This application proposes to conduct a Stage I treatment development study that targets Hispanic drug abusing adolescents and their families, who have unique values and acculturation/ immigration related life experiences that can be shown to directly impact engagement, retention, drug use, and the efficacy/effectiveness of drug treatment. Although the importance of culture related factors have been generally acknowledged, treatment models have failed to link specific culturally derived interventions to specific treatment change mechanisms central to drug abuse treatment. The proposed model, Culturally Rooted Adolescent Family Therapy (CRAFT), will include psycho-educational modules that directly address these culture related factors and are designed to enhance treatment alliance and facilitate the work of family therapy change mechanisms. The proposed model is divided into three AIMs each designed to produce findings that inform the subsequent AIM's work.
AIM I consists of a basic research study that investigates the independent contribution of specific immigration and acculturation-related stressors in disrupting family therapy mechanism of change.
AIM II consist of: 1) the development of a """"""""working"""""""" CRAFT manual, 2) a set of single-case experiments designed to enhance the impact on family change mechanism and CRAFT's feasibility/acceptability, 3) the manualization of the refined CRAFT model, and 4) the development of an adherence checklist and therapist selection and training guidelines.
AIM III focuses on pilot testing the efficacy of the manualized intervention using a small randomized trial design in which subjects are randomized to either CRAFT or Family Therapy as Usual.
AIM I analyses of the basic research study and the AIM II single-case experiments series are intended to provide data that will inform the refinements of the CRAFT intervention.
AIM III analyses of the randomized trial are designed to determine effect sizes for the analyses that would be required in a Stage II efficacy trial, viz., HLM on outcomes (drug abuse and other delinquency problems); HLM analyses of postulated change mechanisms (parent practices, parent-adolescent attachment, parent-ecology interactions, and therapeutic alliance). Moreover, analyses of clinical significance will be used to identify subgroups for whom the interventions work best, and growth curve analyses using Hierarchical Linear Modeling, will be used to compare the trajectory of change in mechanisms of action between successful and unsuccessful cases.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Racioppo, Melissa M
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University of Miami School of Medicine
Schools of Medicine
United States
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Gattamorta, Karina A; Varela, Alberto; McCabe, Brian E et al. (2017) Psychiatric Symptoms, Parental Attachment, and Reasons for Use as Correlates of Heavy Substance Use Among Treatment-Seeking Hispanic Adolescents. Subst Use Misuse 52:392-400
Santisteban, Daniel A; Mena, Maite P; Abalo, Clara (2012) Bridging Diversity and Family Systems: Culturally Informed and Flexible Family Based Treatment for Hispanic Adolescents. Couple Family Psychol 2:246-263
Santisteban, Daniel A; Mena, Maite P; McCabe, Brian E (2011) Preliminary results for an adaptive family treatment for drug abuse in Hispanic youth. J Fam Psychol 25:610-4
Santisteban, Daniel A; Mena, Maite P (2009) Culturally informed and flexible family-based treatment for adolescents: a tailored and integrative treatment for Hispanic youth. Fam Process 48:253-68
Mena, Maite P; Mitrani, Victoria B; Muir, Joan A et al. (2008) Extended parent-child separations: impact on substance-abusing Hispanic adolescents. J Spec Pediatr Nurs 13:50-2
Szapocznik, Jose; Prado, Guillermo; Burlew, Ann Kathleen et al. (2007) Drug abuse in African American and Hispanic adolescents: culture, development, and behavior. Annu Rev Clin Psychol 3:77-105
Santisteban, Daniel A; Suarez-Morales, Lourdes; Robbins, Michael S et al. (2006) Brief strategic family therapy: lessons learned in efficacy research and challenges to blending research and practice. Fam Process 45:259-71
Santisteban, Daniel; Vega, Rodolfo R; Suarez-Morales, Lourdes (2006) Utilizing dissemination findings to help understand and bridge the research and practice gap in the treatment of substance abuse disorders in Hispanic populations. Drug Alcohol Depend 84 Suppl 1:S94-101
Mitrani, Victoria B; Santisteban, Daniel A; Muir, Joan A (2004) Addressing immigration-related separations in Hispanic families with a behavior-problem adolescent. Am J Orthopsychiatry 74:219-29
Santisteban, Daniel A; Coatsworth, J Douglas; Perez-Vidal, Angel et al. (2003) Efficacy of brief strategic family therapy in modifying Hispanic adolescent behavior problems and substance use. J Fam Psychol 17:121-33