1999 — 2000 |
Hogue, Aaron |
R03Activity Code Description: To provide research support specifically limited in time and amount for studies in categorical program areas. Small grants provide flexibility for initiating studies which are generally for preliminary short-term projects and are non-renewable. |
Family Change Mechanisms in Adolescent Drug Use Therapy
The ultimate objective of this small grant study is to increase the effectiveness of family-based therapy for adolescent drug abuse, which is building solid empirical support as an efficacious treatment approach. This study will seek to identify family-related treatment processes associated with reducing drug use in a primarily urban, African American, juvenile justice-involved sample. The attempt to illuminate links between specific therapeutic interventions and positive treatment outcomes is vital to developing more effective, targeted, and transportable therapy models for dissemination in the treatment community. First, the proposed study will examine the importance of therapist efforts to centralize family members and family or individual-based therapy. Adolescents and parents completed measures of adolescent drug use and family functioning (cohesion, parental investment), and videotaped therapy sessions and therapist contact logs will be reviewed to assess the degree of family involvement in each treatment condition. Structural equation modeling will be used to test the following mediational hypotheses: family therapy will lead to comparatively greater reduction in drug use by means of involving family members to a greater extent in treatment, and moreover, it will produce these gains by means of improving family functioning over the course of therapy. Second, the proposed study will explore the success of family therapy in enhancing a crucial ingredient of healthy adolescent development: autonomous-relatedness family interactions. A subsample of 18 family therapy and 11 individual therapy cases participated family interaction tasks that will be coded for family behaviors that support individuation while also providing a secure relationship base for the adolescent. Exploratory correlational analyses will be used to test the hypotheses that family therapy will produce greater gains in autonomous-relatedness and that these gains will be associated with improvement in adolescent drug use and other aspects of family functioning. This study will be among the first to use observational methods for linking family-focused interventions with outcome and for exploring changes in developmentally pivotal family processes in treatment for substance-abusing adolescents.
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0.961 |
2001 — 2003 |
Hogue, Aaron |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Adherence and Competence in Adolescent Drug Use Therapy
DESCRIPTION: (provided by applicant) The ultimate objective of the proposed study is to increase the effectiveness of two manualized treatments for adolescent drug abuse by investigating the relation of treatment adherence and therapist competence to treatment outcomes. The study will examine existing data from a randomized clinical trial comparing multidimensional family therapy (MDFT) and individual cognitive-behavioral therapy (CBT), which represent two widely practiced, empirically supported treatment approaches for adolescent substance use. Treatment adherence and therapist competence have been identified as critical elements of manualized treatment implementation and as key predictors of therapeutic gains in both adolescent and adult populations. Studies that illuminate the associations among adherence, competence, and outcome are vital for developing more effective, targeted, and transportable therapy models for dissemination in diverse clinical settings. Subjects will include 143 inner-city, primarily African American, juvenile-justice involved adolescents and their caregivers. Adolescents and caregivers completed pre- and post-treatment measures of drug use and drug involvement, externalizing and internalizing symptoms, prosocial behavior, and family functioning. Archived videotapes of therapy sessions will be reviewed to assess treatment fidelity, therapist skill, and therapeutic alliance. Study hypotheses will test both the direct and indirect effects of adherence and competence on adolescent drug use and comorbid symptomatology. Structural equation modeling will examine whether: (1) for MDFT, greater adherence and competence produce better outcomes by means of improving parenting skills and family relationships; (2) for CBT, greater adherence and competence produce better outcomes by means of increasing adolescent self-efficacy and prosocial involvement; (3) for both treatments, the effects of treatment adherence are moderated by therapist competence and therapeutic alliance. This study will be among the first to explore the relation between treatment adherence and outcome, and the very first to study therapist competence, with an adolescent drug-using sample.
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0.961 |