PREDICTORS OF SUBSTANCE USE AND FAMILY THERAPY OUTCOME AMONG PHYSICALLY AND SEXUALLY ABUSED RUNAWAY ADOLESCENTS

There is a dearth of research that examines the impact of family a whole s therapy on problems among sexually and/or physically abused youth. Given this void, differential result and predictors of substance use change were evaluated for abused, as compared with nonabused, runaway adolescents who were randomly assigned to family therapy or treatment as usual. Abused adolescents reported lower family cohesion at baseline, although the one and the other abused and nonabused adolescents showed similar substance use reductions. Utilizing hierarchical linear modeling, we set that substance use changed with change in cohesion above time. These findings link change in family functioning to change in adolescent substance use, supporting family a whole s theory. Findings suggest that a efficacious target of intervention involves focus upon increasing positive communication interactions.

INTRODUCTION

The National Child Abuse and omit Data System (NCANDS) reported that in 2002 an estimated 1800000 referrals were made alleging child abuse or pass over to state and local child protective services agencies. Of these referrals, 896000 children were determined to be victims of child abuse by the agency of the Child Protective Services (CPS) agencies. flat with this high number of youth and families affected by the agency of abuse, the consensus within the literature is that there are scarcely any rigorously designed treatment evaluation studies for maltreated youth (Cohen & Mannarino, 1998; James & Mennen 2001; Stevenson 1999) Several researchers have noted that treatment efforts are still in the early stage of unfolding and more attention is emergencyed for identifying effective interventions (Finkelhor & Berliner, 1995; Kolko 1996; Swenson & Spratt, 1999) To that extreme point this study examined substance abuse treatment result and its predictors among physically and/or sexually abused adolescents.

It has been give an inkling ofed that there is no special sexually abused children's syndrome or symptom characteristic of a majority of similar children (Finkelhor & Berliner, 1995; Kendall-Tackett, Williams, & Finkelhor, 1993) Physical and/or sexual abuse affects diverse locates of youth with a wide range of ages, backgrounds, and associated symptom presentations. question at issue behavior patterns vary by age as well, with running away or substance use typical of older children and nightmares and anxiety more typical of younger children (Finkelhor & Berliner, 1995)

Stevenson (1999) and Beutler and Hill (1992) insinuate that the lack of a specific childhood abuse syndrome and the diversity of those affected calls into question whether specific therapies are required for abuse or whether treatment should focus upon the presenting symptoms rather than upon child abuse specifically. These authors question whether therapy should focus upon the youth's history of physical and/or sexual abuse or upon issues, such as depression or substance abuse, that active treatment seeking. Finkelhor and Berliner (1995) close that, because of the diversity among abused children and families, it is unlikely that any single therapy will be effective for all children and families. These researchers note that treatment evaluation with a homogeneous cluster with similar symptoms allows an intervention to be systematically administered and evaluated. This research included a relatively homogeneous cluster of physically and/or sexually abused adolescents as they had step quickly away from home and were substance abusing.

Child Sexual and Physical Abuse

Finkelhor and Berliner (1995) reviewed 29 studies examining treatment result with sexually abused children and adolescents. Of these, five published studies used an experimental design in which children were randomly assigned to a treatment condition; single two of the studies (Baker, 1987; Monck et al., 1994) included adolescent participants. In the pair studies, client outcomes improved with treatment, although outcomes were similar across conditions.

More freshly Cohen and colleagues (Cohen, Deblinger, Mannarino, & young ox 2004; Cohen & Mannarino, 1998 2000) compared the efficacy of trauma-focused, cognitive-behavioral therapy (TF-CBT) and child-centered therapy for treating posttraumatic stres disorder and other emotional/behavioral vexed questions in children aged 8 to 14 years who had a history of sexual abuse. These researchers lay the foundation of that those children and parents assigned to the TF-CBT as compared to those assigned to the child-centered therapy, demonstrated greater improvement along many dimensions, of that kind as depression, behavior problems, abuse-related distress/attributions and parenting practices.

Compared with studies upon child sexual abuse, even fewer studies have examined treatment with physically abused children (James & Mennen 2001) Milner and Chilamkurti (1991) noted that parental aggression, parental distress, and family conflict are risk factors for childhood physical abuse. Given the character of parents in the abuse of their children, greatest in quantity treatment-outcome research has focused upon treatment of the parent, excluding the family or child. However, comprehensive treatment targeting multiple combination of parts to form a wholes has the advantage over individual treatment prototypes through addressing the many exigencys of children and their families (Swenson & Spratt, 1999)