Mark J. Macgowan

Effective Family-Based Interventions for Adolescents With Substance Use Problems: A Systematic Review

Objective: This article is a systematic review identifying effective family-based interventions for adolescent substance use problems. Method: A substantive review of each intervention is conducted using guidelines for effective treatment for substance use problems. Additionally, a methodological review of each study is done using criteria for empirically validated treatments. Results: Treatment components of five interventions—Brief Strategic Family Therapy (BSFT), Family Behavior Therapy, Functional Family Therapy, Multidimensional Family Therapy (MDFT), and Multisystemic Treatment—were consistent with a majority of guidelines for effective treatment. Notable exceptions include no aftercare and poor treatment retention. MDFT and BSFT met criteria of probably efficacious treatment, whereas the other interventions represented promising treatments. Moreover, MDFT demonstrated clinically significant changes in substance use and large effect sizes at posttreatment and follow-up. Conclusion: To increase provision of effective adolescent substance abuse treatment, social workers should use these research findings to guide implementation.

Engagement, Denial, and Treatment Progress Among Sex Offenders in Group Therapy

This study investigates the relationship between engagement, denial, and treatment progress among a sample of 61 male sex offenders in outpatient group therapy. Three hypotheses were posed: (1) that denial is inversely related to engagement in group therapy; (2) that denial is inversely related to treatment progress, and (3) that engagement is correlated with treatment progress. Results revealed a strong correlation between engagement in group therapy, measured by the Group Engagement Measure, and sex offender treatment progress, assessed by the Sex Offender Treatment Rating Scale. Denial, measured by the Facets of Sexual Offender Denial Scale, demonstrated a strong inverse relationship to treatment progress. Engagement and denial were also strongly inversely related. Together, engagement and denial explained a significant amount of the variance in treatment progress. The findings provide support for current standards of practice that maintain that admitting to a sex crime is a necessary condition for progress and engagement in treatment. Strategies for increasing engagement and treatment progress, and reducing denial, are discussed.

The Carolina Child Checklist of Risk and Protective Factors for Aggression

Objective: Extending the Social Health Profile and other instruments that measure problem behavior in childhood, the Carolina Child Checklist (CCC) was developed to measure risk and protective factors related to aggressive behavior in children ages 6 to 12. This study reports the psychometric properties of the CCC. Method: The measure’s dimensionality, reliability (internal consistency and test-retest), standard error of measurement, and validity (convergent, concurrent, treatment sensitivity) were evaluated in a project involving 171 sixth-grade students. Results: Factor analysis indicated four dimensions called Learning Orientation (behaviors and attributes related to classroom success), Relational Aggression, Social Involvement, and Physical Aggression. The measure has high internal consistency with low measurement error. Test-retest findings suggest a stable measure. The CCC has good convergent and concurrent validity and appears sensitive to treatment effects. Conclusions: The CCC is a promising measure for social workers assessing risk and protective factors related to childhood aggression.

Teaching Standards–Based Group Work Competencies to Social Work Students An Empirical Examination

Objectives: Accreditation standards and challenges in group work education require competency-based approaches in teaching social work with groups. The Association for the Advancement of Social Work with Groups developed Standards for Social Work Practice with Groups, which serve as foundation competencies for professional practice. However, there has been no empirical publication about using them in teaching. This pilot study tested a microskills teaching approach to improve competency in the Standards. Methods: The mixed-methods study used a preexperimental, pretest–posttest design involving 123 diverse baccalaureate and master’s students in introductory group work courses. Student responses about the experience were also collected. Results: There were significant, substantial increases in students’ perceived importance of and confidence in using the Standards. Confidence gain scores were significantly associated with performance in role-plays. Comments about the assignments were highly favorable and identified role-plays as contributing most to learning. Conclusions: The teaching approach advanced Standards-based group work education.

Iatrogenic Effects of Group Treatment on Adolescents with Conduct and Substance Use Problems: A Review of the Literature and a Presentation of a Model

Abstract Group therapy is the most popular approach in the treatment of adolescent substance use problems. Recently, concerns have mounted about possible iatrogenic effects of group therapy based on studies on adolescents with conduct disorder. This paper reviews three possible contributors to response to group treatment among adolescents, and proposes a model of the relations among these variables, specifically in regard to how they independently and interactively contribute to outcomes among youth with conduct and substance use problems.

Psychosocial Treatment of Youth Suicide: A Systematic Review of the Research

This article systematically reviews evidence for treatment of adolescent suicidality. In all, 10 empirical studies intended to reduce suicidal behaviors (e.g., suicide attempts) or suicidal ideation were reviewed. Each studys intervention was described and evaluated using two sets of independent criteria to assess the degree to which it was successful in reducing suicidality and the level of its empirical support (well established or probably efficacious). Most of the interventions were successful in reducing suicidality. However, no treatment met the criteria of well established and only two were probably efficacious. Most studies had important methodological limitations. Features of the promising interventions were summarized and methodological limitations highlighted. The number of interventions has increased in the past 10 years, but the research evidence remains weak. Recommendations are offered to strengthen the research, and the role of social workers in using these findings and advancing the research is discussed.

Markers of Marijuana Use Outcomes Within Adolescent Substance Abuse Group Treatment

Objectives: Despite their popularity, little is known about what distinguishes effective from ineffective or even iatrogenic adolescent group interventions. Methods: Audio recordings and transcripts from 19, 8—10 session, school-based treatment groups comprised of 108, substance abusing 10- to 19-year olds were analyzed. Group leader empathy was measured globally, while two new constructs, group commitment and peer response, were measured using discourse analysis. All variables were measured at the group level. Results: Associations among these process variables were tested and supported, as were the hypothesized associations between both group member language constructs and marijuana use outcomes. Conclusions: These findings were consistent with a proposed theoretical model in which group commitment and peer response predict marijuana use outcomes and mediate the effects of group leader empathy. These observable, in-session, verbal behaviors could distinguish whether adolescents in a group intervention will decrease, maintain, or possibly increase the targeted behavior and are likely influenced by group leader empathy.

A Critical Review of Adolescent Substance Abuse Group Treatments

Objective: Evidence-based social work requires the use of interventions that are supported by good research evidence. This article reviews the empirical research on adolescent alcohol and other drug (AOD) abuse group treatments. Despite the popularity of group work, searches of the academic literature yielded only 13 adolescent group treatments for which AOD use outcomes have been reported. These treatments and the studies that evaluated them are systematically reviewed. Method: Methodological, efficacy rating, and treatment factor criteria are applied to these studies. Results: Statistically significant reductions in pre-, post-, and/or follow-up use rates of one or more substances were reported for 10 of the 13 reviewed treatments, but only two met Chambless and Hollons (1998) criteria for “possible efficacy.” Similarities between the two possibly efficacious treatments, as well as among the three treatments with no indication of positive outcomes are described. A major limitation of the studies overall was the lack of group treatment factor descriptions and analyses. Conclusion: If the state of the science is to advance, adolescent AOD group treatment researchers must improve study designs and reporting on group-related treatment factors. Based on the limited information provided, treatment factors and/or active ingredients that may distinguish effective vs. ineffective group work are discussed. Finally, the evidence suggests that group work is a viable modality for treating adolescent AOD abuse despite recent concerns to the contrary. Recommendations for advancing the state of the science are made.

A Standards-Based Inventory of Foundation Competencies in Social Work with Groups.

Objective: This article describes the development of a measure of foundation competencies in group work derived from the Standards for Social Work Practice with Groups. Developed by the Association for the Advancement of Social Work with Groups, the Standards have not been widely used. An instrument based on the Standards can help advance evidence-based teaching and practice. Methods: Items were drawn from the Standards yielding a 70-item inventory measuring two domains for each item: how important the item is for successful group work and how confident the respondent is about demonstrating the skill in practice. Psychometric testing involved 426 mostly students. Results: The alpha for both the importance and the confidence subscales was .98, with low standard errors of measurement. Developed directly from the Standards, the inventory had prima facie content validity, further supported by expert ratings. Significant correlations between the subscales and validators supported a range of validity analyses.

Psychometrics Of The Group Engagement Measure With Male Sex Offenders

This study examined the psychometric properties of the Group Engagement Measure (GEM) with a purposive sample of 61 adult male sex offenders in long-term, open-ended treatment groups. The GEM was highly internally consistent with a low standard error of measurement. Construct validity consisted of assessing the correlations between the GEM and the Group Attitude Scale, the Sex Offender Treatment Rating Scale, and the Facets of Sexual Offender Denial at the scale and subscale levels. The entire scale was favorably correlated with the constructs, and the subscales had mostly significant associations, with correlations ranging from mild to strong, depending on the measure or subscale.