Youth Drug Abuse Family and Cognitive-Behavioral Therapy
Condition: Drug Abuse
MeSH terms: Substance-Related Disorders
Study type: Interventional
Phase: Phase 2

Summary: 
      This Stage II study is in response to NIDA's Behavioral Therapies Development Program
      (PA-99-107). A randomized clinical trial is proposed to evaluate the direct, mediated, and
      moderated effects of Integrated Family and Cognitive-Behavioral Therapy (IFCBT), a
      multisystems treatment for adolescent drug abuse with promising efficacy results. In the
      first study aim, we seek to evaluate the separate and possibly synergistic effects of family
      systems and cognitive-behavioral IFCBT components on posttreatment drug abuse problem
      severity, problem behavior, psychiatric distress, and academic achievement of adolescent drug
      abusers. Innovative analytic strategies are subsequently used to evaluate the degree to which
      successful outcomes are attributable to specific familial and cognitive-behavioral change
      processes targeted by IFCBT components. The possibility of effect-modification also is
      considered, with a focus on neurocognitive, psychiatric comorbidity, and demographic factors.
      Namely, we seek to understand how variations in specific client characteristics, such as
      executive dysfunctions or psychiatric comorbidity, might explain why treatments work for some
      drug abusing youths but not others. In addition to promising findings on IFCBT efficacy, this
      Stage II proposal benefits from the development and Stage I study application of (a)
      treatment manuals; (b) therapist training procedures; (c) therapist adherence and competence
      tools; (d) a neuropsychological battery to assess cognitive functions; (e) a psychodiagnostic
      battery to assess comorbid psychiatric disorders; and (f) a study assessment battery
      comprised of therapeutic process and outcome measures. This revised application has sought to
      address well-taken concerns cited by the reviewers while maintaining proposal strengths. The
      lack of adolescent drug treatment research continues to be a serious gap in the addictions
      literature despite alarmingly high rates of drug abuse among youth and the range of
      morbidities and mortality that result nationwide. If successful, this project should help to
      identify specific behavior change processes targeted by family systems and
      cognitive-behavioral treatments that foster subsequent reductions in drug use and problem
      behavior among recovering youth. Neurocognitive and psychiatric influences on adolescent drug
      treatment outcomes appear to be significant yet are poorly understood. Increasing our
      understanding of relationships between client characteristics, skill development during
      treatments, and subsequent outcomes should also help to improve adolescent drug treatments.
    

Detailed description: 
      This Stage II study is in response to NIDA's Behavioral Therapies Development Program
      (PA-99-107). A randomized clinical trial is proposed to evaluate the direct, mediated, and
      moderated effects of Integrated Family and Cognitive-Behavioral Therapy (IFCBT), a
      multisystems treatment for adolescent drug abuse with promising efficacy results. In the
      first study aim, we seek to evaluate the separate and possibly synergistic effects of family
      systems and cognitive-behavioral IFCBT components on posttreatment drug abuse problem
      severity, problem behavior, psychiatric distress, and academic achievement of adolescent drug
      abusers. Innovative analytic strategies are subsequently used to evaluate the degree to which
      successful outcomes are attributable to specific familial and cognitive-behavioral change
      processes targeted by IFCBT components. The possibility of effect-modification also is
      considered, with a focus on neurocognitive, psychiatric comorbidity, and demographic factors.
      Namely, we seek to understand how variations in specific client characteristics, such as
      executive dysfunctions or psychiatric comorbidity, might explain why treatments work for some
      drug abusing youths but not others. In addition to promising findings on IFCBT efficacy, this
      Stage II proposal benefits from the development and Stage I study application of (a)
      treatment manuals; (b) therapist training procedures; (c) therapist adherence and competence
      tools; (d) a neuropsychological battery to assess cognitive functions; (e) a psychodiagnostic
      battery to assess comorbid psychiatric disorders; and (f) a study assessment battery
      comprised of therapeutic process and outcome measures. This revised application has sought to
      address well-taken concerns cited by the reviewers while maintaining proposal strengths. The
      lack of adolescent drug treatment research continues to be a serious gap in the addictions
      literature despite alarmingly high rates of drug abuse among youth and the range of
      morbidities and mortality that result nationwide. If successful, this project should help to
      identify specific behavior change processes targeted by family systems and
      cognitive-behavioral treatments that foster subsequent reductions in drug use and problem
      behavior among recovering youth. Neurocognitive and psychiatric influences on adolescent drug
      treatment outcomes appear to be significant yet are poorly understood. Increasing our
      understanding of relationships between client characteristics, skill development during
      treatments, and subsequent outcomes should also help to improve adolescent drug treatments.
    

Intervention name(s): Integrated Family and Cognitive-Behavioral Therapy; Education
Intervention type(s): Behavioral; Other
Intervention description(s): The family therapy component of IFCBT includes engagement, active treatment, and maintenance phases. The cognitive program focuses on harmful effects of drugs and strategies to better manage drug abuse risks. The cognitive-behavioral program introduces youths to problem-solving behavior change principles and study skills to promote school achievement.; Drug education curriculum was delivered to participants assigned to this condition.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: drug abuse; drug dependence; treatment; randomized trial; stage II study; adolescents; young adults; efficacy study