If you have a child between the ages of 15 and 20 who is a substance abuser and won't go into counseling or treatment, a Portland researcher has free help for you.
Erica Finstad, an associate scientist with the Oregon Research Institute, has been studying for the past two decades how best to help people who abuse alcohol and drugs. Her research focus is a behavioral strategy called Community Reinforcement and Family Training (CRAFT).
As Finstad describes it, CRAFT is based on the premise that "when people are using drugs, it's often because they're getting some sort of reinforcement from it. The idea, if you want someone to stop using, is that a sober lifestyle has to be more positively reinforcing."
"People use drugs for a reason, so you can't just take it away," Finstad said. "You have to fill it with something else. They need to have some way to fill that void."
Finstad is in the final months of a two-year grant from the National Institute on Drug Abuse that is funding a study, based at the Oregon Research Institute's Center for Family & Adolescent Research, on how well the CRAFT approach works.
Finstad's previous research examined one-on-one counseling, in which a therapist worked with an individual parent or a couple. "What I kept seeing was that (the parents) just felt so alone, so embarrassed, so isolated. I thought, wow, I really want to do this in a group format. That hadn't been done."
Her current study is randomly assigning participants to either the individual approach or a group format. Here are 10 questions and answers about the study.
- Why do the study? "The vast majority of youth who are having trouble with drugs are not receiving treatment," Finstad said. "Sometimes this has to do with the lack of motivation. Sometimes they are not getting in legal trouble – there's not any mandate to get them to do (treatment). Parents know there's a problem but they're not sure what to do."
- What's the idea behind CRAFT? It is designed to help alcohol and drug abusers change their lifestyle and environment so that sobriety and abstinence become more rewarding than substance abuse. "Loved ones can play a significant part in making that happen," Finstad said.
- What specific role do parents play? "We work with the parents to talk about behavioral and communication changes they can make at home," including positive reinforcement. Finstad said parents enjoy this approach because many believed they could not show kindness or warmth to a child abusing drugs or alcohol. "They've gone through so much stress, worry, sadness, and we tell them that yes, it's OK to love your child, to be nice to them, to have fun with them. But let's do it while they're sober so that we're encouraging them to stay that way."
- Why a group format? Finstad said she wants to find out whether sharing stories, seeing other parents' successes and helping other parents with their struggles will decrease parents' stress and anxiety. "Also, group approaches are more economical. That could make it more likely that we could transfer (CRAFT) into the community, that agencies could take it on," Finstad said.
- How well does CRAFT work? Finstad said that between two-thirds and three-fourths of teens whose parents used the approach ultimately "engaged in treatment." That's a higher percentage, she said, than for parents who relied on intervention-style approaches or sought help through Al-Anon.
- Is there still room in this study? Yes. Finstad said she needs about 60 parents and so far has about 20 signed up.
- How much does this cost? Parents receive free counseling plus Fred Meyer gift cards. If you enroll in the study and your child decides to begin treatment, the Center for Family & Adolescent Research can offer your child either free weekly outpatient treatment or free referrals, depending on the level of treatment your child needs.
- How do I sign up? Call 503-243-1065. You'll undergo an initial telephone screening to make sure you meet the eligibility criteria, which include being able to travel to Portland and being able to speak English. (Finstad said she hopes to expand the study to Spanish-only speakers in the future.) Parents whose child has already undergone substance abuse treatment are eligible if the child is using again and refusing treatment.
- How soon can I start? Finstad said there's no waiting list, so eligible parents can start right away. If a child decides to enroll in treatment, "we try to get them in immediately. We know that window of opportunity might be pretty small."
- How much of a commitment is this? After the initial phone screen, there is a one-hour intake appointment and a one-hour pre-treatment assessment. Parents assigned to group counseling meet once a week for 90 minutes for eight weeks. Parents assigned to individual counseling meet once a week for 60 minutes for 12 weeks. After the sessions, there will be 3- and 6-month followups.