Trauma Clinical Trial
Official title:
Family-Based Drug Services for Young Disaster Victims
This protocol seizes this rare scientific opportunity to test an integrative family based model to address youths' coexisting substance abuse and trauma in the wake of Hurricane Katrina. The study would address a number of gaps in the current evidence base related to understanding and treating comorbid teen drug abuse and trauma that may be initiated or exacerbated in the wake of disasters such as Hurricane Katrina. This study would compare two promising interventions for youth with comorbid trauma and substance abuse, family-based treatment and group Cognitive Behavioral Therapy (CBT), potentially yielding new and vital information about effective treatment for substance abusing youth following traumatic events.
This study is a 2 (treatments) by 5 (time points), repeated measures intent-to-treat
randomized control design with multiple dependent variables. The sample includes a total of
150 ethnically diverse adolescents who are clinically referred for substance abuse treatment
throughout St. Charles Parish, a New Orleans area parish that was heavily impacted by
Hurricane Katrina. The parish has high rates of teen substance abuse as documented in school
surveys (State of Louisiana Office for Addictive Disorders, 2002, 2004). Eligible youth, who
meet American Society of Addiction Medicine (ASAM) criteria for outpatient substance abuse
treatment and report trauma symptoms related to Hurricane Katrina, will be randomized to a
family-based treatment (MDFT) or group CBT. Both treatments will be delivered approximately
twice weekly over 4 months. Assessments of youth and family functioning across several
domains will be conducted at intake, 2, 4, 6, and 12 month follow-up. Measuring multiple
domains at several assessment points within and following treatment (Brown, 2004) will
enable investigators to examine trajectories of change as well as mediators and moderators
of treatment effects.
The study has four aims:
Aim 1: To explore links between hurricane-related stress and trauma and youths' substance
abuse.
Hypothesis 1: Severity of youths' substance use at intake to treatment will be predicted by
level of exposure to Hurricane Katrina, stressful life events following Katrina, trauma
symptoms, and coping.
Aim 2: To investigate in a community based randomized control trial the effectiveness of a
family-based intervention (MDFT) vs. group CBT for teen substance abusers impacted by
Hurricane Katrina.
Hypothesis 2a: Family-based treatment (MDFT) will more effectively reduce youths' substance
abuse, delinquency, trauma, and school problems up to one year post-intake than a group CBT
approach.
Hypothesis 2b: Family-based treatment (MDFT) will more effectively reduce parents' stress
and family conflict up to one year post-intake than group CBT.
Hypothesis 2c: Youth assigned to MDFT will be less likely to meet diagnostic criteria for
PTSD at 12 month post-intake than group CBT.
Aim 3: To examine teen and parent coping as mediators of treatment effects.
Hypothesis 3a: Youth in MDFT will develop more effective coping strategies than those in
group CBT through improved parental coping and parenting practices, and lower family
conflict, as well as directly through intervention effects.
Hypothesis 3b: Youth in MDFT will achieve greater reductions in substance abuse and trauma
symptoms than those in group treatment through more effective coping during the 12 month
follow-up period.
Aim 4: To explore moderators of treatment effects based on post-Katrina stress and trauma
symptoms.
Hypothesis 4: The advantage of MDFT over group CBT in decreasing substance abuse will be
more pronounced with youth who report higher levels of disaster-related stress and trauma
symptoms at intake.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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