Latimer William W, Winters Ken C, D'Zurilla Thomas, Nichols Mike
Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, 624 N. Broadway, 850 Hampton House, Baltimore, MD 21205, USA.
Drug Alcohol Depend. 2003 Sep 10;71(3):303-17. doi: 10.1016/s0376-8716(03)00171-6.
This study evaluated the efficacy of Integrated Family and Cognitive-Behavioral Therapy (IFCBT), a multisystems treatment for adolescent drug abuse, versus a Drugs Harm Psychoeducation curriculum (DHPE). A randomized controlled trial assessed youth and parents at baseline and at 1, 3 and 6-month posttreatment points. Youth participants (N=43) met diagnostic criteria for one or more psychoactive substance use disorders with most youth meeting criteria for alcohol and marijuana use disorders. IFCBT produced significant reductions in posttreatment substance use when compared against DHPE. Throughout the 6-month posttreatment period, youth receiving IFCBT used alcohol an average of 2.03 days each month, which was significantly lower than the average number of 6.06 days that DHPE youth used alcohol during the same period. Similarly, youth receiving IFCBT used marijuana an average of 5.67 days each month during the initial 6 posttreatment months which was also significantly lower than the average number of 13.83 days that DHPE youth used marijuana each month during the same period. IFCBT also reduced rates of any marijuana use and produced significant changes in targeted psychosocial risk and protective factors. IFCBT youth exhibited significantly higher levels of rational problem solving and learning strategy skills, and significantly lower levels of problem avoidance when compared with DHPE youths. IFCBT parents exhibited significantly more adaptive scores on communication, involvement, control, and values/norms indices when compared with DHPE parents. No iatrogenic effects were exhibited among youth in either IFCBT or DHPE conditions on the outcome measures examined. The present study findings suggest that IFCBT is a promising approach for the treatment of adolescents with psychoactive substance use disorders.
本研究评估了综合家庭与认知行为疗法(IFCBT)——一种针对青少年药物滥用的多系统治疗方法——与药物危害心理教育课程(DHPE)的疗效。一项随机对照试验在基线以及治疗后1个月、3个月和6个月对青少年及其父母进行了评估。青少年参与者(N = 43)符合一种或多种精神活性物质使用障碍的诊断标准,大多数青少年符合酒精和大麻使用障碍的标准。与DHPE相比,IFCBT在治疗后物质使用方面有显著减少。在整个治疗后6个月期间,接受IFCBT治疗的青少年平均每月饮酒2.03天,这显著低于同期接受DHPE治疗的青少年平均6.06天的饮酒天数。同样,接受IFCBT治疗的青少年在治疗后的最初6个月中平均每月使用大麻5.67天,这也显著低于同期接受DHPE治疗的青少年平均每月13.83天的大麻使用天数。IFCBT还降低了任何大麻使用的发生率,并在目标心理社会风险和保护因素方面产生了显著变化。与接受DHPE治疗的青少年相比,接受IFCBT治疗的青少年在理性问题解决和学习策略技能方面表现出显著更高的水平,而在问题回避方面表现出显著更低的水平。与接受DHPE治疗的父母相比,接受IFCBT治疗的父母在沟通、参与、控制以及价值观/规范指数方面表现出显著更具适应性的得分。在接受IFCBT或DHPE治疗的青少年中,在所检查的结果指标上均未表现出医源性效应。本研究结果表明,IFCBT是治疗患有精神活性物质使用障碍青少年的一种有前景的方法。