Family-based and Adolescent Residential Drug Treatment

Not Applicable

Completed

• Conditions: Substance Use; Delinquency
• Interventions: Behavioral: Multidimensional Family Therapy (MDFT); Behavioral: Adolescent Residential Treatment

• Registration Number: NCT01737632
• Lead Sponsor: University of Miami

Brief Summary

The fundamental objective of this study is to compare the effectiveness of an intensive in-home family-based treatment, Multidimensional Family Therapy, with a multifaceted residential treatment, Adolescent Residential Treatment, over 4 years post-intake and to delineate the mechanisms of change for each treatment. The study targets dually- diagnosed adolescent drug abusers recommended for residential treatment.

Detailed Description

Aim 1: To compare the effectiveness of residential treatment with outpatient, family-based treatment multiple outcomes including substance use, mental health, school functioning, family function and delinquency among dually diagnosed adolescents.

Hypothesis 1. From intake to 2 months, residential treatment will show better outcomes than the family based treatment. Between 2 months and 18 months, family based treatment will show better outcomes than residential. Between 18 months and four years post intake, outpatient family based treatment will maintain its treatment gains, while the residential treatment condition will show an increase in these same symptoms and behaviors.

Aim 2: To examine the relationship between predictors (family, peer, educational/vocational functioning and involvement in post-treatment services), and outcomes (drug use, co-morbid symptoms, and criminal behavior) during the four-year post intake period.

Hypothesis 2a. Family functioning, educational/vocational functioning, and peer relationships measured at discharge will predict drug use, co-morbid symptoms, and criminal behaviors though the four year longer term follow up period.

Hypothesis 2b. Family functioning, educational/vocational functioning, peer relationships, and involvement in post-treatment services during the post treatment period will predict drug use, co-morbid symptoms, and criminal behavior through the longer term follow up period.

Research Question 1. Is the rate of change in family functioning, educational/vocational functioning, peer relationships, and involvement in post-treatment services related to the rate of change in drug use, co-morbid symptoms, and criminal behavior?

Study Timeline

• Study Start: 2000-08
• Primary Completion: 2008-06
• Study Completion: 2010-06
• Status Verified: 2012-11
• Study First Submitted: 2012-11-20
• Study First Submitted QC: 2012-11-26
• Last Update Submitted: 2012-11-26
• Study First Posted: 2012-11-29
• Last Update Posted: 2012-11-29

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 113

Inclusion Criteria

• Youth between the ages of 13 and 17
• Referred to ATP for residential substance abuse treatment in youth dual diagnosis program
• Dually diagnosed for substance abuse or dependence and at least one of the following co-morbid conditions: major depressive disorder, bipolar disorder, I conduct disorder, oppositional defiant disorder,
• At least one parent or parent-figure can be located at the time of referral.
• Obtain informed consent from a parent or formal guardian and assent from youth to participate in the study.

Exclusion Criteria

• Have any of the following disorders: Mental Retardation, Eating Disorders, Schizophrenia, or Pervasive Developmental Disorders.
• Current suicidality.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Multidimensional Family Therapy (MDFT)	Multidimensional Family Therapy (MDFT)	MDFT is an intensive, in-home family-based drug abuse treatment for adolescent substance abusers. MDFT views family factors in their context -in terms of the network (individual, familial, peer, community) or multiplicity of influences on drug use and change.
Adolescent Residential Treatment	Adolescent Residential Treatment	The Adolescent Treatment Program (ATP) is a residential dual diagnosed substance abuse treatment program that is staff secure. It is based on a social learning approach which emphasizes positive reinforcement for appropriate coping behavior and social skills, and incorporates a "levels" system which allocates privileges and responsibilities according to the individual's behavioral capacities.

Primary Outcome Measures

Name	Time	Method
Change in Personal Involvement with Chemicals	Baseline, 2, 4, 12, 18, 24, 36 and 48 months after baseline	Scale from the Personal Experience Inventory (PEI) developed by Ken Winter.
Change in substance use consumption	Baseline, 2, 4, 12,18,24,36,48 months after intake	Measure of substance use consumption as measured by the Timeline Follow-back Method.
Change in externalizing symptoms	Baseline, 2, 4, 12, 18, 24, 36 and 48 months	Externalizing symptoms measured by the Youth Self Report
Change in delinquency	Intake, 2, 4, 12, 18, 24, 35, 48 months after intake	Measured by youth report on the Self Report Delinquency Scale.
Change in internalzing symptoms	Intake, 2, 4, 12, 18, 24, 36, 48 months after baseline	Measured by the Youth Self Report (YSR)

Secondary Outcome Measures

Name	Time	Method
Change in family conflict	Baseline, 2, 4, 12, 18, 24, 36, 48 months after baseline	Parent and youth report on their family conflict as measured by the Family Environment Scale.
Change in parenting practices	Baseline, 2, 4, 12, 18, 24,36, 48 months after baseline	Measures the extent to which parents monitor, set limits, and provide affection to their teens.
Change in family cohesion	Intake, 2, 4, 12, 18, 24, 26, 48 months after intake	Youth and parent reports of family closeness measured by the Family Environment Scale (FES)

Trial Locations

Locations (2)

University of Miami Miller School of Medicine; 🇺🇸 Miami, Florida, United States

The Village, Inc.; 🇺🇸 Miami, Florida, United States