Family Interventions for Adolescent Substance Use

(PCYF Trial)

Overseen By Nicole P Porter, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: The National Center on Addiction and Substance Abuse at Columbia University

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

2300 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to compare a standard adolescent-only approach to substance use screening, brief intervention, and referral to treatment to a in primary care settings. Primary outcomes (AOD use, co-occurring behavior problems, parent-youth communication about AOD use) and secondary outcomes (adolescent quality of life, therapy attendance) are assessed at screen/initial and 3, 6, 9, and 12 months follow-up.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Family Interventions for Adolescent Substance Use?

Research shows that family-based treatments for adolescent substance use, like the ones in this trial, can improve treatment outcomes by involving family members in the therapy process. These approaches have been effective in enhancing engagement, retention, and overall family functioning, which are crucial for successful treatment. ^{1 2 3 4 5}

Is family-based intervention for adolescent substance use generally safe?

Family-based interventions, like Brief Strategic Family Therapy and other similar methods, have been studied in various settings and are generally considered safe for adolescents and their families. These therapies focus on improving family dynamics and addressing substance use without significant safety concerns reported in the research. ^{6 7 8 9 10}

How is the Family Interventions for Adolescent Substance Use treatment different from other treatments?

This treatment is unique because it involves the family in the therapy process, focusing on improving family communication and support, which can help address the root causes of substance use in adolescents. Unlike many other treatments that focus solely on the individual, this approach includes both the adolescent and their family, aiming to strengthen family dynamics and resilience. ^{6 10 11 12 13}

Research Team

Aaron Hogue, PhD

Principal Investigator

Partnership to End Addiction

Eligibility Criteria

This trial is for youths aged 12-17 with substance use disorders, who come to primary care appointments with a caregiver. Both must be fluent in English or Spanish and able to use a tablet for consent procedures.

Inclusion Criteria

I am between 12-17 years old and my parent will come to my doctor's appointments.

You and your caregiver are expected to answer alcohol and drug-related risk assessment queries during the initial medical appointment.

You and your caregiver are proficient in either English or Spanish.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 visit

1 visit (in-person)

Intervention

Participants receive either a standard adolescent-only approach or a family-based approach to substance use screening, brief intervention, and referral to treatment

1 visit

1 visit (in-person)

Follow-up

Participants are monitored for primary and secondary outcomes at 3, 6, 9, and 12 months

12 months

4 visits (virtual or in-person)

Treatment Details

Interventions

• Family Brief Negotiated Interview (BNI)
• Family Facilitated Conversation (FC) & Referral to Treatment (RT)
• Family Psychoeducation

Trial Overview The study compares standard adolescent-only substance abuse interventions against family-inclusive approaches. It measures drug use, behavior problems, communication about drugs, quality of life, and therapy attendance over one year.

Participant Groups

Group I: SBIRT-A-Family Experimental Treatment 4 Interventions

Family-based approach to screening, brief intervention, and referral to treatment for adolescent substance use in which caregivers are systematically included in screening, intervention, and referral activities.

Group II: SBIRT-A-Standard Active Control 4 Interventions

Standard adolescent-only approach to screening, brief intervention, and referral to treatment for adolescent substance use.

Family Brief Negotiated Interview (BNI) is already approved in United States for the following indications:

Approved in United States as Family Brief Negotiated Interview for:

• Substance use screening and intervention in adolescents

Who Is Running the Clinical Trial?

The National Center on Addiction and Substance Abuse at Columbia University

Lead Sponsor

Trials

13

Recruited

3,500+

Columbia University

Collaborator

Trials

1,529

Recruited

2,832,000+

Abt Associates

Industry Sponsor

Trials

11

Recruited

167,000+

UConn Health

Collaborator

Trials

218

Recruited

59,100+

Northwestern University Feinberg School of Medicine

Collaborator

Trials

42

Recruited

15,500+

Massachusetts General Hospital

Collaborator

Trials

3,066

Recruited

13,430,000+

Boston Children's Hospital

Collaborator

Trials

801

Recruited

5,584,000+

Patient-Centered Outcomes Research Institute

Collaborator

Trials

592

Recruited

27,110,000+

Boston Medical Center

Collaborator

Trials

410

Recruited

890,000+

Findings from Research

A proactive assessment and intervention approach for students with traumatic brain injury (TBI) focuses on anticipating cognitive-communicative challenges and creating solutions, emphasizing the importance of early intervention.

The intervention process actively involves family members, teachers, and peers, ensuring that support strategies are integrated into various settings like home, school, and work, which enhances the effectiveness of the treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A proactive model for treating communication disorders in children and adolescents with traumatic brain injury. Blosser, JL., DePompei, R.[2004]

Family-based approaches for treating adolescent substance abuse show positive outcomes in therapy engagement and retention, as well as improvements in various areas of adolescent and family functioning.

Future research should focus on how to effectively deliver evidence-based family treatments in everyday practice, ensuring that therapeutic alliances and core techniques are maintained for better treatment fidelity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-based treatment for adolescent substance abuse: controlled trials and new horizons in services research. Hogue, A., Liddle, HA.[2021]

Adolescent substance use can lead to serious long-term issues such as dependence, criminal behavior, and mental health disorders, highlighting the need for effective family-based interventions.

The article reviews various evidence-based family treatments for adolescent substance use, including multisystemic therapy and functional family therapy, emphasizing their outcomes and implementation factors to help clinicians choose the best approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-Based Treatments for Adolescent Substance Use. Horigian, VE., Anderson, AR., Szapocznik, J.[2020]

The study focused on implementing Brief Strategic Family Therapy (BSFT) as a drug intervention for adolescents in eight community substance abuse treatment programs, highlighting its evidence-based approach.

Researchers worked closely with treatment programs to ensure the trial was both scientifically rigorous and applicable to diverse adolescent substance abuse settings, utilizing insights from various research methodologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transporting clinical research to community settings: designing and conducting a multisite trial of brief strategic family therapy. Robbins, MS., Alonso, E., Horigian, VE., et al.[2021]

Family involvement in addiction treatment can significantly improve outcomes, including treatment entry and completion, yet current services often focus on individuals rather than families.

This scoping review aims to identify the extent and nature of existing evidence on family interventions in addiction treatment, highlighting gaps to inform future research and best practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-focused practices in addictions: a scoping review protocol. Kourgiantakis, T., Ashcroft, R.[2018]

Beardslee's family intervention (BFI) was reported to improve openness about substance use disorders within families, which was a key positive outcome for both children and parents six months after the intervention.

Children participating in the BFI showed a perceived reduction in psychological symptoms, and parents noted improvements in their children's wellbeing, suggesting that BFI can be an effective preventive method for families affected by parental substance use disorder.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Talking about parental substance abuse with children: eight families' experiences of Beardslee's family intervention. Pihkala, H., Dimova-Bränström, N., Sandlund, M.[2018]

Brief strategic family therapy (BSFT) is being evaluated in a multisite clinical trial to determine its effectiveness in reducing drug use and behavior problems among adolescents compared to standard treatment (TAU).

The study aims to assess not only the reduction in drug use and conduct issues but also improvements in family functioning and prosocial behaviors, highlighting the comprehensive approach of BSFT in addressing adolescent issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief strategic family therapy for adolescent drug abusers: a multi-site effectiveness study. Robbins, MS., Szapocznik, J., Horigian, VE., et al.[2021]

The Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) showed significant improvements in self-reported drug use and parenting practices among Hispanic adolescents with substance abuse disorders, based on a small randomized trial with 28 participants over 8 months.

CIFFTA outperformed traditional family therapy in reducing drug use and enhancing parenting practices, indicating its potential effectiveness, but further research with a larger sample size is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary results for an adaptive family treatment for drug abuse in Hispanic youth. Santisteban, DA., Mena, MP., McCabe, BE.[2021]

A time-limited and intensive format of Parent-Child Interaction Therapy (PCIT) was found feasible for 15 families with young children aged 2-5 years who had experienced a traumatic brain injury (TBI) and exhibited behavior problems.

The intervention led to high caregiver satisfaction and significant reductions in child behavior issues, with 71% of families completing the program and showing improvements at post-assessment and follow-up, suggesting it may effectively address challenges following early childhood TBI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intensive Parent-Child Interaction Therapy for Children with Traumatic Brain Injury: Feasibility Study. Garcia, D., Rodríguez, GM., Lorenzo, NE., et al.[2022]

The Treatnet Family intervention, designed for adolescents with substance use disorders, was successfully implemented by 23 trained practitioners in community settings in Jakarta, Indonesia, over a 6-week period.

Supervisors observed that practitioners adhered to the core skills of the Treatnet Family intervention, indicating that the program can be effectively delivered in real-world settings with fidelity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fidelity Assessment of the Treatnet family (TF): A family-based intervention for adolescents with substance use disorders and their families. Busse, A., Kashino, W., Suhartono, S., et al.[2022]

Family-based interventions for preventing substance use disorders in children and adolescents are effective when they focus on enhancing developmental competencies and family resources, rather than just addressing substance use directly.

Evidence-based family treatment programs like Multisystemic Therapy and Functional Family Therapy show small-to-medium effects, but there is a need for more research on their effective components and how to implement these programs effectively in communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review]. Arnaud, N., Sack, PM., Thomasius, R.[2019]

Family-based preventive interventions are becoming an important approach to reduce substance use and antisocial behavior, focusing on high-risk and adolescent populations.

Key recommendations for improving these interventions include customizing strategies for individual families, collaborating with various social systems, and combining insights from both prevention and treatment fields.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Family-based preventive intervention: an approach to preventing substance use and antisocial behavior. Hogue, A., Liddle, HA.[2022]

A study involving 125 adolescents aged 13 to 17 showed that both individual motivational interviews (IMI) and those combined with family motivational interviews (Family Check-Up, FCU) significantly reduced alcohol use after an emergency department visit for alcohol-related issues.

The combination of IMI and FCU led to a greater reduction in high-volume drinking days at the 3-month follow-up compared to IMI alone, suggesting that involving family support can enhance the effectiveness of motivational interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department: results of a randomized clinical trial. Spirito, A., Sindelar-Manning, H., Colby, SM., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

A proactive model for treating communication disorders in children and adolescents with traumatic brain injury. [2004]

2. England pubmed.ncbi.nlm.nih.gov

Family-based treatment for adolescent substance abuse: controlled trials and new horizons in services research. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Family-Based Treatments for Adolescent Substance Use. [2020]

4. England pubmed.ncbi.nlm.nih.gov

Transporting clinical research to community settings: designing and conducting a multisite trial of brief strategic family therapy. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Family-focused practices in addictions: a scoping review protocol. [2018]

6. England pubmed.ncbi.nlm.nih.gov

Talking about parental substance abuse with children: eight families' experiences of Beardslee's family intervention. [2018]

7. United States pubmed.ncbi.nlm.nih.gov

Brief strategic family therapy for adolescent drug abusers: a multi-site effectiveness study. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Preliminary results for an adaptive family treatment for drug abuse in Hispanic youth. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Intensive Parent-Child Interaction Therapy for Children with Traumatic Brain Injury: Feasibility Study. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Fidelity Assessment of the Treatnet family (TF): A family-based intervention for adolescents with substance use disorders and their families. [2022]

11. Germany pubmed.ncbi.nlm.nih.gov

[Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review]. [2019]

12. United States pubmed.ncbi.nlm.nih.gov

Family-based preventive intervention: an approach to preventing substance use and antisocial behavior. [2022]

13. United States pubmed.ncbi.nlm.nih.gov

Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department: results of a randomized clinical trial. [2022]