Randomized Controlled Trial of an Integrated Family-Based Treatment for Adolescents Presenting to Community Mental Healt
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ORIGINAL PAPER
Randomized Controlled Trial of an Integrated Family‑Based Treatment for Adolescents Presenting to Community Mental Health Centers Ashli J. Sheidow1 · Kristyn Zajac2 · Jason E. Chapman1 · Michael R. McCart1 · Tess K. Drazdowski1 Received: 14 May 2020 / Accepted: 23 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Most adolescents presenting to community mental health centers have one or more comorbidities (internalizing, externalizing, and substance use problems). We evaluated an integrated family-based outpatient treatment for adolescents (OPT-A) that can be delivered in a community mental health center by a single therapist. A sample of 134 youth/families were randomized to receive OPT-A or usual services, delivered at the same public sector mental health center. Repeated, multi-informant assessments occurred through 18-months post-baseline. At baseline, the sample displayed low internalizing symptoms, moderate substance use, and high externalizing problems. Compared to usual services, OPT-A had effects on abstinence rates, retention, motivation, parent involvement, and satisfaction, but not on internalizing or externalizing problems. While OPT-A achieved some key improvements for youth who present to community mental health centers, and families were satisfied with treatment, continued work is necessary to examine treatments for comorbidity while balancing treatment feasibility and complex strategies to boost treatment effectiveness. Keywords Comorbidity · Adolescent substance use · Adolescent mental health · Community-based treatment · Family therapy The majority of adolescents presenting for outpatient treatment at public sector community mental health centers have comorbid symptoms such as internalizing, externalizing, and substance use problems, but there is a striking paucity of Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10597-020-00735-z) contains supplementary material, which is available to authorized users. * Kristyn Zajac [email protected] Ashli J. Sheidow [email protected] Jason E. Chapman [email protected] Michael R. McCart [email protected] Tess K. Drazdowski [email protected] 1
Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, USA
University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA
2
experimental treatment research on integrated psychosocial treatments for these teens (Hogue et al. 2018; Hulvershorn et al. 2015). In general, multicomponent treatments that have been found to effectively target each of these presenting problems (e.g., cognitive behavioral therapy [CBT], behavioral family-based treatment, motivational enhancement) tend to be most effective for treating substance use and comorbid disorders simultaneously (Brewer et al. 2017). However, research in this area is still limited by very few well-powered randomized controlled trials; and, of these, most are very limited (e.g., substance use and depression only), a
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