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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    • "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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    ABSTRACT: Youth involved in the juvenile justice system report significantly higher rates of STI/HIV infections, compared to youth in the general population. A limited number of epidemiological studies document that social–ecological factors at the peer, family, school, and policy levels are significantly related to unsafe sexual behaviors among this population. However, no existing studies have evaluated the extent to which existing STI/HIV intervention approaches target the various social–ecological factors that are implicated in STI/HIV risk behaviors among this cohort. Applying the social–ecological framework, we review research on STI/HIV prevention and intervention programs, which targeted family, peers, and school contexts of children and adolescent involved in the juvenile justice system. Our findings suggest that these youth report significantly higher rates of STI than do those with no juvenile justice involvement. However, we also found that a bulk of the programs reviewed have targeted individual risk factors as the primary target for behavior change, even though contextual factors beyond the individual are implicated in sexual behaviors. We conclude with implications for research and practice based on this review.
    No preview · Article · Sep 2015 · Journal of Child and Family Studies
    • "Despite the elevated rates of sexual risk behaviors engaged in by substance abusing delinquent youth, few interventions specifically target this population. Apart from the study reported above (Tolou-Shams et al., 2011), Marvel and colleagues (Marvel et al., 2009) identified just four other published preventive interventions that specifically targeted the sexual risk behaviors of substance using juvenile offenders. Three of these were delivered to youth in juvenile justice settings, all four involved group formats, none included youths' caregivers and just one was associated with relevant behavioral changes (e.g., increased condom use; Magura, Kang & Shapiro, 1994). "

    No preview · Article · Jan 2015 · Drug and Alcohol Dependence
    • "Despite the elevated rates of sexual risk behaviors engaged in by substance abusing delinquent youth, few interventions specifically target this population. Apart from the study reported above (Tolou-Shams et al., 2011), Marvel and colleagues (Marvel et al., 2009) identified just four other published preventive interventions that specifically targeted the sexual risk behaviors of substance using juvenile offenders. Three of these were delivered to youth in juvenile justice settings, all four involved group formats, none included youths' caregivers and just one was associated with relevant behavioral changes (e.g., increased condom use; Magura, Kang & Shapiro, 1994). "

    No preview · Conference Paper · Jul 2014
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