Family therapies such as multisystemic family therapy, multidimensional family therapy, and brief strategic family therapy (BSFT) have been shown to help reduce substance use among adolescents.
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Brief strategic family therapy (BSFT) is based conceptually on strategic family therapy (developed by Salvador Minuchin) and structural family therapy (developed by a group led by Jay Haley and Cloe Madanes). It regards the adolescent with the presenting substance use disorders (SUD) as the “identified patient” within a family system marked by maladaptive boundaries and interactions.
Studies have yet to examine whether parents receiving these evidence-based family therapies also make changes to their own substance use.
This is important for two reasons:
In this secondary analysis of a randomized controlled trial comparing Brief strategic family therapy (BSFT) to Treatment as Usual (TAU) in eight outpatient addiction treatment programs across the country, Horigian et al. assessed 480 adolescents and their families on adolescent substance use, parent substance use, and family functioning (using the Parenting Practices Questionnaire and the Family Environment Scale). Reporting parents were 85% female, 43 years old on average, and had a variable, albeit very modest family income (25% between $10-19,999, and 18% < $10,000).
At baseline (past 30 days), approximately 40% of parents reported alcohol use, 14% drug use, and 45% neither. Adolescents were 80% male, 15.5 years old on average, and 44% Hispanic, 31% White, and 23% African American. Three-quarters of adolescents met DSM-IV criteria for drug use disorder.
Although Brief strategic family therapy (BSFT) families were not significantly different from treatment as usual (TAU) families on family functioning over time, BSFT families showed what is considered a small clinical improvement (i.e., a small effect size) on family functioning relative to TAU families. Contrary to authors’ hypotheses, changes in parent substance use from baseline to 12-month follow-up were not related to adolescent substance use at 12-months.
Parent substance use is a powerful risk factor for adolescent substance use. The current study showed that among adolescents with drug using parents, Brief strategic family therapy (BSFT) may buffer this risk. In addition, well articulated family therapies targeting adolescents with substance use disorders (SUD) may also simultaneously lead to changes in parents’ alcohol use.
This study is important to contextualize in the larger adolescent addiction treatment/recovery literature. In the large multisite Cannabis Youth Treatment Study (N=600), a separate but related family therapy, Multidimensional Family Therapy (MDFT), promoted reductions in adolescent substance use to the same degree as the Adolescent Community Reinforcement Approach (A-CRA) and another treatment that combined motivational enhancement therapy (MET) with cognitive behavioral therapy (CBT), but at a greater cost.
Although MET/CBT does not involve parents directly, A-CRA focuses on improving communication and problem solving between patient and parent(s). The extent to which A-CRA and MET/CBT leads to reductions in parents’ substance use and adolescents’ use when parents are drug users is unclear, and thus important to consider when implementing interventions for adolescents with substance use disorder.
Horigian, V. E., Feaster, D. J., Brincks, A., Robbins, M. S., Perez, M. A., & Szapocznik, J. (2015). The effects of Brief Strategic Family Therapy (BSFT) on parent substance use and the association between parent and adolescent substance use. Addictive behaviors, 42, 44-50.
Image Source: http://www.coram.org.uk
l
Brief strategic family therapy (BSFT) is based conceptually on strategic family therapy (developed by Salvador Minuchin) and structural family therapy (developed by a group led by Jay Haley and Cloe Madanes). It regards the adolescent with the presenting substance use disorders (SUD) as the “identified patient” within a family system marked by maladaptive boundaries and interactions.
Studies have yet to examine whether parents receiving these evidence-based family therapies also make changes to their own substance use.
This is important for two reasons:
In this secondary analysis of a randomized controlled trial comparing Brief strategic family therapy (BSFT) to Treatment as Usual (TAU) in eight outpatient addiction treatment programs across the country, Horigian et al. assessed 480 adolescents and their families on adolescent substance use, parent substance use, and family functioning (using the Parenting Practices Questionnaire and the Family Environment Scale). Reporting parents were 85% female, 43 years old on average, and had a variable, albeit very modest family income (25% between $10-19,999, and 18% < $10,000).
At baseline (past 30 days), approximately 40% of parents reported alcohol use, 14% drug use, and 45% neither. Adolescents were 80% male, 15.5 years old on average, and 44% Hispanic, 31% White, and 23% African American. Three-quarters of adolescents met DSM-IV criteria for drug use disorder.
Although Brief strategic family therapy (BSFT) families were not significantly different from treatment as usual (TAU) families on family functioning over time, BSFT families showed what is considered a small clinical improvement (i.e., a small effect size) on family functioning relative to TAU families. Contrary to authors’ hypotheses, changes in parent substance use from baseline to 12-month follow-up were not related to adolescent substance use at 12-months.
Parent substance use is a powerful risk factor for adolescent substance use. The current study showed that among adolescents with drug using parents, Brief strategic family therapy (BSFT) may buffer this risk. In addition, well articulated family therapies targeting adolescents with substance use disorders (SUD) may also simultaneously lead to changes in parents’ alcohol use.
This study is important to contextualize in the larger adolescent addiction treatment/recovery literature. In the large multisite Cannabis Youth Treatment Study (N=600), a separate but related family therapy, Multidimensional Family Therapy (MDFT), promoted reductions in adolescent substance use to the same degree as the Adolescent Community Reinforcement Approach (A-CRA) and another treatment that combined motivational enhancement therapy (MET) with cognitive behavioral therapy (CBT), but at a greater cost.
Although MET/CBT does not involve parents directly, A-CRA focuses on improving communication and problem solving between patient and parent(s). The extent to which A-CRA and MET/CBT leads to reductions in parents’ substance use and adolescents’ use when parents are drug users is unclear, and thus important to consider when implementing interventions for adolescents with substance use disorder.
Horigian, V. E., Feaster, D. J., Brincks, A., Robbins, M. S., Perez, M. A., & Szapocznik, J. (2015). The effects of Brief Strategic Family Therapy (BSFT) on parent substance use and the association between parent and adolescent substance use. Addictive behaviors, 42, 44-50.
Image Source: http://www.coram.org.uk
l
Brief strategic family therapy (BSFT) is based conceptually on strategic family therapy (developed by Salvador Minuchin) and structural family therapy (developed by a group led by Jay Haley and Cloe Madanes). It regards the adolescent with the presenting substance use disorders (SUD) as the “identified patient” within a family system marked by maladaptive boundaries and interactions.
Studies have yet to examine whether parents receiving these evidence-based family therapies also make changes to their own substance use.
This is important for two reasons:
In this secondary analysis of a randomized controlled trial comparing Brief strategic family therapy (BSFT) to Treatment as Usual (TAU) in eight outpatient addiction treatment programs across the country, Horigian et al. assessed 480 adolescents and their families on adolescent substance use, parent substance use, and family functioning (using the Parenting Practices Questionnaire and the Family Environment Scale). Reporting parents were 85% female, 43 years old on average, and had a variable, albeit very modest family income (25% between $10-19,999, and 18% < $10,000).
At baseline (past 30 days), approximately 40% of parents reported alcohol use, 14% drug use, and 45% neither. Adolescents were 80% male, 15.5 years old on average, and 44% Hispanic, 31% White, and 23% African American. Three-quarters of adolescents met DSM-IV criteria for drug use disorder.
Although Brief strategic family therapy (BSFT) families were not significantly different from treatment as usual (TAU) families on family functioning over time, BSFT families showed what is considered a small clinical improvement (i.e., a small effect size) on family functioning relative to TAU families. Contrary to authors’ hypotheses, changes in parent substance use from baseline to 12-month follow-up were not related to adolescent substance use at 12-months.
Parent substance use is a powerful risk factor for adolescent substance use. The current study showed that among adolescents with drug using parents, Brief strategic family therapy (BSFT) may buffer this risk. In addition, well articulated family therapies targeting adolescents with substance use disorders (SUD) may also simultaneously lead to changes in parents’ alcohol use.
This study is important to contextualize in the larger adolescent addiction treatment/recovery literature. In the large multisite Cannabis Youth Treatment Study (N=600), a separate but related family therapy, Multidimensional Family Therapy (MDFT), promoted reductions in adolescent substance use to the same degree as the Adolescent Community Reinforcement Approach (A-CRA) and another treatment that combined motivational enhancement therapy (MET) with cognitive behavioral therapy (CBT), but at a greater cost.
Although MET/CBT does not involve parents directly, A-CRA focuses on improving communication and problem solving between patient and parent(s). The extent to which A-CRA and MET/CBT leads to reductions in parents’ substance use and adolescents’ use when parents are drug users is unclear, and thus important to consider when implementing interventions for adolescents with substance use disorder.
Horigian, V. E., Feaster, D. J., Brincks, A., Robbins, M. S., Perez, M. A., & Szapocznik, J. (2015). The effects of Brief Strategic Family Therapy (BSFT) on parent substance use and the association between parent and adolescent substance use. Addictive behaviors, 42, 44-50.
Image Source: http://www.coram.org.uk
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