Including parents in interventions for adolescent substance abusers may be the best way to prevent them from relapsing after treatment, according to research results presented at APA's 2003 Annual Convention and slated to be published this year in Drug and Alcohol Dependence.
"The findings prove what your grandmother may have told you," said epidemiologist and lead author William W. Latimer, PhD. "The family unit is important," especially to adolescents with psychoactive drug abuse disorders. Although adding a family therapy component to cognitive-behavioral substance abuse treatment programs for teenagers may seem to be common sense, Latimer and his colleagues are among a small group of researchers evaluating the efficacy of the approach in a randomized, controlled trial. In fact, he said, they're among the few researchers focusing on adolescents with serious drug problems.
To help close this gap in the literature, Latimer and colleagues created Integrated Family and Cognitive-Behavioral Therapy (IFCBT) in response to the National Institute on Drug Abuse's Behavioral Therapies Development Program--an initiative designed to develop and evaluate science-based approaches to drug treatment across the life span. IFCBT uses a multisystems approach that integrates family therapy with peer-group cognitive-behavioral therapy approaches.
For example, IFCBT's family therapy component identifies and modifies maladaptive behavior patterns in family members' interactions while promoting familial protective factors, such as parental limit-setting and support. The cognitive-behavioral component of IFCBT includes rational-emotive peer-group therapy, which helps teenagers identify and replace irrational beliefs associated with substance abuse and psychiatric distress, such as the belief that substance use has no harmful consequences. The cognitive-behavioral portion of IFCBT also includes problem-solving peer-group therapy, which helps adolescents develop skills to manage drug-abuse risks by, for example, handling negative emotions. Learning-strategy peer-group training teaches study skills to promote adolescents' school achievement--a key protective factor against relapse.
The researchers found that IFCBT significantly reduced adolescents' marijuana and alcohol use during the first six months after treatment. For example, adolescents who received IFCBT used alcohol an average of two days per month post-treatment versus an average of six days each month for participants randomly assigned to a psychoeducation comparison condition. Likewise, IFCBT teenagers used marijuana an average of six days each month during the first six months after treatment, while average use for adolescents in the psychoeducation condition was about 15 days per month.
Urinalysis results also demonstrated that IFCBT teenagers achieved higher rates of abstinence during the six months after treatment than youths in psychoeducation.
"This study is an important first step in the examination of the efficacy of adolescent drug treatments that coordinate family-based and cognitive-behavioral approaches," said Latimer, a professor at Johns Hopkins University's department of mental health. "The study findings suggest that the IFCBT model is a promising approach for the treatment of adolescent drug abuse."
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