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养育实践在多维家庭治疗早期干预试验中对治疗效果的中介作用。

Parenting practices as mediators of treatment effects in an early-intervention trial of multidimensional family therapy.

机构信息

Department of Psychology, Sam Houston State University, Huntsville, Texas 77341-2247, USA.

出版信息

Am J Drug Alcohol Abuse. 2009;35(4):220-6. doi: 10.1080/00952990903005890.

Abstract

BACKGROUND

Contemporary intervention models use research about the determinants of adolescent problems and their course of symptom development to design targeted interventions. Because developmental detours begin frequently during early-mid adolescence, specialized interventions that target known risk and protective factors in this period are needed.

METHODS

This study (n = 83) examined parenting practices as mediators of treatment effects in an early-intervention trial comparing Multidimensional Family Therapy (MDFT), and a peer group intervention. Participants were clinically referred, low-income, predominantly ethnic minority adolescents (average age 14). Assessments were conducted at intake, and six weeks after intake, discharge, and at 6 and 12 months following intake.

RESULTS

Previous studies demonstrated that MDFT was more effective than active treatments as well as services as usual in decreasing substance use and improving abstinence rates. The current study demonstrated that MDFT improves parental monitoring-a fundamental treatment target-to a greater extent than group therapy, and these improvements occur during the period of active intervention, satisfying state-of-the-science criteria for assessing mediation in randomized clinical trials.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

Findings indicate that change in MDFT occurs through improvements in parenting practices. These results set the foundation for examining family factors as mediators in other samples.

摘要

背景

当代干预模式利用关于青少年问题决定因素及其症状发展过程的研究,来设计有针对性的干预措施。由于在青少年早期到中期经常出现发展弯路,因此需要针对这一时期已知风险和保护因素的专门干预措施。

方法

本研究(n=83)考察了养育实践作为早期干预试验中两种治疗效果的中介因素,该试验比较了多维家庭治疗(MDFT)和同伴小组干预。参与者是经临床推荐的、收入低、以少数民族为主的青少年(平均年龄 14 岁)。评估在入组时、入组后 6 周、出院时以及入组后 6 个月和 12 个月进行。

结果

先前的研究表明,MDFT 在减少药物使用和提高戒断率方面比积极治疗和常规服务更有效。本研究表明,MDFT 比小组治疗更能提高父母的监督能力——这是一个基本的治疗目标,而且这些改善发生在积极干预期间,满足了随机临床试验中介评估的科学标准。

结论和科学意义

研究结果表明,MDFT 的变化是通过改善养育实践来实现的。这些结果为在其他样本中检验家庭因素作为中介因素奠定了基础。

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