Home-Based Program to Help Parents of Drug Abusing Adolescents

• Adolescent Substance Use [ Time Frame: Changes from Baseline at 3-, 6-, and 12- months post-baseline ] [ Designated as safety issue: No ]
  Adolescent participants will complete the Timeline Follow Back in order to assess days of drug use.
  
  
• Adolescent Drug Use Consequences [ Time Frame: Changes from Baseline at 3-, 6-, and 12- months post-baseline ] [ Designated as safety issue: No ]
  The adolescent participant will complete the Personal Consequences Scale in order to measure their drug use consequences.
  
  
• DSM-IV Substance Use Diagnosis [ Time Frame: Changes from Baseline at 3-, 6-, and 12- months post-baseline ] [ Designated as safety issue: No ]
  The Adolescent Diagnostic Interview (ADI) will be used to determine a diagnosis.
  
  

• Adolescent Mental Health [ Time Frame: Baseline and 3-, 6-, and 12- months post-baseline ] [ Designated as safety issue: No ]
  Adolescent mental health will be measured in two ways. The parent participant will complete the ADI-Parent version and the adolescent participant will complete the Comprehensive Adolescent Severity Inventory (CASI).
  
  
• Adolescent Treatment History [ Time Frame: Baseline and 3-, 6-, and 12- months post-baseline ] [ Designated as safety issue: No ]
  Parent participants will provide this data when completing the ADI-Parent version.
  
  
• Program Acceptability [ Time Frame: Parent Training (average of 2 weeks post-baseline) and Post-Session 3 (average of 6 weeks after the parent training) ] [ Designated as safety issue: No ]
  The Credibility/Expectancy Questionnaire (CEQ) will be completed by parents during the training session and the Working Alliance Inventory (WAI) will be completed my the parent after he or she completes the third training session with the adolescent.
  
  
• Program Satisfaction [ Time Frame: Post-Session 3 (average of 6 weeks after the parent training) ] [ Designated as safety issue: No ]
  Parents will complete a satisfaction questionnaire after completing the third session with the adolescent participant.
  
  
• Training Fidelity [ Time Frame: Parent Training (average of 2 weeks post-baseline) ] [ Designated as safety issue: No ]
  A training fidelity checklist will be completed by an assessor following the training.
  
  

Little attention has been paid to the large group of adolescents who use substances but are not, or not yet, dependent and who could successfully reduce substance use through early intervention. Brief interventions (BI) that are based in cognitive-behavioral and motivational interviewing (CB-MI) strategies provide an option for such mid-level drug abusers (e.g., DSM-IV substance abuse disorder), and extant research on them suggests this approach can be effective with youth.

Winters and colleagues have studied with controlled designs the efficacy of brief interventions for application to mild-to-moderate substance abusing adolescents. These studies have used the more traditional approach of counselor-led interventions. This program will be parent-led rather than directed by a counselor in a clinical setting.

The stage I activities will involve manual development, parent training development, and a small feasibility study; Stage II involves a formal efficacy randomized controlled trial. Two samples, 110 families each, will participate in the trial. Families will be randomly assigned to either an intervention or control condition. Data to quantify intervention effects will be obtained by interviewing adolescents and the target parent at multiple time points (baseline and, 3-, 6- and 12-months post baseline). The investigators hypothesize that the home-based intervention will be superior to the control condition. In addition, the investigators expect response to the intervention by the adolescent to be mediated by motivation, cognitions, problem solving, peer drug use, parenting skills and parent self-efficacy. Secondary analyses will focus on additional predictors of intervention effects, and analyses of parent adherence, parent acceptance, and of training adherence.

The final product of the work will be a tested comparative intervention protocol that is shaped in an engaging and useful presentation format for use by parents.