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Biomedical subjects

Cynthia L Rowe

Publications and source records attributed to Cynthia L Rowe.

6 recordsLinked to original sources

Changing provider practices, program environment, and improving outcomes by transporting multidimensional family therapy to an adolescent drug treatment setting.

Effective interventions for drug abusing adolescents are underutilized. Using an interrupted time series design, this study tested a multicomponent, multi-level technology transfer intervention developed to train clinical staff within an existing day treatment program to implement multidimensional family therapy (MDFT), an evidence-based adolescent substance abuse treatment. The sample included 10 program staff and 104 clients. MDFT was incorporated into the program and changes were noted in the program environment, therapist behavior, and in most (e.g., drug abstinence, and out of home placements) but not all (e.g., drug use frequency) client outcomes. These changes remained after MDFT supervision was withdrawn.

Adolescent↗

Impact of psychiatric comorbidity on treatment of adolescent drug abusers.

Comorbidity of substance abuse disorders (SUD) and psychiatric disorders is one of the most important areas of investigation in contemporary drug abuse treatment research. This study examined the impact of psychiatric comorbidity on the treatment of 182 adolescent drug abusers in a randomized clinical trial comparing family and individual cognitive-behavioral therapy. Three distinct groups of adolescent substance abusers were compared: (1) Exclusive Substance Abusers (SUD only); (2) Externalizers (SUD + externalizing disorder); and (3) Mixed Substance Abusers (SUD + externalizing and internalizing disorder). The purpose of this study was to determine whether adolescents in these comorbid groups differed in clinical presentation and treatment response. More severe comorbidity was associated with greater family dysfunction and being female and younger at intake. An examination of substance use trajectories over time indicated that the Mixed group initially responded to treatment but returned to intake levels of substance use by 1 year post-discharge.

Adolescent↗

Early intervention for adolescent substance abuse: pretreatment to posttreatment outcomes of a randomized clinical trial comparing multidimensional family therapy and peer group treatment.

This randomized clinical trial evaluated a family-based therapy and a peer group therapy with 80 urban, low-income, and ethnically diverse young adolescents (11 to 15 years) referred for substance abuse and behavioral problems. Both treatments were outpatient, relatively brief, manual-guided, equal in intervention dose, and delivered by community drug treatment therapists. Adolescents and their parents were assessed at intake to treatment, randomly assigned to either MDFT or group therapy, and reassessed at six weeks after intake and at discharge. Results indicated that the family-based treatment (MDFT, an intervention that targets teen and parent functioning within and across multiple systems on a variety of risk and protective factors) was significantly more effective than peer group therapy in reducing risk and promoting protective processes in the individual, family, peer, and school domains, as well as in reducing substance use over the course of treatment. These results, which add to the body of previous findings about the clinical and cost effectiveness of MDFT, support the clinical effectiveness and dissemination potential of this family-based, multisystem and developmentally-oriented intervention.

Adolescent↗

Substance abuse.

Liddle and Dakof's (1995) comprehensive review of the status of family-based treatment for drug abuse concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using family-based approaches, particularly with adolescents. Family-based treatments are currently recognized as among the most effective approaches for adolescent drug abuse. Family-based treatment of adult drug abuse problems has also advanced in important ways with the recent systematic application and testing of engagement techniques and behavioral couples therapy approaches. The current review characterizes and discusses the developmental status of this subspecialty and outlines areas in which continued research attention is needed.

Adolescent↗

Transporting a research-based adolescent drug treatment into practice.

This article describes the key ingredients and processes in transporting an empirically supported, research-developed family therapy for adolescent drug abusers, Multidimensional Family Therapy (MDFT), into an intensive day treatment program. Using the same systems change principles that guide this treatment approach, the technology transfer process has been, from its inception, a collaborative, multidimensional, systemic intervention aimed at changing organizational structures, and attitudinal and behavioral patterns with multiple staff members at several levels of the program. This article describes: (1) the conceptual and empirical basis for these technology transfer efforts; (2) the technology being adapted and transferred; and (3) the critical events and processes that have shaped the transfer of MDFT into this program. We discuss this process and the outcomes thus far through the lens of Simpson's organizational change model and specify the implications of this experience for the expansion of current conceptualization of technology transfer.

Adolescent↗

Family-based treatment development for adolescent alcohol abuse.

A range of family-related risk factors have been linked to adolescent alcohol problems and predict escalation of use and alcohol dependence into adulthood. Family-based interventions have strong research and clinical traditions in the treatment of adult alcoholism and adolescent drug abuse, but have been infrequently applied to the unique problems of adolescent alcohol abuse and dependence. Researchers in the adolescent alcohol abuse specialty area have developed a robust developmentally oriented knowledge base about alcohol-specific risk and protective factors. Adolescent alcohol treatment researchers have made significant advances in recent years, including a deeper understanding of outcome trajectories. However youth relapse to alcohol use at high rates following standard community-based treatment, and few empirically supported treatments exist for adolescent alcohol abusers. Employing selected contemporary research findings, this article outlines specific areas of focus for a family-based intervention for alcohol abusing teens. We first review intervention-relevant research on the development of alcohol problems among adolescents with a focus on family risk and protective factors. Second, clinical research findings are presented supporting the use of family-based interventions with alcohol abusing youth. Finally, areas of intended focus in an empirically supported family-based intervention for adolescent alcohol problems are outlined. By addressing these gaps, empirically supported family-based interventions for adolescent alcohol abuse have significant potential to advance the field of adolescent alcohol treatment.

Adolescent↗