Principal Investigator: Dr. Natasha Slesnick
Funding Agency: National Institute on Drug Abuse (NIDA)
This study is a FIRST award grant to evaluate and develop a family therapy intervention for substance abusing runaway youth. The intervention, Ecologically-Based Family Therapy (EBFT) is a multisystemic home-based treatment based upon the homebuilders, family preservation model. Shelters for runaways are overcrowded, and many shelters are not equipped to treat youth for drug, alcohol and family problems beyond crisis intervention. This study extends the current research as most studies to date have collected self-report data on the family and social history; virtually no research has examined treatment effectiveness with this population. Given the void of treatment outcome research with these youths, and the high level of risk for health and psychological problems, there is a great need for identifying potent interventions. Although research supports the effectiveness of behavioral family therapy in reducing substance use among adolescents, no study has systematically applied and evaluated a family-based intervention with runaways. This Stage 1 behavioral treatment development project was designed to examine the effectiveness of EBFT in reducing substance use and HIV risk behaviors, while increasing family and psychological functioning in a sample of runaway adolescents.
Youth were recruited from two local runaway shelters in Albuquerque, NM who serve youth between the ages of 12-17. Inclusion criteria for adolescents were: youth between the ages of 12 to 17, residing within a 60-mile radius of the research site, youth has the legal option of returning to a home situation (including foster or other family member) and reports at least ten days of substance use in the past 90 days or meets DSM-IV criteria for a Psychoactive Substance Use Disorders. Also, youth must have had at least one parent, or surrogate parent willing to participate in therapy. After an intake assessment, youth were randomly assigned to EBFT or to Service as Usual (SAU) through the drop-in shelter. Youth were tracked for follow-up assessments at 3, 9 and 15 months post-intake. Assessments included measures of substance use, HIV risk, psychological functioning, and family functioning.
Overall, youth assigned to EBFT reported greater reductions in overall substance abuse compared to youth assigned to SAU, while other problem areas improved in both conditions. Findings suggest that EBFT is an efficacious intervention for this relatively severe population of youth who experience greater substance use, family and individual problems compared to non-runaway youth. EBFT showed a differential positive impact on substance abuse for all youth assigned to EBFT. Given the role of the family in precipitating the runaway episode, it follows that inclusion of all those involved should increase the opportunity to resolve family problems that may have led to the current family situation. Family therapy can facilitate family members' movement forward in seeking new ways of coping with difficult family stressors and related situations that arise in the household.
Further, this project specifies a set of procedures for intervening with runaway families, with a developed treatment manual to guide such intervention. To our knowledge, this is the first randomized clinical trial of a comprehensive substance use and mental health intervention for runaway youth. The findings suggest that family therapy with this subpopulation of substance abusing adolescents is an efficacious treatment modality. Runaway youth and their parents have been described as difficult to engage and maintain in treatment and have been considered "difficult to work with." This project showed that these families, similar to non-runaway families, can be effectively engaged and maintained into family treatment.
PapersSlesnick, N., & Meade, M. (2001). System youth: A subgroup of substance-abusing homeless adolescents. Journal of Substance Abuse, 13, 367-384.
Slesnick, N., Meyers, R. J., Meade, M., & Segelken, D. H. (2000). Bleak and hopeless no more: Treatment engagement of substance abusing runaway youth and their families. Journal of Substance Abuse Treatment, 19, 215-222.
Meade, M., & Slesnick, N. (2002). Ethical Considerations for Research and Treatment with Runaway and Homeless Adolescents. Journal of Psychology, 136, 1-15.
Slesnick, N., Vasquez, C., & Bittinger, J. (2002). Family functioning, substance use and related problem behaviors: Hispanic vs. Anglo runaway youth. Journal of Ethnicity and Substance Use, 1, 83-101.
Slesnick, N. & Prestopnik, J. L. (in press). Office versus Home-Based Family Therapy for Runaway, Alcohol Abusing Adolescents: Examination of Factors Associated with Treatment Attendance. Alcoholism Treatment Quarterly, 22(2).
Slesnick, N. & Tonigan, J.S. (in press). Form 90 Assessment of Runaway Youth's Substance Use: Reliability and Validity. Alcoholism Treatment Quarterly, 22(2).
Slesnick, N., & Prestopnik, J. L. (2004). Family Therapy Outcome with Substance Abusing Runaway Adolescents. Manuscript submitted for publication.
Slesnick, N. & Prestopnik, J. L. (2004). Dual and Multiple Comorbidity among Runaway and Homeless Youth. Manuscript submitted for publication.Conference Presentations
Funding Agency: National Institute on Drug Abuse (NIDA)
This study is a FIRST award grant to evaluate and develop a family therapy intervention for substance abusing runaway youth. The intervention, Ecologically-Based Family Therapy (EBFT) is a multisystemic home-based treatment based upon the homebuilders, family preservation model. Shelters for runaways are overcrowded, and many shelters are not equipped to treat youth for drug, alcohol and family problems beyond crisis intervention. This study extends the current research as most studies to date have collected self-report data on the family and social history; virtually no research has examined treatment effectiveness with this population. Given the void of treatment outcome research with these youths, and the high level of risk for health and psychological problems, there is a great need for identifying potent interventions. Although research supports the effectiveness of behavioral family therapy in reducing substance use among adolescents, no study has systematically applied and evaluated a family-based intervention with runaways. This Stage 1 behavioral treatment development project was designed to examine the effectiveness of EBFT in reducing substance use and HIV risk behaviors, while increasing family and psychological functioning in a sample of runaway adolescents.
Youth were recruited from two local runaway shelters in Albuquerque, NM who serve youth between the ages of 12-17. Inclusion criteria for adolescents were: youth between the ages of 12 to 17, residing within a 60-mile radius of the research site, youth has the legal option of returning to a home situation (including foster or other family member) and reports at least ten days of substance use in the past 90 days or meets DSM-IV criteria for a Psychoactive Substance Use Disorders. Also, youth must have had at least one parent, or surrogate parent willing to participate in therapy. After an intake assessment, youth were randomly assigned to EBFT or to Service as Usual (SAU) through the drop-in shelter. Youth were tracked for follow-up assessments at 3, 9 and 15 months post-intake. Assessments included measures of substance use, HIV risk, psychological functioning, and family functioning.
Overall, youth assigned to EBFT reported greater reductions in overall substance abuse compared to youth assigned to SAU, while other problem areas improved in both conditions. Findings suggest that EBFT is an efficacious intervention for this relatively severe population of youth who experience greater substance use, family and individual problems compared to non-runaway youth. EBFT showed a differential positive impact on substance abuse for all youth assigned to EBFT. Given the role of the family in precipitating the runaway episode, it follows that inclusion of all those involved should increase the opportunity to resolve family problems that may have led to the current family situation. Family therapy can facilitate family members' movement forward in seeking new ways of coping with difficult family stressors and related situations that arise in the household.
Further, this project specifies a set of procedures for intervening with runaway families, with a developed treatment manual to guide such intervention. To our knowledge, this is the first randomized clinical trial of a comprehensive substance use and mental health intervention for runaway youth. The findings suggest that family therapy with this subpopulation of substance abusing adolescents is an efficacious treatment modality. Runaway youth and their parents have been described as difficult to engage and maintain in treatment and have been considered "difficult to work with." This project showed that these families, similar to non-runaway families, can be effectively engaged and maintained into family treatment.
Papers
- Johnson, W. R., Prestopnik, J. L., & Slesnick, N. (2003). Predictors of Aggression in Substance Abusing Adolescent Runaways. Alcoholism: Clinical and Experimental Research, 26, (5, Supplement). 614. (Abstract).
- Prestopnik, J. L., & Slesnick, N. (2003). Comparing the Structure of Delinquency between Alcohol and Drug using Adolescent Runaways. Alcoholism: Clinical and Experimental Research, 26, (5, Supplement). 618. (Abstract)
- Slesnick, N. (2001, October). Ecologically-Based Family Therapy for Substance-Abusing Runaway Youth. Paper presented at the American Public Health Association Conference, Atlanta, GA.
- Slesnick, N. (2002, October). Treatment for Substance Abusing Runaway Youth. Invited paper presented at NIDA work group on Runaway, Homeless and Street Youth, Washington, D.C.
- Slesnick, N. (2003, April). Ecologically-Based Family Therapy with Substance-Abusing Runaway Youth. Invited paper presented at Society for Research on Child Development, Tampa, Fl.
- Slesnick, N., & Prestopnik, J. L. (September, 2003). Evaluation of Family Therapy vs. Service as Usual for Shelter-Residing, Substance Abusing, Runaway Adolescents. Poster presented at International Conference on Addictive Behaviors, Heidelberg, Germany.
- Slesnick, N., & Prestopnik, J. L. (November, 2003). Shelter-Based versus Family Therapy Outcome for Runaway, Substance Abusing Youth. Paper presented at American Public Health Association, San Francisco, CA.
