Two University of Arizona psychologists have embarked on a five-year study to evaluate how and for whom family therapy is effective in reducing adolescent drug abuse.
UA psychology professors Varda Shoham and Michael Rohrbaugh are the principal investigators looking at processes by which young drug abusers might benefit from a technique called Brief Strategic Family Therapy (BSFT).
The $2,344,991 grant from the National Institute on Drug Abuse builds upon the first large-scale testing of Brief Strategic Family Therapy (BSFT), a treatment shown to reduce adolescent behavior problems in previous scientific studies.
The "parent study" will be conducted within the framework of NIDA's Clinical Trial Network, in which Rohrbaugh and Shoham are also collaborating investigators.The Arizona-based grant project will enroll at least 400 drug-using adolescents from outpatient community treatment programs around the country. One of those programs is in Tucson's La Frontera Center. There, as elsewhere, BSFT will be compared to conventional treatments.
Adolescent drug abuse continues to represent one of the most pressing health issues in the United States. There is strong evidence that specific interventions, especially those that address the family context of drug use, can have a dramatic impact on adolescent drug use and related behavior problems.
BSFT was developed over the past few decades by José Szapocznik and colleagues at the University of Miami Center for Family Studies. Szapocznik, Michael Robbins and Daniel Feaster at Miami will collaborate with Shoham and Rohrbaugh on the new study.
A central premise of BSFT is that adolescent drug problems are interwoven with ongoing patterns of family interaction. From this perspective, drug use is maintained to a significant degree by repetitive, problematic interactions between the adolescent and his or her family members (e.g., parent and child are too involved or are not involved enough; child has power over parent or joins one parent in coalition over the other). These maladaptive structural patterns become the focus for strategic interventions.
Previous research on BSFT has focused on whether it is effective overall, giving little attention to how it works (mediator questions) or for whom in works best (moderator questions). Rohrbaugh and Shoham hypothesize that family functioning plays a critical mediating and moderating role in effective implementation of this treatment.
A fundamental "mediating" question in the grant project is whether BSFT produces family change, and whether this in turn leads to sustained reduction of drug abuse by the adolescent. On the moderator side, unanswered questions concern what works best for whom.
Shoham, Rohrbaugh and their collaborators hypothesize that BSFT has advantages over other, individually-oriented, treatments, particularly when the adolescent's family functions poorly as a unit. They hypothesize that for some adolescents (i.e., those with relatively well-functioning families) BSFT may not be necessary to achieve good outcomes because individually-oriented treatments may perform just as well.
Al Kaszniak, professor and head of the UA psychology department, said, "Professor Shoham and Rohrbaugh's research is extremely important for our department and the entire field of clinical psychology. Developing a firm scientific understanding of how this promising treatment works in reducing drug abuse, and for whom it works best, is at the cutting edge of clinical science. The result will be a major leap forward in providing proven, effective help for a problem that affects the lives of so many families."