Family-Based Treatment for Parental Substance Abuse and Child Maltreatment
Parental substance abuse is a leading determinant of child maltreatment and, consequently, is often linked with negative clinical outcomes for children, exorbitant financial costs for the child welfare system, and serious social costs for the investigators nation. Yet, in spite of the seriousness of child maltreatment in the context of parental substance abuse and that there are well-established effective treatments for adult substance abuse, substance-abusing parents in the child welfare system are less likely to be offered services and receive services. Well-integrated treatments for the dual problem of substance abuse and child maltreatment are virtually nonexistent in the research literature. This study is a randomized controlled trial comparing Comprehensive Community Treatment to Multisystemic Therapy-Building Stronger Families (MST-BSF), an integrated model of two evidence-based treatments for parental substance abuse and child maltreatment that has shown promise in a 4-year pilot.
Statement of Study Hypothesis:
Compared to Comprehensive Community Treatment, parents receiving MST-BSF will show greater reductions in parental substance abuse and psychological distress, greater increases in employment, drug-free activities, social support, and positive parenting, and fewer incidents of reabuse of a child. Children whose families receive MST-BSF will experience fewer child out-of-home placements and greater reductions in internalizing symptoms such as anxiety.
Behavioral: Comprehensive Community Treatment
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Family-Based Treatment for Parental Substance Abuse and Child Maltreatment|
- Parental Substance Abuse [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]
- Abuse of a child [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]physical abuse and/or neglect
- Child Out-of-Home Placement [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]
- Parental Psychological Distress [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]
- Child Internalizing Symptoms [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]Anxiety, Depression, Post-Traumatic Stress Disorder Symptoms
- Abusive Parenting [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]physical assault, psychological aggression, neglectful parenting
- Parental Social Support [ Time Frame: 18 months post baseline ] [ Designated as safety issue: No ]
|Study Start Date:||April 2011|
|Study Completion Date:||August 2016|
|Primary Completion Date:||July 2016 (Final data collection date for primary outcome measure)|
MST-BSF integrates two models with empirical support for their effectiveness, MST-CAN for child maltreatment (Swenson, Schaeffer, Henggeler, Faldowski, & Mayhew, 2012) and RBT for adult substance abuse (Tuten, Jones, Schaeffer, Wong, & Stitzer, 2012) into one comprehensive treatment package. MST-BSF is intended to be comprehensive. The major interventions within the MST-BSF arm include safety planning and implementation, functional analysis of the abuse incident, cognitive behavioral interventions for PTSD symptomatology and low anger management, family communication and problem solving, abuse clarification, and Reinforcement Based Treatment for adult substance abuse. RBT is an incentive-based drug treatment program for adults who abuse opiates, cocaine, or other illicit drugs.
Experimental: Comprehensive Community Treatment
Families randomized to the CCT condition receive an array of services consistent with existing DCF practices. Project Safe community providers offer individual, couples, and family therapy for substance abuse/dependence, early intervention groups, treatment for co-occurring disorders, gender-specific trauma/substance abuse groups, and relapse prevention groups. The DCF caseworker also is responsible for coordinating care for the behavioral and mental health needs of the children. Services include individual outpatient treatment, family therapy, intensive in-home treatment, extended day programs, intensive outpatient, partial and inpatient hospitalization, residential programs/temporary housing (safe homes, shelters), emergency mobile psychiatric services, and crisis stabilization.
|Behavioral: Comprehensive Community Treatment|
Show Detailed Description
Please refer to this study by its ClinicalTrials.gov identifier: NCT01656837
|United States, Connecticut|
|Connecticut Department of Children and Families|
|New Britain, Connecticut, United States, 06051|
|Principal Investigator:||Cynthia C Swenson, Ph.D.||Medical University of South Carolina|
|Principal Investigator:||Cindy M Schaeffer, Ph.D.||University of Maryland|