This article updates the evidence base on outpatient behavioral treatments for adolescent substance use (ASU) since publication of the previous review completed for this journal by Waldron and Turner (2008). It first summarizes the Waldron and Turner findings as well as those from more recent literature reviews and meta-analytic studies of ASU treatment. It then presents study design and methods criteria used to select 19 comparative studies subjected to Journal of Clinical Child & Adolescent Psychology level of support evaluation. These 19 studies are grouped by study category (efficacy or effectiveness) and described for sample characteristics, methodological quality, and substance use outcomes. Cumulative level of support designations are then made for each identified treatment approach: ecological family-based treatment, group cognitive-behavioral therapy, and individual cognitive-behavioral therapy are deemed Well Established; behavioral family-based treatment and motivational interviewing are deemed...

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

https://repub.eur.nl/pub/73456/1-s2.0-S0376871612004139-main.pdf

Multidimensional family therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings

The extent to which therapist adherence to guidelines and clinician skill or competence may play a role in the prediction of therapeutic outcomes remains inconclusive. This systematic literature review and meta-analysis considers whether adherence or competence predicts youth outcome in child and adolescent psychotherapy, and whether there are any identifiable factors which moderate the strength or direction of this relationship. A systematic literature search identified 35 studies in 52 papers. The studies contained 29 effect sizes for the relationship between adherence and outcome, while nine effect sizes were extracted for competence, and a further five effects measured a composite of adherence and competence constructs, referred to as fidelity in this report. The meta-analysis indicated a small but significant relationship between therapist adherence and outcome, although the small size of effect suggests that outcomes are likely to be more strongly associated with factors other than adherence. No significant relationship was identified between competence or composite fidelity and outcome. Although variance was observed in effect sizes, no significant moderation by client group, intervention type, or implementation measure informant was identified. Further study is needed to understand the specific circumstances under which adherence and outcome are related.

https://link.springer.com/content/pdf/10.1007/s00787-018-1265-2.pdf

Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents.

Vetenschappelijke Raad voor het Regeringsbeleid

The proportion of the juvenile justice population that comprises females is increasing, yet few evidence-based models have been evaluated and implemented with girls in the juvenile justice system. Although much is known about the risk and protective factors for girls who participate in serious delinquency, significant gaps in the research base hamper the development and implementation of theoretically based intervention approaches. In this review, we first summarize the extant empirical work about the predictors and sequelae of juvenile justice involvement for girls. Identified risk and protective factors that correspond to girls’ involvement in the juvenile justice system have been shown to largely parallel those of boys, although exposure rates and magnitudes of association sometimes differ by sex. Second, we summarize findings from empirically validated, evidence-based interventions for juvenile justice-involved youths that have been tested with girls. The interventions include Functional Family Therapy, Multisystemic Therapy, Multidimensional Family Therapy, and Treatment Foster Care Oregon (formerly known as Multidimensional Treatment Foster Care). We conclude that existing evidence-based practices appear to be effective for girls. However, few studies have been sufficiently designed to permit conclusions about whether sex-specific interventions would yield any better outcomes for girls than would interventions that already exist for both sexes and that have a strong base of evidence to support them. Third, we propose recommendations for feasible, cost-efficient next steps to advance the research and intervention agendas for this under-researched and underserved population of highly vulnerable youths.

Risks, outcomes, and evidence-based interventions for girls in the US juvenile justice system

Implementation fidelity of Multidimensional Family Therapy in an international trial

To address a growing public health problem with youth cannabis use, five Western European countries – Belgium, France, Germany, the Netherlands and Switzerland – collaborated on a cannabis treatment research effort. After deliberation, the research priority chosen was to implement and rigorously evaluate a treatment program for adolescents with cannabis use disorders – virtually unavailable in Western Europe at the time. Adolescent cannabis use disorders were even denied by some policy makers as bona fide public health problems. The most promising candidate for the treatment program to be studied, based on cross-national expert analyses and an exhaustive review of research findings to date, was Multidimensional Family Therapy (MDFT), developed in the USA. When pilot training with candidate clinicians began, some claimed it was “too American.” Some did not understand its innovation at first glance, stating that aspects of MDFT interventions were already part of daily clinical work. Others worried whether the senior role of psychiatrists would be jeopardized, and if the approach engaged in too much outreach, and would be a threat to in-office work. Still others said the model might be too practical, and ignore the need for depth-oriented, psychodynamic treatment – still dominant in parts of Europe. While at the outset MDFT presented as a cultural shock, concerns disappeared when the approach was taught, attempted and integrated into the regular practice settings. The multi-country randomized controlled trial was designed with considerable discussion and collaboration. Referred to as INCANT (International Cannabis Need of Treatment), this study, the first independent replication of MDFT, showed that most adolescents with cannabis use disorders in these five countries have multiple behavioral problems, including criminality, truancy and mental co-morbidity. MDFT proved to be more effective than a high level treatment as usual in reducing cannabis dependence and on other problem behavior measures as well. Positive outcomes were seen in all the five countries. And given the clinical outcomes, the therapist competence and fidelity outcomes, and the capacity of the sites to absorb this new clinical approach, MDFT was found to be feasible and adaptable to representative regular clinical care Western Europe settings, adding expanded treatment alternative to standard care. The challenges 890 H. Rigter et al.

From Research to Practice: The International Implementation of Multidimensional Family Therapy

Dit artikel beschrijft een intramurale toepassing van multidimensionele familietherapie voor justitiele jeugdinrichtingen, een van oorsprong volledig ambulante behandeling. Deze behandelmethode past in het streven van de overheid en van de justitiele jeugdinrichtingen om systeem- en gezinsgericht denken en werken in deze instellingen te stimuleren, al vanaf het moment van plaatsing van de jongere. De eerste ervaringen met deze aanpak zijn gunstig.

Gezinsgericht werken in justitiële jeugdinrichtingen

In plaats van een artikel over ‘beleid’ plaatsen wij hier vier notities die de kloof tussen de reguliere hulpverlening en justitie illustreren. Er zijn veel raakvlakken tussen de twee werelden. Wij beperken ons tot twee onderwerpen: wetenschappelijk onderzoek en behandelfilosofie. Justitie predikt het principe van ‘evidence based’ werken. Maar het paradepaardje onder de methoden voor bepaling van de ‘evidence’ (bewijskracht) in medische en psychologische kring - de ‘randomized controlled trial’ (RCT) - heeft in justitieland nog weinig aanhang gekregen. Er worden bezwaren opgeworpen die in andere vakgebieden ethisch en juridisch (door ethische toetsingscommissies), theoretisch en feitelijk allang zijn weerlegd. In justitieland is nog een lange weg van bekering en opleiding te gaan, maar er kan worden aangesloten bij de expertise en opleidingsmogelijkheden die inmiddels in de gezondheidswetenschappen zijn opgebouwd. Marianne van Ooyen-Houben breekt een lans voor de RCT, zonder de methode heilig te verklaren.

Hulpverlening en justitie: twee werelden: Vier notities

Met adolescenten die al jong verslavingsproblematiek vertonen - in de praktijk gaat het vooral om misbruik en afhankelijkheid van alcohol en cannabis - is vaak meer aan de hand. Bij complexe problematiek past een meervoudige therapie, met aandacht voor de rol van gezin, leeftijdgenoten, school en andere omgevingen. Van bestaande meervoudige therapieen heeft ‘multidimensional family therapy’ (MDFT) de beste papieren voor vermindering van verslavingsproblematiek. Deze van origine Amerikaanse behandeling helpt ook bij ander probleemgedrag van jongeren. In Nederland en andere Europese landen staat een experiment met MDFT op stapel, dat moet aantonen of de aanpak ook werkt aan deze kant van de oceaan. MDFT is deel van een nieuwe generatie gezinstherapieen met elementen van ‘bemoeizorg’.

Meervoudige gezinstherapie voor adolescenten met verslavingsproblemen

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