61 |
| Waldron, Holly Barrett; Kern-Jones, Sheryl; Turner, Charles W et al. (2007) Engaging resistant adolescents in drug abuse treatment. J Subst Abuse Treat 32:133-42 |
| Waldron, Holly Barrett; Kaminer, Yifrah (2004) On the learning curve: the emerging evidence supporting cognitive-behavioral therapies for adolescent substance abuse. Addiction 99 Suppl 2:93-105 |
