functional family therapyfor adolescent substance use disorders（功能性家庭therapyfor青少年物质使用障碍）.doc

Functional Family Therapy for Adolescent Substance Use Disorders Holly Barrett Waldron and Janet L. Brody Center for Family and Adolescent Research Oregon Research Institute Correspondence: Holly Barrett Waldron, Ph.D. Oregon Research Institute 1715 Franklin Blvd. Eugene, OR 97403 Overview of the Clinical Problem: Adolescent Substance Use Disorders Adolescent substance use disorders (SUD) encompass a broad spectrum of phenomena involving distinct substances used, a range in quantity and frequency of use, an array of associated problem behaviors, and multiple ecological influences (Winters, Stinchfield, Bukstein, 2008). SUD is often viewed as just another manifestation of adolescent disruptive behavior. However, the pharmacological effects and physiologically addictive properties of alcohol and illicit drugs have important and unique implications for treatment, relative to treatments for other adolescent disorders. And, unlike other clinical problems, the development and maintenance of SUD may be influenced by the immediate social environment, including the extent of peer and/or parent substance abuse, the availability of substances, and the prevailing societal influences (e.g., tobacco and alcohol taxes, stringent law enforcement, bans on non-prescription medications). Another unique feature of adolescent SUD is that substance use is a covert behavior not always readily apparent to parents, teachers, or other health professionals. The majority of teens with SUD are characterized by lack of motivation to change and resistance to treatment, entering treatment only under a court mandate or in lieu of school suspension. The consequences associated with SUD can be severe. Potential adverse consequences include school failure and drop out, substance-related injuries, and increased risk for STIs, HIV/AIDS, teen pregnancy, violent exchanges, overdose, and death. Substance use can also interfere with crucial developmental tasks, such as prosocial identity fo