Pugatch Marianne, Knight John R, McGuiness Patricia, Sherritt Lon, Levy Sharon
a Adolescent Substance Abuse Program, Boston Children's Hospital , Boston , Massachusetts , USA.
Subst Abus. 2014;35(4):435-41. doi: 10.1080/08897077.2014.958208.
Opioid dependence is a significant problem for adolescents in the United States. Psychosocial treatment for adolescents with opioid use disorders may be effective, although it has not been well studied.
This paper describes a 13-week psychoeducational group therapy program with parallel tracks for adolescents with opioid use disorders and their parents attending an outpatient substance use program in a children's hospital. In addition to group therapy, participating adolescents received medical care, including medication-assisted treatment for opioid dependence, drug testing, medical follow-up, psychopharmacology, individual counseling, and parent guidance. Data were collected as part of a quality improvement project for the program. Forty-two adolescents and 72 parents attended the group program between 2006 and 2009. Frequencies were computed and a weighted kappa was used to assess agreement between adolescent and parent reports of use and driving risk.
Of the 42 adolescents participating in the 13-week group program, 36 (86%) completed 3 or more group sessions, and 24 (57%) completed 10 or more sessions. Twenty-two (52%) adolescent participants reported abstinence from all substances on each of their weekly evaluations. Adolescent-parent agreement for substance use was good to very good: weighted kappa (95% confidence interval) .76 (.60, .87), but poor for driving risk, weighted kappa .11 (-.20, .40).
Completion rates and self-report of outcomes from this group program indicate promise and warrant further testing.
在美国，阿片类药物依赖是青少年面临的一个重大问题。针对患有阿片类药物使用障碍的青少年进行心理社会治疗可能有效，尽管这方面尚未得到充分研究。
本文描述了一个为期13周的心理教育团体治疗项目，该项目为患有阿片类药物使用障碍的青少年及其父母提供并行的治疗路径，他们在一家儿童医院的门诊物质使用项目中接受治疗。除团体治疗外，参与项目的青少年还接受医疗护理，包括针对阿片类药物依赖的药物辅助治疗、药物检测、医疗随访、精神药理学、个体咨询以及家长指导。数据作为该项目质量改进项目的一部分进行收集。2006年至2009年期间，42名青少年和72名家长参加了该团体项目。计算了频率，并使用加权kappa系数来评估青少年和家长关于使用情况及驾驶风险报告之间的一致性。
在参与为期13周团体项目的42名青少年中，36名（86%）完成了3次或更多次团体治疗课程，24名（57%）完成了10次或更多次课程。22名（52%）青少年参与者在每周评估中均报告戒除了所有物质。青少年与家长在物质使用方面的一致性良好至非常好：加权kappa系数（95%置信区间）为.76（.60，.87），但在驾驶风险方面一致性较差，加权kappa系数为.11（-.20，.40）。
该团体项目的完成率和结果自我报告显示出前景，值得进一步测试。
