CRA for Substance Abusing Caregivers of Delinquent Youth

Medical University Of South Carolina, Charleston SC

Investigators

Abstract

DESCRIPTION (provided by applicant): During the past decade, major advances have been made in the treatment of serious antisocial behavior in adolescents (U.S. Public Health Service, 2001). For example, three treatment models (i.e., Multisystemic Therapy [MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998], Multidimensional Treatment Foster Care [MTFC; Chamberlain & Mihalac, 1998], and Functional Family Therapy [FFT; Alexander et al., 1998]) have been identified as effective treatments of adolescent criminal behavior by the Office of Juvenile Justice and Delinquency Prevention and the Surgeon General (U.S. Public Health Service, 1999). Favorable outcomes for adolescents with serious antisocial behavior, however, are often compromised by caregiver substance abuse. In light of the well-documented effectiveness of several treatments for adult substance abuse (Budney & Higgins, 1998; Carroll, 1998; McLellan 2002), the coordination of effective interventions aimed at adult substance abusers (e.g., parents and caregivers) with evidence-based treatments of serious antisocial behavior (i.e., violence, substance abuse) in adolescents holds promise in improving outcomes. The overriding purpose of the proposed study, therefore, is to take substantive steps in developing protocols to coordinate evidence-based treatment of adult substance abuse with evidence-based treatments of serious antisocial behavior. Specific aims include: Aim 1. Specify adaptations to the CRA and MST treatment, supervisory and consultation protocols such that treatment of caregiver substance use disorders (SUD) can be integrated into the intensive home-based services provided to MST youth. Aim 2. Develop adherence measures for the protocols specified in Aim 1. These will build on existing adherence measures used to evaluate treatment adherence to MST (Henggeler & Borduin, 1992; Schoenwald et al., 2000) and protocols developed to support treatment fidelity to CRA for adolescents (Randall, Halliday- Boykins, et al., 2001). Aim 3. Conduct a randomized pilot study of the revised manualized therapies with 20 MST families with substance abusing caregivers in real world practice settings. Aim 4. Work with the primary developer of MTFC (i.e., Dr. Patricia Chamberlain) to adapt the protocols and procedures developed in Aims 1 and 2 to be compatible with the MTFC treatment model. Test the protocols with 6 MTFC families. Aim 5. If findings are favorable, use the materials and results obtained in the pilot studies to develop a R01 grant application using MST practice sites and a R21 grant application using MTFC sites.