"Treatment of Alcohol Problems for Violence Prone Youth" is a five-year research project designed to develop and test a school-based alcohol abuse/violent behavior intervention with a multicultural sample of violence prone alternative school youth with alcohol and substance use problems. Adolescent alcohol and drug use/abuse and juvenile violence are pressing social problems in America. Moreover, an extensive literature has documented significant associations between substance use/abuse and juvenile violence. Compared with the general population of adolescents, juvenile offenders are more likely to use alcohol, tobacco, and other drugs, are more likely to have substance use problems, and use substances at earlier ages. The proposed study is a randomized clinical trial evaluating the efficacy of a school-based intervention (Guided Self-Change). Key features of the study include manualized treatments, theory-driven hypotheses, a randomized controlled trial design, and a culturally/ethnically diverse sample of youth with co-occurring problems of substance abuse and violent behaviors. Participants (n=800) will be randomly assigned to two conditions: a brief intensive school-based intervention (GSC) or standard care (SC and referral] provided by Communities in Schools of Miami. The school-based intervention will consist of 5-7 weekly individual sessions of GSC. Participants will be assessed immediately before and after intervention and at 3- and 6-month follow-up. Primary hypotheses include: 1) adolescents assigned to GSC will demonstrate significantly greater reductions in alcohol and other drug involvement thanadolescents assigned to SC; and 2) adolescents assigned to GSC will demonstrate significantly greater reductions in violent behavior and attitudes than those assigned to SC. Our second aim is to examine processes of change associated with response to the GSC intervention. Analyses will involve: 1) measuring the degree to which participants demonstrate pretreatment/post-treatment changes in selected domains (i.e., stress-coping skills, social skills, adolescent-parent communication skills, motivation to change) directly reflecting each of the intervention components; and 2) examining whether changes in these domains predict participants? ultimate response to intervention. A third aim is to examine contextual variables, representing significant subgroups of adolescents that may predict differential treatment. These include family and neighborhood substance use and violence, and peer and adult social support. Finally, the fourth aim is to examine treatment response by factors related to race/ethnicity and gender. These factors include acculturation level, acculturation stress, discrimination, and cultural mistrust for race/ethnic factors, and psychopathology and abuse experiences for gender factors.

R01AA013369

2002-08-01

2008-07-31