Comparison of Driving Transect Methods for Acoustic Monitoring of Bats

Acoustic monitoring for bats along driving transects typically involves recording call sequences (bat passes) continuously while driving. While this offers benefits over other survey techniques, it also poses challenges, including background noise on recordings. An alternative approach that may rectify this involves conducting sampling at discrete points along each transect instead. We compared these methods using the same bat detector, along with an additional higher sensitivity detector to determine which method yields the highest amount and quality of data per unit of time. Results from 26 18 km transects, each sampled continuously and at 10 point count sites indicate that, with a lower sensitivity detector, the two methods yield a similar number of passes per minute, percent of passes identified to species, and species documented. The higher sensitivity bat detector could not be used for continuous sampling due to background noise. However, at point count sites, the higher sensitivity detector recorded 17 times more passes per minute, 44 times more passes identified to species, and documented nearly twice as many species. Thus, while both sampling designs appear comparable, for most applications, a higher sensitivity detector trumps sampling design

Autonomy and Relatedness in Inner-City Families of Substance Abusing Adolescents

This study examined parent-adolescent autonomous-relatedness functioning in inner-city, ethnic minority families of adolescents exhibiting drug abuse and related problem behaviors. Seventy-four parent-adolescent dyads completed a structured interaction task prior to the start of treatment that was coded using an established autonomous-relatedness measure. Adolescent drug use, externalizing, and internalizing behaviors were assessed. Parents and adolescents completed assessment instruments measuring parenting style and family conflict. Confirmatory factor analysis found significant differences in the underlying dimensions of parent and adolescent autonomous-relatedness in this sample versus previous samples. It was also found that autonomous-relatedness was associated with worse adolescent symptomatology and family impairment. Results based on both self-report and observational measures contribute to the understanding of key family constructs in this population and provide insight for both researchers and the treatment community

Linking Session Focus to Treatment Outcome in Evidence-Based Treatments for Adolescent Substance Abuse

The relation between specific therapy techniques and treatment outcome was examined for 2 empirically supported treatments for adolescent substance abuse: individual cognitive–behavioral therapy and multidimensional family therapy. Participants were 51 inner-city, substance-abusing adolescents receiving outpatient psychotherapy within a larger randomized trial. One session per case was evaluated using a 17-item observational measure of model-specific techniques and therapeutic foci. Exploratory factor analysis identified 2 subscales, Adolescent Focus and Family Focus, with strong interrater reliability and internal consistency. Process–outcome analyses revealed that family focus, but not adolescent focus, predicted posttreatment improvement in drug use, externalizing symptoms, and internalizing symptoms within both study conditions. Implications for the implementation and dissemination of individual-based and family-based approaches for adolescent drug use are discussed

A Randomized Trial to Identify Accurate and Cost-Effective Fidelity Measurement Methods for Cognitive-Behavioral Therapy: Project FACTS Study Protocol

Background: This randomized trial will compare three methods of assessing fidelity to cognitive-behavioral therapy (CBT) for youth to identify the most accurate and cost-effective method. The three methods include self-report (i.e., therapist completes a self-report measure on the CBT interventions used in session while circumventing some of the typical barriers to self-report), chart-stimulated recall (i.e., therapist reports on the CBT interventions used in session via an interview with a trained rater, and with the chart to assist him/her) and behavioral rehearsal (i.e., therapist demonstrates the CBT interventions used in session via a role-play with a trained rater). Direct observation will be used as the gold-standard comparison for each of the three methods. Methods/design: This trial will recruit 135 therapists in approximately 12 community agencies in the City of Philadelphia. Therapists will be randomized to one of the three conditions. Each therapist will provide data from three unique sessions, for a total of 405 sessions. All sessions will be audio-recorded and coded using the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale. This will enable comparison of each measurement approach to direct observation of therapist session behavior to determine which most accurately assesses fidelity. Cost data associated with each method will be gathered. To gather stakeholder perspectives of each measurement method, we will use purposive sampling to recruit 12 therapists from each condition (total of 36 therapists) and 12 supervisors to participate in semi-structured qualitative interviews. Discussion: Results will provide needed information on how to accurately and cost-effectively measure therapist fidelity to CBT for youth, as well as important information about stakeholder perspectives with regard to each measurement method. Findings will inform fidelity measurement practices in future implementation studies as well as in clinical practice. Trial registration: NCT02820623, June 3rd, 2016

Using policy codesign to achieve multi-sector alignment in adolescent behavioral health: a study protocol

Background: Policymaking is quickly gaining focus in the field of implementation science as a potential opportunity for aligning cross-sector systems and introducing incentives to promote population health, including substance use disorders (SUD) and their prevention in adolescents. Policymakers are seen as holding the necessary levers for realigning service infrastructure to more rapidly and effectively address adolescent behavioral health across the continuum of need (prevention through crisis care, mental health, and SUD) and in multiple locations (schools, primary care, community settings). The difficulty of aligning policy intent, policy design, and successful policy implementation is a well-known challenge in the broader public policy and public administration literature that also affects local behavioral health policymaking. This study will examine a blended approach of coproduction and codesign (i.e., Policy Codesign), iteratively developed over multiple years to address problems in policy formation that often lead to poor implementation outcomes. The current study evaluates this scalable approach using reproducible measures to grow the knowledge base in this field of study. Methods: This is a single-arm, longitudinal, staggered implementation study to examine the acceptability and short-term impacts of Policy Codesign in resolving critical challenges in behavioral health policy formation. The aims are to (1) examine the acceptability, feasibility, and reach of Policy Codesign within two geographically distinct counties in Washington state, USA; (2) examine the impact of Policy Codesign on multisector policy development within these counties using social network analysis; and (3) assess the perceived replicability of Policy Codesign among leaders and other staff of policy-oriented state behavioral health intermediary organizations across the USA. Discussion: This study will assess the feasibility of a specific approach to collaborative policy development, Policy Codesign, in two diverse regions. Results will inform a subsequent multi-state study measuring the impact and effectiveness of this approach for achieving multi-sector and evidence informed policy development in adolescent SUD prevention and treatment

Chapter 11 - Multidimensional Family Therapy for Adolescent Substance Abuse

This chapter discusses the treatment, development history of an outpatient family-based intervention for adolescent drug use, and behavior problems and Multidimensional Family Therapy (MDFT). MDFT is an ecological, developmentally based psychotherapy that focuses on changing individual behavior, within-family interactions as well as interactions between the family members and relevant social systems. Interventions target the interconnected contexts of the adolescent development. Within these contexts, interventions target on: the circumstances, and processes known to create and/or continue dysfunction. MDFT incorporates multiple social systems into the therapeutic work (individual family members, various family subgroups, and influential extra familial persons and systems) and operates within multiple domains of adolescent and family functioning (affective, behavioral, cognitive, and interpersonal). The approach strives for a consistent and obvious connection among its organizational levels—theory, principles of intervention, intervention strategies, and methods, and clinical assessment of family progress. MDFT is recognized as one of a new generation of comprehensive, multicomponent, theoretically derived, and empirically supported treatments for adolescent drug abuse. This chapter focuses on the articulation, testing and refinement of MDFT, in accordance with the science standards of intervention and in pursuit of empirical support as an efficacious treatment for adolescent substance abuse and related behavior problems

FAMILY-BASED PREVENTIVE INTERVENTION An Approach to Preventing Substance Use and Antisocial Behavior

Family-based preventive intervention for substance use and antisocial behavior is introduced as an emerging specialty. Major program parameters are outlined, and intervention techniques endorsed by contemporary models are presented. Recommendations are made for advancing family-based prevention in key areas: targeting high-risk and adolescent populations, customizing interventions for individual families, working with multiple social systems, and integrating knowledge from the fields of prevention and treatment

A FAMILY‐BASED, DEVELOPMENTAL‐ECOLOGICAL PREVENTIVE INTERVENTION FOR HIGH‐RISK ADOLESCENTS

Family‐based preventive intervention has emerged as a promising modality for preventing antisocial behavior problems in youth. This article introduces an intensive, family‐based preventive intervention for high‐risk adolescents: Multidimensional Family Prevention. Multidimensional Family Prevention combines the advantages of standard prevention models (curriculum based and protection focused) with those of psychosocial treatment models (assessment based and problem focused). The model's main features are described: theoretical foundations (risk and protection theory, developmental psychopathology, ecological theory), guidelines for constructing a multidomain prevention program (family and peer relationships, school and prosocial activities, drug use and health issues, cultural themes), and strategies for tailoring and implementing five flexible intervention modules (adolescent, parent, interactional, extended family, extrafamilial). Implemented in the family's home, the intervention works to create a resilient family environment that supports the basic adolescent developmental goals of renegotiated attachment bonds within the family and durable connections with prosocial institutions

Profiles of systems involvement in a sample of high-risk urban adolescents with unmet treatment needs

This study examined profiles of involvement in four systems (education, child welfare, legal, and treatment) in a sample of 253 high-risk urban adolescents with unmet behavioral health needs. Self-report data were collected on multiple dimensions of involvement within each system, demographics, and DSM-IV diagnoses. Latent class analysis revealed four profiles: Education System: Academic and Disciplinary, Education System: Academic Only, Legal/Juvenile Justice Involved, and Multiple Systems/Child Welfare. Profiles differed based on gender and psychiatric diagnoses. Boys were overrepresented in Education System: Academic and Disciplinary and Legal/Juvenile Justice Involved, and girls were overrepresented in Multiple Systems/Child Welfare. The two education system focused classes were characterized by depressive disorders and ADHD. Youth in Legal/Juvenile Justice Involved and Multiple Systems/Child Welfare were characterized by conduct disorder and substance abuse. Implications for assessment and treatment planning for high-risk youth and for the organization of community-based behavioral health services are discussed.Adolescent Service systems Mental health

Family-based treatment for adolescent substance abuse: controlled trials and new horizons in services research

This article provides an overview of controlled trials research on treatment processes and outcomes in family-based approaches for adolescent substance abuse. Outcome research on engagement and retention in therapy, clinical impacts in multiple domains of adolescent and family functioning, and durability and moderators of treatment effects is reviewed. Treatment process research on therapeutic alliance, treatment fidelity and core family therapy techniques, and change in family processes is described. Several important research issues are presented for the next generation of family-based treatment studies focusing on delivery of evidence-based treatments in routine practice settings