Treatment focus in individual and family therapy for adolescent drug abuse
The central aim of this study was to examine differences in treatment focus in two empirically-based treatments for adolescent substance abuse, multidimensional family therapy (MDFT) and cognitive-behavioral therapy (CBT). Treatment focus is a key element of therapy process that has never been examined in an adolescent sample. Five treatment focus domains were examined in this study, corresponding to five key domains of risk for adolescent substance abuse (family, drug use, peer, prosocial, and antisocial). This study investigated four interrelated dimensions of treatment focus. First, adherence within each model with respect to treatment focus was examined. Second, the extent of consistency of treatment focus across cases and across therapists was examined. Third, links between treatment focus, therapeutic alliance, and adolescent outcome were sought. Finally, the developmental sensitivity of each model was explored, by examining differences in treatment focus and in focus-outcome links based on the age, sex, and race of the adolescents. Subjects were 113 substance-abusing, juvenile justice involved adolescents originally recruited to participate in an outcome study comparing the efficacy of MDFT and CBT. Therapists within each model demonstrated high adherence with respect to treatment focus. As expected, MDFT had higher mean levels of family focus, and CBT had higher mean levels of drug focus. Both conditions also demonstrated consistency across cases and therapists in treatment focus. Contrary to prediction, variability in drug focus was highest for CBT, and variability in family focus was highest for MDFT. Treatment focus was overall not found to be associated with adolescent outcome. No significant effects of alliance were found. Finally, differences in treatment focus based on characteristics of the adolescents were found for both conditions, suggesting that the models were delivered with developmental sensitivity. Implications of the findings for future process studies are discussed, as are the developmental implications of the findings.
Dauber, Sarah, "Treatment focus in individual and family therapy for adolescent drug abuse" (2004). ETD Collection for Fordham University. AAI3125006.