Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents

Michael S. Robbins, Daniel J. Feaster, Viviana E. Horigian, Michael Rohrbaugh, Varda Shoham, Ken Bachrach, Michael Miller, Kathleen A. Burlew, Candy Hodgkins, Ibis Carrion, Nancy Vandermark, Eric Schindler, Robert Werstlein, José Szapocznik

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Objective: To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to TAU with a multiethnic sample of adolescents (213 Hispanic, 148 White, and 110 Black) referred for drug abuse treatment at 8 community treatment agencies nationwide. Randomization encompassed both adolescents' families (n = 480) and the agency therapists (n = 49) who provided either TAU or BSFT services. The primary outcome was adolescent drug use, assessed monthly via adolescent self-report and urinalysis for up to 1 year post randomization. Secondary outcomes included treatment engagement (≥2 sessions), retention (≥8 sessions), and participants' reports of family functioning 4, 8, and 12 months following randomization. Results: No overall differences between conditions were observed in the trajectories of self-reports of adolescent drug use. However, the median number of days of self-reported drug use was significantly higher, χ 2(1) = 5.40, p <.02, in TAU (Mdn = 3.5, interquartile range [IQR] = 11) than BSFT (Mdn = 2, IQR = 9) at the final observation point. BSFT was significantly more effective than TAU in engaging, χ 2(1) = 11.33, p <.001, and retaining, χ 2(1) = 5.66, p <.02, family members in treatment and in improving parent reports of family functioning, χ 2(2) = 9.10, p <.011. Conclusions: We discuss challenges in treatment implementation in community settings and provide recommendations for further research.

Original languageEnglish (US)
Pages (from-to)713-727
Number of pages15
JournalJournal of consulting and clinical psychology
Issue number6
StatePublished - Dec 2011


  • adolescent substance abuse
  • community-based treatment
  • effectiveness research
  • family therapy
  • treatment as usual

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)


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