Waldron Holly Barrett, Turner Charles W
Oregon Research Institute, Eugene, OR 97403, USA.
J Clin Child Adolesc Psychol. 2008 Jan;37(1):238-61. doi: 10.1080/15374410701820133.
This review synthesized findings from 17 studies since 1998 regarding evaluation of outpatient treatments for adolescent substance abuse. These studies represented systematic design advances in adolescent clinical trial science. The research examined 46 different intervention conditions with a total sample of 2,307 adolescents. The sample included 7 individual cognitive behavior therapy (CBT) replications (n = 367), 13 group CBT replications (n = 771), 17 family therapy replications (n = 850) and 9 minimal treatment control conditions (n = 319). The total sample was composed of approximately 75% males, and the ethnic/racial distribution was approximately 45% White, 25% Hispanic, 25% African American, and 5% other groups. Meta-analysis was used to evaluate within-group effect sizes as well as differences between active treatment conditions and the minimal treatment control conditions. Methodological rigor of studies was classified using Nathan and Gorman (2002) criteria, and treatments were classified using criteria for well-established and probably efficacious interventions based on Chambless et al. (1996). Three treatment approaches, multidimensional family therapy, functional family therapy, and group CBT emerged as well-established models for substance abuse treatment. However, a number of other models are probably efficacious, and none of the treatment approaches appeared to be clearly superior to any others in terms of treatment effectiveness for adolescent substance abuse.
本综述综合了自1998年以来17项关于青少年药物滥用门诊治疗评估的研究结果。这些研究代表了青少年临床试验科学在系统设计方面的进展。该研究考察了46种不同的干预条件,总样本为2307名青少年。样本包括7项个体认知行为疗法(CBT)重复研究(n = 367)、13项团体CBT重复研究(n = 771)、17项家庭疗法重复研究(n = 850)以及9项最小治疗对照条件研究(n = 319)。总样本中约75%为男性,种族分布约为45%白人、25%西班牙裔、25%非裔美国人以及5%其他群体。采用荟萃分析来评估组内效应量以及积极治疗条件与最小治疗对照条件之间的差异。研究的方法严谨性依据内森和戈尔曼(2002年)的标准进行分类,治疗方法则依据钱布利斯等人(1996年)确立的成熟且可能有效的干预标准进行分类。三种治疗方法,即多维家庭疗法、功能家庭疗法和团体CBT,成为了药物滥用治疗的成熟模式。然而,许多其他模式可能也是有效的,就青少年药物滥用的治疗效果而言,没有一种治疗方法明显优于其他方法。