Natasha Slesnick

Assessment of Alcohol and Other Drug Use by Runaway Youths: A Test-Retest Study of the Form 90.

Abstract While excellent adolescent alcohol and drug screening tools are available, there are relatively few, if any, psychometrically validated measures to use in the assessment of adolescent treatment outcome. This study conducted a test-retest exercise of the Form 90 Drug and Alcohol (Form 90 DnA) to determine the stability of adolescent responses when administering the day-by-day calendar/grid approach. Homeless youth (N = 37) with alcohol, drug, or alcohol and drug abuse/dependence combined were recruited to participate in the test-retest study. High pre-post stability in means was obtained on measures of frequency of substance use in general, and on specific measures of alcohol, cocaine, marijuana use. The findings from this paper provide support for the reliability and validity of the Form 90 for use with adolescent runaways with a substance abuse or dependence diagnosis.

Interpersonal problem-solving interactions of depressed adolescents and their parents

Research to date suggests that the family plays a significant role in the development, perpetuation, and relapse of depression in its members. This study examined the videotaped interactions of parents with a depressed adolescent and control parents and youth during a conflictual, problem-solving task. In comparison with parents of nondepressed adolescents, parents of depressed adolescents engaged in higher rates of incongruent communication in which aversive content behavior was linked with positive affective behavior. Adolescent depressed content behavior led to greater suppression of parent aversive content behavior in nondepressed families than in depressed families. The findings argue that dysfunctional family communication may be associated with the development or maintenance of depression in the child.

Office versus Home-Based Family Therapy for Runaway, Alcohol Abusing Adolescents: Examination of Factors Associated with Treatment Attendance

Abstract There is a dearth of research examining treatment engagement and attendance among runaway youth and their families. Such research is needed in order to inform treatment providers on factors associated with engagement and maintenance of these difficult to engage families into counseling. This study examined differential treatment attendance for alcohol abusing runaway youth residing at a local shelter. A traditional office-based family systems approach, Functional Family Therapy (FFT), was compared to a non-traditional, home-based, multisystemic family therapy approach, Ecologically Based Family Therapy (EBFT). As expected, treatment engagement and attendance was significantly higher for those assigned to EBFT (N = 37) compared to FFT (N = 40). Predictors of treatment attendance (income, family chaos, externalization problems and level of youth substance use) were examined within each treatment modality. Findings suggest that home-based (compared to office-based) treatment modalities may significantly increase treatment attendance and engagement of runaway youth and their families. Non-traditional forms of treatment may need to be considered in order to best meet the needs of highly chaotic and disorganized family systems.

Perceptions of the Family Environment and Youth Behaviors: Alcohol-Abusing Runaway Adolescents and Their Primary Caretakers

Research suggests family disturbance is highly correlated to adolescents running away from home. However, given methodological challenges, few studies assess parent report of the family situation and instead, rely primarily on adolescent self-report. This article reports the findings of parents’ and runaway adolescents’ reports on several behavioral dimensions. Substance-using runaway adolescents completed measures about their family environment and adolescent problem behaviors. Of 119 adolescents, 49 of their parents also completed measures at intake. Adolescents perceived a more negative family environment than did their parents, and parents rated their youth as having more externalizing problems than did the youth themselves. Findings are consonant with prior research showing a relationship between parental distress and child problems. Contrary to prior findings, this sample of parents did not report significant alcohol use, and there was no relationship between their use and their child’s use. Implications for future research and family therapy are discussed.

Evidence-Based Cognitive-Behavioral and Family Therapies for Adolescent Alcohol and Other Substance Use Disorders

Although the research on adolescent substance abuse treatment is increasing, it still lags far behind that of adults. In comparison to over 1,000 alcohol treatment outcome studies with adults (Miller et al., 1995), Williams and Chang (2000) were able to locate and review only 53 empirical studies investigating the relative effectiveness of treatments for adolescents. Family Therapies (FT) and Cognitive Behavioral Therapy (CBT) has demonstrated repeatedly to be effective in randomized trials since the 1970s for adult alcohol and other substance use disorders (AOSUD). CBT has been an active ingredient in a variety of intervention conditions including FT. In comparison, while the evidence supporting FT and CBT use either independent or jointly in youth is promising, controlled clinical efficacy and effectiveness trials have only begun to emerge in 1990s. Latest innovations in the management of treatment protocols for adolescent AOSUD and the recent completion of several randomized clinical trials examining manualized FT and CBT, have established the empirical support for these approaches in youth (Dennis et al., in press; Kaminer et al., 2002; Liddle, 2002; Waldron et al., 2001). The purpose of this chapter is to review: 1) theoretical models underlying FT and CBT, 2) evidence-based literature on FT and CBT for AOSUD in youth, and 3) mechanisms and therapeutic processes of FT and

Family Functioning, Substance Use and Related Problem Behaviors: Hispanic vs. Anglo Runaway Youths

Abstract Runaway youths represent a neglected clinical group, and few studies have examined ethnicity differences within this population. Substance use, family functioning and related problem behaviors were examined in a sample of Hispanic and Anglo runaway youths with substance abuse diagnoses (N = 145). Youths, aged 12-17, were recruited from two urban, southwestern runaway shelters. Within single-parent families, Anglo youths reported more marijuana use, and, regardless of family constitution, reported more tobacco use than did Hispanic youths. Overall, Anglo youths reported more externalizing problems and more conflict tactics used in resolving disagreements with their primary caretaker while Hispanic youths reported higher depression and familism scores. Given the differences found between Hispanic and Anglo youths, the findings argue that culturally sensitive interventions for runaway youths and families are warranted.

Establishing and Maintaining Evidence-Based Treatment in Community Programs

Over the past 40 years, an abundance of research has focused on which alcohol treatment approaches are most effective. Adult alcoholism treatment research clearly indicates that even brief treatment is generally better than no treatment at all, that certain treatments are more consistently effective than other methods, and also that there is no single treatment that is superior to all others. However, a handful of treatments seem to rise to the top in all meta-analytic reviews of the alcohol treatment literature. Even though most of these well-supported treatments have been available for some time, the gap between science and practice remains vast.