Runaway youth report a broader range and higher severity of substance-related, mental health and family problems relative to non-runaway youth. Most studies to date have collected self-report data on the family and social history; virtually no research has examined treatment effectiveness with this population. This study is a treatment development project in which 124 runaway youth were randomly assigned to (1) ecologically based family therapy (EBFT) or (2) service as usual (SAU) through a shelter. Youth completed an intake, posttreatment, 6 and 12 months follow-up assessment. Youth assigned to EBFT reported greater reductions in overall substance abuse compared to youth assigned to SAU while other problem areas improved in both conditions. Findings suggest that EBFT is an efficacious intervention for this relatively severe population of youth.
This paper reports findings from the first randomized clinical trial examining treatment outcome for family therapy with substance abusing runaway youth. Overall, many researchers have concluded that family based intervention for substance abuse is an effective therapeutic modality (Gurman, Kniskern, & Pinsof, 1986; Craig, 1993; Stanton & Shadish, 1997). It has been recognized as particularly effective with adolescent substance abusers and behaviour problem youth (Bry, 1988; Szapocznik, Kurtines, Foote, Perez-Vidal, & Hervis, 1983; Szapocznik, Kurtines, Santisteban, & Rio, 1990; Liddle, Dakof, & Diamond, 1991; Joanning, Thomas, Quinn & Millen, 1992). Reviews of formal clinical trials of family based treatments consistently found that more drug-abusing adolescents enter, engage in, and remain in family therapy longer than in other modalities, and family therapy produces significant reductions in pre to posttreatment substance use (Liddle & Dakof, 1995; Stanton & Shadish, 1997; Waldron, 1997; Ozechowski & Liddle, 2000).
Fifteen randomized trials have evaluated substance use outcomes for adolescents and their families (for reviews: Kaminer & Slesnick, in press; Ozechowski & Liddle, 2000; Stanton & Shadish, 1997). All adolescent family therapy studies showed significant pre to posttreatment reductions in substance use for the family based intervention utilized, with eight of the 12 studies that used a non-family therapy control showing superior effects for those youth assigned to family therapy. In addition to substance use, recent studies have shown that family therapy positively impacts school performance and attendance, family functioning, delinquency and aggression (Henggeler, Pickrel & Brondino, 1999; Liddle et al., 2001; Henggeler, Clingempeel, & Brondino, 2002; Santisteban, Perez-Vidal, Coatsworth, & Kurtines, 2003).
