Treatment for substance use disorders is often hampered by client lack of motivation to change. The significant problem of engaging resistant substance abusing adult clients into treatment is well-known and research on developing engagement procedures for adults has been examined in a number of studies. However, procedures for engaging resistant adolescents, who differ from adults in important ways, have not been developed or evaluated. In our originally-funded project, we proposed to adapt and refine two established procedures, CRAFT and CRA, in developmentally appropriate ways for use with adolescents and their parents. For this continuation application, we have developed theoretical formulations concerning the process of engaging resistant youth in treatment and the change processes associated with reductions in substance use. We now propose to 1) increase our original sample to allow for an evaluation of the validity of our full measurement models and 2) add an additional follow-up assessment for parents and adolescents to evaluate treatment efficacy over a longer period of time. The proposed 5-year continuation project will focus on further developing our intervention for counseling parents of adolescents who are resistant to treatment, using a community reinforcement and family training (CRAFT) approach in order to improve parents' own functioning, promote treatment initiation for adolescents with drug abuse and dependence, and enhance behavior change. Two phases of treatment will be offered. During Phase I, parents of resistance adolescents (n=60) 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=54) will receive 12 sessions of individual therapy involving motivational and community reinforcement approach strategies with the goal of reducing substance use. Multidimensional assessments will extend to 15 months for parents and for adolescents in Phases I and II, respectively. 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 |
