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Randomized Controlled Trial of an Integrated Family-Based Treatment for Adolescents Presenting to Community Mental Health Centers

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Abstract

Most adolescents presenting to community mental health centers have one or more comorbidities (internalizing, externalizing, and substance use problems). We evaluated an integrated family-based outpatient treatment for adolescents (OPT-A) that can be delivered in a community mental health center by a single therapist. A sample of 134 youth/families were randomized to receive OPT-A or usual services, delivered at the same public sector mental health center. Repeated, multi-informant assessments occurred through 18-months post-baseline. At baseline, the sample displayed low internalizing symptoms, moderate substance use, and high externalizing problems. Compared to usual services, OPT-A had effects on abstinence rates, retention, motivation, parent involvement, and satisfaction, but not on internalizing or externalizing problems. While OPT-A achieved some key improvements for youth who present to community mental health centers, and families were satisfied with treatment, continued work is necessary to examine treatments for comorbidity while balancing treatment feasibility and complex strategies to boost treatment effectiveness.

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Acknowledgements

The authors extend their appreciation to participating youth and families, to the South Carolina Department of Mental Health and Lexington County Mental Health, to Dr. Scott Henggeler for his early mentorship in this work, and to Bothwell Graham, Catherine Glen, Lauren Molen, Jennifer Wilson, Alfred Thomas, Jr., and Ligia Navas-Murphy for assistance in implementing the study.

Funding

This work was supported by the National Institutes of Health (NIH) [Grant Numbers R01DA025616, R21DA017118, K23DA015658, and K23DA034879]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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  1. Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR, 97401, USA

    Ashli J. Sheidow, Jason E. Chapman, Michael R. McCart & Tess K. Drazdowski

  2. University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA

    Kristyn Zajac

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Contributions

AJS, MRM, and JEC contributed to the study conception and design. Material preparation, data collection and analysis were performed by AJS, KZ, MRM, and JEC. The first draft of the manuscript was written by AJS, KZ, MRM, and JEC. TKD substantively contributed to writing and reviewing the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kristyn Zajac.

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Sheidow, A.J., Zajac, K., Chapman, J.E. et al. Randomized Controlled Trial of an Integrated Family-Based Treatment for Adolescents Presenting to Community Mental Health Centers. Community Ment Health J 57, 1094–1110 (2021). https://doi.org/10.1007/s10597-020-00735-z

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