The primary aims of the proposed study are to: 1) investigate the efficacy of Structural Ecosystems Therapy (SET) in reducing adolescent drug use and conduct problems, and 2) examine it's theoretical mechanisms of action. SET is a culturally sensitive comprehensive ecosystemic intervention that systematically targets maladaptive patterns of interaction at three levels of the adolescent's social ecology: microsystem (family, peers, school, and justice system), mesosystem (family-peer, family-school, and family-justice system), and exosystem (parental support system). It is hypothesized that improvements in functioning at these three levels will lead to: 1) reductions in symptomatic behaviors of a) drug use, and b) conduct, delinquent, and antisocial behaviors; and 2) improvements in psychosocial functioning. An experimental design is achieved by randomly assigning 312 (156 African-American, 156 Hispanic) drug using, behavior problem adolescents to one of three treatment conditions: SET, Structural family therapy (FAM), and community control (CC). FAM represents one standard of care in the treatment of drug using, behavior problem adolescents, and CC is intended to replicate the typical range of services currently provided in our community. Three rigorous procedures are designed to ensure fidelity to conditions. Comprehensive assessments of adolescent drug use, conduct problems, and functioning at each of the three ecosystemic levels are conducted at baseline, and 6, 12, and 18 months post-baseline. Analyses investigate the intervention's direct effects on behavioral outcomes (drug use, conduct problems, and psychosocial functioning), and hypothesized mediators (micro-, meso-, and exosystemic functioning), as well as the contribution of each mediator to outcome. Proposed analyses include RMANOVA, structural equations modeling, and Hierarchical Linear Modeling. Additional analyses explore the moderating effects of race/ethnicity, culture, treatment adherence, and treatment dosage.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA010574-02
Application #
2458476
Study Section
Special Emphasis Panel (SRCD (21))
Program Officer
Racioppo, Melissa M
Project Start
1996-09-30
Project End
2001-07-31
Budget Start
1997-08-01
Budget End
1998-07-31
Support Year
2
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of Miami School of Medicine
Department
Psychiatry
Type
Schools of Medicine
DUNS #
City
Miami
State
FL
Country
United States
Zip Code
33146
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