title: Brief strategic family therapy versus treatment as usual: results of a multisite randomized trial for substance using adolescents.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to TAU with a multiethnic sample of adolescents (213 Hispanic, 148 White, and 110 Black) referred for drug abuse treatment at 8 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 sessions), retention (≥8 sessions), and participants' reports of family functioning 4, 8, and 12 months following randomization.
  
  
  RESULTS
  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, χ2(1) = 5.40, p < .02, in TAU (Mdn = 3.5, interquartile range [IQR] = 11) than BSFT (Mdn = 2, IQR = 9) at the final observation point. BSFT was significantly more effective than TAU in engaging, χ2(1) = 11.33, p < .001, and retaining, χ2(1) = 5.66, p < .02, family members in treatment and in improving parent reports of family functioning, χ2(2) = 9.10, p < .011.
  
  
  CONCLUSIONS
  We discuss challenges in treatment implementation in community settings and provide recommendations for further research.
authors.affiliation: Miller School of Medicine, University of Miami, FL, USA. mrobbins@ori.org
authors.forename: Michael S
authors.initials: MS
authors.lastname: Robbins
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.forename: Viviana E
authors.initials: VE
authors.lastname: Horigian
authors.forename: Michael
authors.initials: M
authors.lastname: Rohrbaugh
authors.forename: Varda
authors.initials: V
authors.lastname: Shoham
authors.forename: Ken
authors.initials: K
authors.lastname: Bachrach
authors.forename: Michael
authors.initials: M
authors.lastname: Miller
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Burlew
authors.forename: Candy
authors.initials: C
authors.lastname: Hodgkins
authors.forename: Ibis
authors.initials: I
authors.lastname: Carrion
authors.forename: Nancy
authors.initials: N
authors.lastname: Vandermark
authors.forename: Eric
authors.initials: E
authors.lastname: Schindler
authors.forename: Robert
authors.initials: R
authors.lastname: Werstlein
authors.forename: José
authors.initials: J
authors.lastname: Szapocznik
mesh_terms: D000293:Adolescent; D000328:Adult; D005190:Family / Q000523:psychology; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011614:Psychotherapy, Brief / Q000379:methods*; D057566:Self Report; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome