Multidimensional Family Therapy for Adolescent Drug Abuse: A Clinical Demonstration of Core Therapist Skills and Treatment Techniques Elda Veloso Center for Treatment Research on Adolescent Drug Abuse University of Miami School of Medicine Presented at the 2005 Joint Meeting on Adolescent Effectiveness Society for Substance Abuse Treatment Effectiveness (SASATE) Washington, DC, March 20-23, 2005

Case P05 and the MDFT Approach Objectives: To review the main pieces of the MDFT approach through the lens of a specific case. To highlight the process in which MDFT therapists conceptualize and build the intervention.

Case PO5 Summary/Conceptualization Having viewed the 9-minute DVD of Case PO5: Mother’s use Currently using alcohol Substance abuse history – crack/cocaine Adolescent’s use Reported using marijuana, cocaine, Xanax and Ecstasy on a weekly basis Adolescent was failing school; repeated 8th grade 2 times

Case PO5 Summary/Conceptualization Adolescent dealing with past hurt from Mother not being around  Adolescent having to parent himself They did not communicate with each other

Pieces of MDFT Approach/Intervention Targets Given any case, the MDFT therapist will conceptualize the case through the following four areas of work: Adolescent Parent Family Extrafamilial

Rationale for MDFT Intervention Targets Problems are multidimensional Multidimensional problems require multidimensional conceptualizations Parent(s) MDFT Family Adolescent Multidimensional conceptualizations yield multi-systems interventions Extrafamilial MDFT assesses and intervenes into multiple systems of development and influence

Pieces of MDFT Approach/Intervention Targets Family MDFT Parent(s) Extrafamilial Therapist - Adolescent Adolescent Self Family Peers

Pieces of MDFT Approach/Intervention Targets Self Overall functioning Stress and burden Who they are as individual human beings Parent Love and commitment Guidance and limit setting Strong stance against drug use and delinquency Therapist - Parent Parent(s) Family MDFT Adolescent Extrafamilial

Pieces of MDFT Approach/Intervention Targets Healthy family relationship and work on family functioning Help family communicate in a new and positive way MDFT Adolescent Parent(s) Extrafamilial Therapist - Family Family GOAL: Help parents get to know the Adolescent so that they can influence him/her

Pieces of MDFT Approach/Intervention Targets Family MDFT Adolescent Parent(s) School Neighborhood Legal (Juvenile Justice) Social Medical Other – Anything outside of the family that may impact adolescent or parent functioning Extrafamilial Therapist -Extrafamilial

Pieces of MDFT Approach/Intervention Targets Family MDFT Parent(s) Extrafamilial Therapist - Parent Therapist must be thinking at all times about the four areas of work and how work in one area impacts progress in all other areas Adolescent Therapist - Family Therapist Therapist - Adolescent Therapist -Extrafamilial

MDFT: P05 Case Study We have reviewed how the MDFT therapist approaches each case and why We have discussed the main issues for Case P05 This is how the MDFT principles would be applied to Case P05

5. Therapist–Family-Extrafamilial MDFT: P05 Case Study 1. Therapist - Adolescent 2. Therapist – Parent(s) Listen to mom’s stress and burden “You’re the medicine” Self-care: See own drug use as a problem and work towards recovery Help adol talk about past hurt regarding mom not being around about his hopes and changes he wants to make – i.e. school “There’s something in this for you.” 3. Therapist - Family Help adol talk to mom about pain she caused him Help mom listen to adol and apologize for the past Help mom talk about where she is now and what she is willing to do to make the situation better Facilitate negotiation about house rules 5. Therapist–Family-Extrafamilial Guide mom in becoming more involved in school to help adol succeed Help mom get assistance from court to keep adol off drugs