Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents.
This is the primary outcomes article for CTN-0014.
This study was designed to determine the effectiveness of brief strategic family therapy (BSFT, an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. In protocol CTN-0014, BSFT was compared to TAU with a multiethnic sample of adolescents (213 Hispanic, 148 White, and 110 Black) referred for drug abuse treatment at eight community treatment agencies nationwide. Randomization encompassed both adolescents’ families (n=480) and the agency therapists (n=49) who provided either TAU or BSFT services. The primary outcome was adolescent drug use, assessed monthly via adolescent self-report and urinalysis for up to 1 year post-randomization. Secondary outcomes included treatment engagement (2 or more sessions), retention (8 or more sessions), and participants’ reports of family functioning 4, 8, and 12 months following randomization. No overall differences between conditions were observed in the trajectories of self-reports of adolescent drug use. However, the median number of days of self-reported drug use was significantly higher in TAU than in BSFT at the final observation point. BSFT was significantly more effective than TAU in engaging and retaining family members in treatment and in improving parent reports of family functioning.
Conclusions: The current findings provide support for the impact of the BSFT intervention on engagement, retention, and parent-reported family functioning with adolescents from diverse racial/ethnic groups. However, the weak effects on drug use outcomes, combined with the difficulties in establishing optimal implementation of the BSFT model, raise concerns about how to most successfully transport the BSFT model into community settings. These challenges, as well as recommendations for further research, are discussed.
Related protocols: CTN-0014