Toward a Developmental Family Therapy: The Clinical Utility of Research on Adolescence

Liddle, Howard A.; Rowe, Cynthia L.; Diamond, Gary M.; Sessa, Frances M.; Schmidt, Susan E.; Ettinger, Debra

doi:10.1111/j.1752-0606.2000.tb00318.x

Cited by 36 publications

(19 citation statements)

References 64 publications

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“…This study advances the literature by examining multiple dimensions of the parent-adolescent relationship among higher-risk families and testing whether variations were associated with longitudinal adolescent outcomes. This is important because lower-quality parent-adolescent relationships are common among families seeking services (Liddle, Rowe, & Diamond, 2000). Parent-adolescent relationships that provided a secure psychosocial resource tended to be associated with lower levels of adverse mental health outcomes among adolescents in higher-risk family settings.…”

Section: Discussionmentioning

confidence: 99%

Parent–Adolescent Relationship Factors and Adolescent Outcomes Among High‐Risk Families

2016

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Using a stress‐process and attachment theory framework, we identified salient aspects of the parent–adolescent relationship and tested the extent to which those aspects were longitudinally associated with depression, withdrawal, delinquency, and aggressive behavior outcomes among a sample of high‐risk adolescents (N = 498). First, four dimensions of the parent–adolescent relationship were identified: emotional closeness, communication, autonomy, and conflict. Next, latent profile analyses were conducted, and four distinct parent–adolescent relationship profiles emerged: secure, avoidant, anxious, and detached. Adolescent outcomes were assessed 2 years later. Results indicated that (a) adolescents in the avoidant and anxious profiles demonstrated higher depression symptoms than did those in the secure profile, (b) higher levels of aggression were demonstrated in the avoidant profile, and (c) higher levels of delinquency were demonstrated in the detached profile. Implications for parent–adolescent relationships and family therapy interventions are provided.

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Section: Discussionmentioning

confidence: 99%

Parent–Adolescent Relationship Factors and Adolescent Outcomes Among High‐Risk Families

2016

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“…FBTalso demonstrated gains in school performance (attendance, grade point average) in both studies reporting on this key developmental outcome (Friedman, 1989; Liddle et al , 2001). These findings highlight the pressing need for additional clinical and research focus on developmental outcomes beyond drug use and behavioural symptomatology (Liddle et al , 2000; Meyers et al , 1999). …”

Section: Treatment Outcomes In Multiple Domains Of Functioningmentioning

confidence: 91%

Family‐based treatment for adolescent substance abuse: controlled trials and new horizons in services research

Hogue

Liddle²

2009

Journal of Family Therapy

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This article provides an overview of controlled trials research on treatment processes and outcomes in family-based approaches for adolescent substance abuse. Outcome research on engagement and retention in therapy, clinical impacts in multiple domains of adolescent and family functioning, and durability and moderators of treatment effects is reviewed. Treatment process research on therapeutic alliance, treatment fidelity and core family therapy techniques, and change in family processes is described. Several important research issues are presented for the next generation of family-based treatment studies focusing on delivery of evidence-based treatments in routine practice settings.Family-based treatment (FBT) is the most thoroughly studied behavioural treatment modality for adolescent substance abuse (ASA) (Becker and Curry, 2008). The extensive empirical support for FBT has been described in comprehensive literature reviews (Deas and Thomas, 2001;Williams et al., 2000), meta-analyses of controlled outcome studies (Stanton and Shadish, 1997;Vaughn and Howard, 2004;Waldron and Turner, 2008), and quality of evidence analyses (Becker and Curry, 2008;Vaughn and Howard, 2004). In addition, basic research on developmental psychopathology has emphasized the central role played by family environments in the development of adolescent alcohol and drug problems (Repetti et al., 2002). As a result, clinical practice guidelines put forth by federal agencies (Center for Substance Abuse Treatment, 1999), national associations (American Academy of Child and Adolescent Psychiatry, 1997) and influential policy-making groups (Drug Strategies, 2003 all underscore the importance of involving caregivers and other family members in the treatment of adolescent drug users.This article provides an overview of the extant research literature on treatment processes and outcomes in family-based approaches for ASA. First, we review outcome research on engagement and retention in therapy, clinical impacts in multiple domains of adolescent and family functioning, and durability and moderators of treatment effects. Second, we describe treatment process research on therapeutic alliance, treatment fidelity and core family therapy techniques, and change in family processes. Finally, we present several important research issues for the next generation of FBT studies focusing on delivery of evidence-based treatments in routine practice settings. Treatment outcome research on family-based treatment for ASAThe first wave of controlled studies testing clinical outcomes and treatment engagement strategies in FBT for ASA were conducted during the 1980s (Friedman, 1989;Joanning et al., 1992;Lewis et al., 1990;Szapocznik et al., 1983Szapocznik et al., , 1986Szapocznik et al., , 1988. These studies exemplified cutting-edge research according to prevailing standards: well-defined treatment and comparison conditions, availability of documented treatment procedures or treatment manuals, (Liddle and Dakof, 1995). However, these studies were also limit...

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“…The use of treatments that fail to incorporate findings on culture-related variables ignores the individual differences and differences in life experiences that define ethnic minorities (Bernal & Scharron-Del-Rio, 2001). Just as one would expect that treatments used with adolescents should incorporate the findings of developmental research (Liddle et al, 2000) and findings on family processes (Alexander, Sexton, & Robbins, 2002), we believe that state of the science interventions with minority groups must be explicitly informed and enhanced by findings on important culture-related processes. We do not believe that the onus should be solely on a culturally competent therapist to deliver a manualized treatment that makes only passing reference to issues of culture.…”

Section: Increasing Content and Themes Relevant To Hispanic Youth Andmentioning

confidence: 99%

Culturally Informed and Flexible Family‐Based Treatment for Adolescents: A Tailored and Integrative Treatment for Hispanic Youth

Santisteban

Mena

2009

Family Process

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The increasing utilization of evidence-based treatments has highlighted the need for interventions that are effective with Hispanic substance abusing youth and families. The list of evidence-based treatments is limited in its inclusion of interventions that are responsive to the unique characteristics and treatment needs of young Hispanics and that have been tested with this population. Some treatments that have been tested with Hispanics do not articulate the manner in which cultural characteristics and therapy processes interact. Other treatments have emphasized the important role of culture but have not been tested rigorously. The value of well designed interventions built upon an appreciation for unique patient characteristics was highlighted by Beutler et al.,1996 when they argued that "psychotherapy is comprised of a set of complex tasks, and practitioners need comprehensive knowledge of how different processes used in psychotherapy interact with patient characteristics in order to make treatment decisions that will maximize and optimize therapeutic power" (page 30). A focus on how treatment processes interact with patient characteristics is particularly relevant in the Hispanic population because of the considerable heterogeneity beneath the Hispanic umbrella. Our new program of clinical research focuses on articulating how the varied profiles with regard to immigration stressors, acculturation processes, values clashes, sense of belonging to the community, discrimination, and knowledge about issues important to adolescent health, can be more effectively addressed by a culturally informed treatment.

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Toward a Developmental Family Therapy: The Clinical Utility of Research on Adolescence

Cited by 36 publications

References 64 publications

Parent–Adolescent Relationship Factors and Adolescent Outcomes Among High‐Risk Families

Parent–Adolescent Relationship Factors and Adolescent Outcomes Among High‐Risk Families

Family‐based treatment for adolescent substance abuse: controlled trials and new horizons in services research

Culturally Informed and Flexible Family‐Based Treatment for Adolescents: A Tailored and Integrative Treatment for Hispanic Youth

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