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Effective family‐based interventions are needed for youth who are experiencing emotional and behavioral difficulties and who are impacted by powerful environmental stressors. Culturally Informed and Flexible Family‐Based Treatment for Adolescents (CIFFTA) is a manualized and evidence‐based, multicomponent family‐based treatment that has been shown to be efficacious in research settings. The purpose of this paper is to report on the effectiveness of implementing CIFFTA for the treatment of Latino and Black youth and families in community settings. Utilization of services offered and changes in youth presenting problems and family functioning were used to evaluate the program. Two hundred thirty‐two youth (11–18 years of age) and their caregivers were recruited over 2 years and CIFFTA was delivered by experienced masters‐level family therapists over a 12–16‐week period. Seventy‐six percent met the 8‐session criteria for retention in treatment and 71% completed treatment. Results showed significant improvements in youth behavioral and emotional presenting problems, reduction in family conflict and improvement in family cohesion and communication. Caregiver well‐being such as reductions in parental stress, relational frustration, and improvement in parental confidence also showed significant improvement. Analyses of reliable change indices showed a substantial improvement in youth who entered the program in the clinical range of presenting problems. The findings point to CIFFTA's ability to retain youth and families who tend to underutilize needed services, to significant reductions in presenting problems, and to improvements in family functioning when implemented in a community setting. [ABSTRACT FROM AUTHOR]

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Objective: This article examines how Haitian families with youth interfacing with the juvenile justice system cope with structural racism and socioethnic discrimination (RSD). Background: Haitian families' experiences of discrimination based on their histories, immigrant status, and positionality illustrates the need for more scientific scrutiny of the experiences of RSD among Black immigrant groups. This National Institute on Drug Abuse (NIDA)–funded study details the narratives of and responses to RSD experienced by Haitian families interfacing with the juvenile justice system. Method: Data are drawn from psychosocial assessment tools, therapeutic sessions, and ethnographic interviews conducted with Haitian families participating in a family‐based therapeutic intervention. Using critical race theory, we foreground the voices of those negatively impacted and use Bourdieu's theory of practice to examine the intersectionality of race and ethnicity in this population's experiences of RSD. Results: The different experiences of and responses to RSD among youth and caregivers of Haitian descent are both a variation of the complex continuum of structural racism in the United States and unique to their immigrant experience of marginalization and cultural invalidation by public institutions, community members, and peers. Conclusion: Professionals working with this population must be sensitive to the ways these experiences impact young people's identity development processes, their health, and well‐being. Haitian caregivers should be encouraged to protect their children by engaging in racial and socioethnic socialization that validates their RSD experiences. Implications: Understanding the intergenerational experiences of RSD among Black, immigrant groups and encouraging family dialogue and adolescent support will strengthen family cohesion during this period of racial reckoning. [ABSTRACT FROM AUTHOR]

Rigorous randomized trials that test promising culturally centered treatments for Latino youth and families are needed. This study adds to the knowledge base by comparing the efficacy of Culturally Informed and Flexible Family Treatment for Adolescents (CIFFTA) to an Individually Oriented Treatment‐As‐Usual (ITAU) in its ability to retain Latino youth and families in treatment, reduce internalizing and externalizing child symptoms, and improve family functioning. CIFFTA uses an adaptive/flexible approach to deliver individual therapy, family therapy, and psycho‐educational modules tailored to each family's unique clinical and cultural characteristics. Two hundred Latino adolescents 11–14 years of age completed a baseline assessment, were randomly assigned to CIFFTA or ITAU, then were assessed again after 16 weeks of intervention. Results show that CIFFTA had significantly higher retention (83%) than ITAU (71%), OR = 2.05, p =.036. Youth in both conditions showed significant reductions in youth and parent reported externalizing and internalizing behaviors, and there were no differences in change between conditions. Parents in CIFFTA reported significantly greater reductions in family conflict, d = 0.38, p =.025 than in ITAU. In CIFFTA, children of less acculturated Latino parents showed more improvement than the children of more acculturated parents. In ITAU, the reverse was true, children of more acculturated parents reported more improvement. This evidence of CIFFTA's impact on retention, family conflict, and differential effect depending on cultural values and behaviors, has important implications for the field of Latino psychology and family treatment. [ABSTRACT FROM AUTHOR]

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1545-5300.2009.01280.x Byline: DANIEL A. SANTISTEBAN (*), MAITE P. MENA (*) Keywords: Hispanic; Adolescent; Integrative Drug Treatment; Culture; Adaptive Interventions; Family Therapy Abstract: The increasing utilization of evidence-based treatments has highlighted the need for treatment development efforts that can craft interventions that are effective with Hispanic substance abusing youth and their families. The list of evidence-based treatments is extremely limited in its inclusion of interventions that are explicitly responsive to the unique characteristics and treatment needs of young Hispanics and that have been rigorously 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' (p. 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. Abstract (French) RESUMEN El uso creciente de tratamientos basados en evidencia ha puesto de relieve la necesidad de que surjan iniciativas para el desarrollo de tratamientos que produzcan intervenciones eficaces con los jovenes hispanos y sus familias. La lista de tratamientos basados en evidencia es limitada porque no incluye intervenciones que respondan a las caracteristicas y necesidades de tratamiento unicas de los hispanos jovenes y que se hayan evaluado rigurosamente con esta poblacion. Las iniciativas comunicadas en este articulo condujeron a la creacion de un tratamiento mejorado basado en la familia, el cual se denomino: 'Terapia familiar culturalmente informada para adolescentes,' a fin de trabajar con jovenes hispanos que tienen problemas de comportamiento y de abuso de sustancias. En este articulo explicamos: 1) una investigacion basica de los factores particulares de estres y de las caracteristicas culturales que comunicaron los jovenes hispanos en busca de tratamiento y sus familias, y sus interacciones con procesos clave de tratamiento familiar; y 2) el proceso de creacion de un tratamiento flexible con reglas de decision reproducibles que permitan la adaptacion del tratamiento a circunstancias familiares unicas. Dos supuestos basicos de este trabajo son, en primer lugar, que un tratamiento flexible basado en un manual optimizara el impacto terapeutico del tratamiento y, en segundo lugar, que los medicos aceptaran mejor las intervenciones, ya que generalmente piensan que los tratamientos basados en manuales son demasiado rigidos y no responden a problemas clinicos complejos ni a la heterogeneidad de los pacientes.Palabras clave: Hispanos, adolescentes, tratamiento integrador contra las drogas, cultura, intervenciones adaptativas, terapia familiar Author Affiliation: (*)School of Nursing and Health Studies, University of Miami-El Centro, Miami, FL. Article note: Correspondence concerning this article should be addressed to Daniel A. Santisteban, El Centro, School of Nursing and Health Studies, University of Miami, PO Box 248153, Coral Gables, FL 33124. E-mail: dsantist@miami.edu

Hispanic adolescents have been shown to have high prevalence of sexually transmitted infections and HIV, and substance abuse has been linked to risky sexual behaviors. The literature indicates that good parent-adolescent communication about sexual risk and safe sexual behaviors may help protect youth, yet little is known about this type of communication in Hispanic families. This article reports data on adolescent and parent factors associated with communication about moral and birth control talk between 108 Hispanic substance abusing adolescents and their parents. Results indicate that Hispanic parents who had older adolescents, reported more involvement, were less concerned of possible negative reactions from their child, and felt more knowledgeable and confident regarding sex and birth control also reported greater frequency of birth control talk. Hispanic parents with a daughter, who reported more involvement, or whose child reported more communication were more likely to report greater frequency of talking about moral issues.

This article presents specialized family therapy intervention strategies for Hispanic families with behavior-problem adolescents who have experienced an immigration-related separation. Such specialized interventions correspond to a philosophy of customized treatment delivery for Hispanic families. Interactional and cognitive/affective features are presented, and guidelines for building therapeutic alliances, identifying core family processes/themes, and transforming interactions are offered.

Strategic Structural Systems Engagement (SSSE), as a specialized engagement intervention, is an effective family therapy approach. Cultural and ethnic variables significantly affect the outcome of the intervention. Eighty one percent of the SSSE families in one study remained engaged in the therapy as compared to 60% of the non-SSSE families. Contextual conditions are important for effectiveness of therapeutic interventions.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1744-6155.2008.00134.x Byline: Maite P. Mena (1), Victoria B. Mitrani (2), Joan A. Muir (3), Daniel A. Santisteban (4) Keywords: Adolescent behavior; Hispanics; immigrants; immigration; mother-child relations; mother-child separations; substance abuse Author Affiliation: (1)Research Assistant Professor Center for Family Studies University of Miami Miller School of Medicine Miami, FL (2)Professor School of Nursing and Health Studies University of Miami Coral Gables, FL (3)Associate Training Director Brief Strategic Family Therapy Training Institute Center for Family Studies University of Miami Miller School of Medicine Miami, FL (4)Research Professor Center for Family Studies University of Miami Miller School of Medicine Miami, FL Article note: Author contact: mmena@med.miami.edu, with a copy to the Editor: roxie.foster @uchsc.edu

The assessment of maladaptive family functioning among adolescent drug abusers is particularly important because maladaptive family functioning has been linked to adolescent drug abuse/delinquent behaviors, and there are now highly effective family interventions available for treating these family dysfunctions. The purpose of the study reported in this article was to investigate the degree to which the Problem Oriented Screening Instrument for Teenagers screen for the family domain provides useful information regarding family functioning when used with clinic-referred youths with behavior problems. Participants in this study were 135 Hispanic and African-American youth referred for the treatment of severe behavior problems, including drug use. Our findings provide support for the usefulness of the 11-item POSIT family functioning screen. Data supporting the criterion validity of the POSIT Family screen, its ability to classify families correctly in terms of their family functioning, and its significant loading on the latent variable resulting from a confirmatory factor analysis all lend support to the usefulness of this screen of family functioning. In addition, analyses designed to explore the relationships between gender and race/ethnicity and the POSIT Family subscale showed that differences in scores by gender and race/ethnicity are not unique to the POSIT, but rather reflect similar differences in family functioning reported by the adolescent on more extensive family measures., Maladaptive family functioning has been strongly linked to both adolescent drug abuse and antisocial/delinquent behaviors (1-9). Parents of youths with behavior problems show less acceptance, warmth, affection, and emotional support [...]

Objective: The comorbidity of psychiatric disorders and substance abuse disorders among adolescents and adults is well-documented in the literature. The current study investigates the relationship between psychiatric and substance use disorders in a sample of treatment-seeking Hispanic adolescents. Methods: The study uses baseline data (N = 190) from a randomized control trial testing the effectiveness of a family-based treatment for Hispanic adolescents with substance abuse disorder to examine the relationship between psychiatric disorders and substance use patterns at baseline, including types of substances used (both lifetime use and past-month use) and age at onset of substance use, controlling for age and gender. Results: Linear regression models were used to examine predictors of age at onset, while logistic regression models examined predictors of lifetime substance use. Significant findings predicting age at onset for marijuana and alcohol are discussed. In addition, psychiatric profiles were differentially associated with lifetime use of sedatives, stimulants, and hallucinogens, but not alcohol or marijuana. Conclusions: Findings from this study can be used to help inform the treatment of adolescents seeking mental health and substance use services. [ABSTRACT FROM AUTHOR]

In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents.Methods:This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14–17 years old (N= 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents.Results:Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use.Conclusion:These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use. [ABSTRACT FROM PUBLISHER]

In this study, we examined data from 200 families to investigate whether family functioning and adolescent psychiatric symptomatology were associated with differential attendance in a family-based or individually focused intervention for Latino adolescents. Latent profile analysis was used to identify families, and regression models were used to examine whether profiles exhibited differential attendance. Overall, three latent profiles were observed. The first described families where parents and adolescents reported discrepancies on psychiatric symptoms and family conflict. The second profile described families with elevated adolescent psychiatric symptoms but no family conflict. The third profile described families with low family cohesion and high levels of adolescent psychiatric symptoms. For this third profile, attendance in family-based treatment was significantly higher than in individual treatment. Results indicate that a family-based intervention may be better able to address issues of poor family cohesion. [ABSTRACT FROM AUTHOR]

Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. [ABSTRACT FROM AUTHOR]

Prescription opioid use has grown rapidly, but few studies examined whether users have similar treatment responses as heroin users. Participants were 1,648 opioid users in Florida Access to Recovery (2004-2007). Participants engaged in methadone or buprenorphine maintenance had better retention than those in nonmaintenance treatment. Heroin only users (HO) had better engagement in nonmaintenance treatments and had worse retention than prescription opioid only users (PO). In methadone maintenance, PO were more likely to report opioid abstinence during treatment than heroin and prescription opioid users (H&P). Future research should focus on understanding and improving the treatment experience of opioid use subgroups. [ABSTRACT FROM AUTHOR]

In the adolescent research literature, acculturation processes have been linked to the development of serious behavior problems in Hispanic adolescents, but not enough is known about how that process takes place. This article reports an investigation that sought to shed light on empirically plausible mechanisms by which family processes (i.e., familism and parenting practices) may operate as mediators of acculturation-related factors on adolescent problem behaviors among 167 Hispanic sixth- or seventh-grade early adolescents. SEM analyses identified an empirically plausible mediated pathway through which parenting practices may operate as a mediator of the effects of acculturation-related variables on adolescent problem behaviors. Second, although the role of familism as a mediator was not supported, the results did provide support for familism having indirect effects on behavior problems also through parenting practices. The findings are discussed in the context of existing research and clinical developments in the treatment of Hispanic adolescents and families. [ABSTRACT FROM AUTHOR]

The article focuses on several factors including, psychiatric, family, and ethnicity, that can impact treatment utilization among Hispanic substance abusing adolescents. It is widely accepted that a small minority of youth requiring treatment for a diagnosable disorder actually ever receive treatment and this is particularly true among substance abusing youth. For this purpose, a study of treatment utilization has been carried out in which one hundred and ten Hispanic substance abusing adolescents and their parents participated. Analysis showed that adolescents with lower numbers of externalizing disorders and parents with better parenting strategies, predicted overall treatment utilization, i.e., residential and outpatient. Better parenting practices and higher parental years in the U.S. predicted more utilization of outpatient services and lower parenting stress predicted more utilization of residential services. Without specialized engagement strategies, adolescents and families most in need may be the least likely to engage in recommended treatment.

This study investigated the efficacy of brief strategic family therapy (BSFT) with Hispanic behavior problem and drug using youth, an underrepresented population in the family therapy research literature. One hundred twenty-six Hispanic families with a behavior problem adolescent were randomly assigned to 1 of 2 conditions: BSFT or group treatment control (GC). Results showed that, compared to GC cases, BSFT cases showed significantly greater pre- to post-intervention improvement in parent reports of adolescent conduct problems and delinquency, adolescent reports of marijuana use, and observer ratings and self reports of family functioning. These results extend prior findings on the efficacy of family interventions to a difficult to treat Hispanic adolescent sample. [ABSTRACT FROM AUTHOR]

Brief Strategic/Structural Family Therapy was implemented as an indicated prevention intervention to reduce the likelihood that African American and Hispanic youth initiated drug use. The intervention was designed to impact two important risk factors for initiation, namely behavior problems and poor family functioning. One hundred twenty-two youth, 12–14 years of age and exhibiting behavior problems, were assigned within a basic one-group pretest/posttest/follow-up design. The first important finding was that the prevention intervention was effective in significantly modifying both high-risk factors, reducing behavior problems [F(2, 120) × 32.92; p < .000] and improving family functioning [F(1, 121) × 41.8; p < .000]. A second important finding was that both high-risk variables targeted were statistically significant predictors of initiation nine months later. A third important finding was that for a small subset of youth who entered the program already using, overall use was significantly decreased [t(22) × 2.11, p < .05]. © 1997 John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

Examines the factor structure the Revised Behavior Problem Checklist (SRBPC), a rating scale used to determine the behavior of child-functioning. Features of the behavior rating scale; Use of principal-axis method with varimax rotation; Significant use of SRBPC among children and adolescents.

Presents a discussion that aims to bridge the gap between systems theory, clinical research and clinical practice in order to more successfully address family interactional patterns that prevent families with a substance abusing youth from entering treatment. Developments in family systems thinking.

The article presents a study that discusses the extended parent-child separations, and the impact on substance-abusing Hispanic adolescents in the U.S. The purposes of this study are to explore some of the clinical characteristics that appear to be associated with these separations and to discuss some of the important clinical implications for nurses as well as other healthcare disciplines.

Motivation is a prominent target for substance use interventions because it is theorized to increase engagement in therapy and predict treatment outcomes. Establishing the validity of measures relevant to motivation among Hispanic/Latino adolescents will improve the resources available for screening and measuring change processes in a multicultural population. We examined the structure of the Problem Recognition Questionnaire (PRQ; Cady, Winters, Jordan, Solberg, & Stinchfield, 1996) with Hispanic/Latino adolescents. Participants were adolescents (n=191) in a randomized controlled trial for substance abuse. Data were collected during a baseline pre-treatment time point and post-treatment time point that was four-months post-baseline. Confirmatory factor analysis (CFA) showed that the three-factor structure proposed by Cady et al. (1996) had a poor fit with pre-treatment data. Follow-up exploratory analyses with principal axis factoring identified an alternate three-factor structure with pre-treatment data (problem recognition, readiness, and treatment resistance). A second CFA showed this three-factor model fit data from participants at the post-treatment time point (n=155). The results provide preliminary evidence for using our proposed factor structure for the PRQ subscales with Hispanic/Latino adolescents. We discuss the dimensions we identified in the context of similar measures and the implications for measuring problem recognition, readiness, and treatment resistance. [ABSTRACT FROM AUTHOR]