Article

Multidimensional family therapy HIV/STD risk-reduction intervention: an integrative family-based model for drug-involved juvenile offenders.

Department of Epidemiology and Public Health, Center for Treatment Research on Adolescent Drug Abuse, University of Miami Miller School of Medicine, 1120 NW 14th Street Stc. 1019, Miami, FL 33136, USA.
Family Process (Impact Factor: 1.73). 04/2009; 48(1):69-84.
Source: PubMed

ABSTRACT Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/ STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies (www.cjdats.org). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/ STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.

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Available from: Howard A. Liddle, Aug 09, 2015
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    • "Longitudinal 484 youth in 3 juvenile correctional facilities in Denver Colorado Age: 14–17 Gender: 82.7 % males Race/ethnicity: 36.6 % White, 28.5 % Hispanic, 12.9 % African American, 3.5 % Asian/Pacific Islander, 4.8% Native American, 2.1 % Other, 12.6 % Bi-racial/mixed race/ ethnicity Positive outlook had significant effects on attitudes toward condom use Intervention effects were stronger for those with low level of protective factors Those high in positive outlook did not demonstrate differential response to the intervention, as attitudes and selfefficacy were relatively high The effects of intervention on perceptions of supportive norms for condom use was stronger for youth with higher positive outlooks Higher positive outlook scores at baseline predicted decreased levels of risk behaviors over time Youth with low levels of positive outlook responded better to the intervention Family Level Marvel et al. (2009) "
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    • "Examples of working principles included a reasoned openmindedness about the possibility of change with focused therapeutic effort and the scientific support for this notion; the MDFT program's commitment to comply with juvenile justice requirements while providing an intensive, comprehensive, parentinvolved system of services that push hard to obtain practical, developmentally meaningful outcomes; and rules of collaboration that do not increase the workload of justice personnel. A family-oriented HIV/STD prevention module was designed and integrated within the standard MDFT intervention (Marvel et al., 2009). Youth and their parents participate in three 2-hr multifamily groups designed to (a) enhance adolescents' and parents' awareness about the nature of STDs and HIV, (b) personalize their sexual and drug-associated risk behaviors that increase adolescents' likelihood for exposure to and infection with HIV and STDs, and (c) provide communication (parent(s) and partner ) and condom-use skills for HIV/STD prevention. "
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    • "Slesnick and Prestopnik (2009) found that both types of family therapy led to reduced alcohol and drug use and improved family and adolescent functioning at 15 months follow up compared with service as usual. In an article in Family Process Marvel et al. (2009) described the development and implementation of the multidimensional family therapy HIV/STD risk-reduction intervention. Multidimensional family therapy is a well-established, empirically supported intervention for adolescent drug abuse (Liddle, 2010). "
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