Increasing Family Engagement and Treatment Initiation Through Family Assessment, Motivation, and Linkage Intervention (FAMLI)

(PI: Danica Knight)

The FAMLI study tests the integration of existing tools applied to juvenile justice (JJ) populations and examines the feasibility, acceptability, and preliminary efficacy of a caregiver-youth intervention aimed at increasing substance use (SU) treatment initiation and engagement. The Family Assessment, Motivation, and Linkage Intervention (FAMLI) is an intervention that incorporates three evidence-based components:

1) assessment of motivation and linkage-related barriers with personalized feedback
2) Mapping-Enhanced Counseling (MEC) for improving readiness for change and interpersonal communication
3) Active Linkage (AL) for addressing logistical barriers to service initiation

Youth-caregiver dyads are randomly assigned to receive an initial dose (two one-hour sessions) of either MEC or AL. Following this initial dose, youth are randomized to one of two interventions: an additional dose (two one-hour sessions) of the initial intervention (MEC or AL) or a different dose (two one-hour sessions of the other).

The specific aims are to:

1) integrate and adapt appropriate evidence-based intervention components as a dyadic intervention approach for JJ youth and caregivers
2) test the feasibility, acceptability, and optimal configuration of the dyadic intervention components and the protocol used to evaluate effectiveness (including feasibility of recruitment, implementation, and measurement)
3) preliminarily explore for whom:

a) an initial dose of MEC or AL is sufficient for promoting early initiation or engagement
b) an additional dose of MEC or AL or a change in dose is more beneficial

c) which component sequence is most effective

Primary outcomes consider both youth and caregiver measures. For the youth, measures consist of documenting youth initiation and engagement in substance use services. Caregiver measures are comprised of documenting caregiver attendance at youth services.

Secondary outcomes include both youth and caregiver attitudes (problem recognition and desire for help), normative beliefs (SU norms), perceived control (stressors and obstacles), and youth SU (self-report corroborated by urinalysis results).

The proposed study addresses the sizeable gap in service receipt among JJ youth by addressing family engagement and focuses on improving motivation to change, linkage to services, and treatment engagement.