基于社区的青少年物质使用循证治疗的效果。
The effectiveness of community-based delivery of an evidence-based treatment for adolescent substance use.
机构信息
Drug Policy Research Center, RAND, Santa Monica, CA 90407, USA.
出版信息
J Subst Abuse Treat. 2012 Sep;43(2):211-20. doi: 10.1016/j.jsat.2011.11.003. Epub 2011 Dec 29.
Abstract
This study evaluates the effectiveness of motivational enhancement therapy/cognitive behavioral therapy-5 (MET/CBT-5) when delivered in community practice settings relative to standard community-based adolescent treatment. A quasi-experimental strategy was used to adjust for pretreatment differences between the MET/CBT-5 sample (n = 2,293) and those who received standard care (n = 458). Results suggest that youth who received MET/CBT-5 fared better than comparable youth in the control group on five of six 12-month outcomes. A low follow-up rate (54%) in the MET/CBT-5 sample raised concerns about nonresponse bias in the treatment effect estimates. Sensitivity analyses suggest that although modest differences in outcomes between the MET/CBT-5 nonrespondents and respondents would yield no significant differences between the two groups on two of the six outcomes, very large differences in outcomes between responders and nonresponders would be required for youth receiving MET/CBT-5 to have fared better had they received standard outpatient care.
摘要
本研究评估了动机增强疗法/认知行为疗法-5（MET/CBT-5）在社区实践环境中的有效性，相对于标准的基于社区的青少年治疗。采用准实验策略来调整 MET/CBT-5 样本（n=2293）和接受标准护理的样本（n=458）之间治疗前的差异。结果表明，在六项 12 个月的结果中，接受 MET/CBT-5 的青少年在五项结果上的表现优于对照组的可比青少年。MET/CBT-5 样本的随访率低（54%）引起了对治疗效果估计中无应答偏倚的关注。敏感性分析表明，尽管 MET/CBT-5 无应答者和应答者之间的结果存在适度差异，但如果接受 MET/CBT-5 的青少年接受标准门诊护理，那么两组在六项结果中的两项上也不会有显著差异，需要在应答者和无应答者之间存在非常大的结果差异，才能说明接受 MET/CBT-5 的青少年表现更好。
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