Family Assessment Motivation, and Linkage Intervention (FAMLI)
Condition: Mapping Enhanced Counseling (MEC); Active Linkage (AL)
Study type: Interventional

Summary: 
      The R34 study will integrate existing tools for use with JJ populations and examine the
      feasibility, acceptability, and preliminary efficacy of a caregiver-youth intervention aimed
      at increasing SU treatment initiation. The adaptive intervention incorporates three
      evidence-based components: 1) assessment of motivation and linkage-related barriers with
      personalized feedback, 2) Mapping-Enhanced Counseling (MEC) for improving readiness for
      change and interpersonal communication, and 3) Active Linkage (AL) for addressing logistical
      barriers to service initiation. Youth-caregiver dyads will be randomly assigned to receive an
      initial dose (2, 1-hr sessions) of either MEC or AL. After 30 days, participants will be
      classified as Responders (1 or more services initiated) or Non-responders (no service
      initiation). All participants will be randomized to one of two intervening interventions: an
      additional dose (2, 1-hr sessions) of the initial intervention (MEC or AL) or a different
      dose (2, 1-hr sessions of the other). The specific aims are to 1) integrate and adapt
      appropriate evidence-based intervention components as a dyadic intervention approach for JJ
      youth and caregivers; 2) test the feasibility, acceptability, and optimal configuration of
      the dyadic intervention components and the protocol used to evaluate effectiveness (including
      feasibility of recruitment, implementation, measurement); and 3) preliminarily explore a)
      whether an initial dose of MEC or AL is sufficient for promoting early initiation and
      engagement, b) whether an additional dose of MEC or AL or a change in dose is more effective,
      and c) which component sequence is most effective. Primary outcomes include youth (initiation
      of assessment or counseling; counseling attendance) and caregiver (attendance at assessment,
      first counseling, and/or family sessions) measures. Secondary outcomes include youth and
      caregiver attitudes (problem recognition, desire for help), normative beliefs (SU norms),
      perceived control (stressors and obstacles), and youth SU (self-report corroborated by UA
      results). The study addresses the sizeable gap in service receipt among JJ youth by
      addressing family engagement, and focuses on improving motivation to change, linkage to
      services, and treatment engagement.
    


Intervention name(s): Mapping Enhanced Counseling; Active Linkage
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Practitioner-led, collaborative discussion with the youth and their caregiver on co-creating guide maps for decision making around starting treatment and continuing substance use that can help users organize information and think through a series of steps, questions, and behavior choices. encountered when attempting to initiate substance use treatment services. MEC is a communication and decision-making approach that uses graphic visualization tools to train individuals to monitor and control their decision making, improve judgment and behavioral choices (self-regulation), and improve communication and mutual understanding.; Practitioner-led, collaborative discussion with the youth and their caregiver on how to overcome barriers encountered when attempting to initiate substance use treatment services. Discussion focuses around the top barriers identified through assessment and identification of 1 or more treatment agency/options that fit the family's needs. Practitioner takes a more active role in addressing barriers to treatment by helping the family find ways to access resources for payment, childcare, or other needs, and actively linking them to the treatment provider (e.g., scheduling the initial appointment with family present).
Allocation: Randomized
Intervention model: Sequential Assignment
Masking: None (Open Label)
Primary purpose: Treatment