International MDFT Studies

INCANT (INternational CAnnabis Need of Treatment)

INCANT (International Cannabis Need of Treatment http://www.incant.eu/) is a multi-country collaborative treatment study funded under Europe’s Cannabis Research Action Plan.  The Cannabis Research Action Plan is a joint initiative of Belgium, France, Germany, the Netherlands and Switzerland designed to answer important research questions in order to further develop an effective health-based cannabis policy.  Aims of the projects funded under the Cannabis Research Action Plan include: 1) improving the primary and secondary prevention of cannabis consumption; 2) improving the treatment of people who experience problems with cannabis; and 3) developing practical tools to assist national and local policy makers and authorities in implementing and monitoring effective and efficient policies.  INCANT has been designated as a top priority study by the Scientific and Steering Committees of the Cannabis Research Action Plan.  The INCANT pilot and the main study are designed to address the urgent need for more effective treatment for cannabis dependent youth in the 5 participating countries.  The pilot study phase was successfully completed between September, 2004 and March, 2005, in all of the five countries: Belgium (Cannabis Clinic and Rimbaud Centre, both from the Centre Hospitalier Universitaire Brugmann); France (Centre Emergence and Institut Mutualiste Montsouris); Germany (Therapieladen); Netherlands (Parnassia Verslavingszorg, Palmhuis [De Jutters], and Parnassia Research Centre [PARC]); and Switzerland (Jugendberatung der Stadt Zürich and Institut für Suchtforschung [ISF/ARI, Zurich]).  The INCANT Pilot project team is led by H. Rigter (Principal Investigator), Erasmus University Rotterdam, in partnership with H. Liddle and C. Rowe, University of Miami. The major aims of the pilot were: 1) to assess the feasibility of training European therapists from a range of backgrounds in an empirically supported treatment developed and validated in the United States, Multidimensional Family Therapy MDFT; (Liddle, 2002); 2) to assess whether European therapists can deliver MDFT to adequate levels of adherence; and 3) to develop study procedures and a proposal for the main study, which include identifying an appropriate comparison treatment and developing adequate methods of screening, recruitment, and assessment of cannabis abusers.  We are currently conducting a multinational randomized trial comparing MDFT with a treatment comparison condition. The objective of the main study is to evaluate the efficacy of MDFT in cannabis dependent adolescents across the 5 participating European countries compared with the comparison treatment. Outcome measures target substance use, symptoms of cannabis dependence, well-being and mental health, family functioning and school performance and track youth up to 18 months following treatment.

Training Youth Addiction Workers in Scotland in Empirically Based family Therapy

This research expands the scope of a recently funded NIDA study that aims to develop a theory-based, multicomponent community therapist training system (CTTS) to teach and foster competence among community drug treatment providers in Multidimensional Family Therapy (MDFT; Liddle, 2002a), a manualized, empirically supported therapy for drug abusing adolescents. In this supplemental study, collaborative research teams in Miami, Florida (University of Miami Center for Treatment Research on Adolescent Drug Abuse, CTRADA, H. Liddle, Director) and Glasgow, Scotland (University of Glasgow Centre for Drug Misuse Research, CDMR, N. McKeganey, Director) will pilot test the feasibility, acceptability and effectiveness of the CTTS in changing clinician practices and clinical outcomes in Glasgow’s Young People’s Community-Based Alcohol and Drug Services. The proposed study significantly broadens the impact of the parent study by examining the feasibility and impact of the CTTS with youth addiction workers in Scotland, and locating the training system within a national drug treatment professional training program (CDMR’s Scottish Training on Drugs and Alcohol, STRADA). The Scottish Executive’s Effective Interventions Unit, whose mission it is to identify and disseminate effective practice to support the implementation of the national drug misuse strategy, is also a full partner in the research and funds the bulk of the local research activities to be conducted by the CDMR. The aims of this proposed supplemental project follow directly from those of the parent grant by investigating the feasibility of utilizing this training system with youth addiction workers and their supervisors in Glasgow, Scotland, and examining the impact of the training on youths’ outcomes. The supplemental study employs the same interrupted time series design used in the parent grant, which allows the subjects, in this supplement 6 youth addiction workers and 4 supervisors from 4 Community Addiction Teams in Glasgow, to serve as their own controls. The study has three phases. Phase I (1 year) involves start up activities (6 months) and collection of Baseline data (6 months). 34 youth served in the CATs were recruited during the baseline phase and assessed at intake to treatment, 3 months, and six months after the start of treatment.  In addition, interviews with the program staff were also completed during the baseline phase.  The experimental intervention in the study, the training system (CTTS), is in the process of being implemented with the youth addiction workers and supervisors in Phase II (6 months). Interviews with program staff were completed prior to CTTS implementation.  In Phase III (6 months), training will end but the practice patterns of the clinicians will continue to be tracked to evaluate the durability of training effects. The implications of the study include the potential to create an effective training module that could be used in other cultural and practice settings to implement an effective family-based treatment for drug abusing adolescents and their families. In broader terms, this work sets the stage of a larger scale study in which MDFT training and implementation could be examined on a national level throughout Scotland.