JMIR Publications

ABSTRACT

Background:

Caregiver-involved treatments for adolescents with alcohol use disorder and co-occurring disorders (AUD+CODs) are associated with the best treatment outcomes. Understanding what caregivers do (e.g., caregiving practices) during treatment to improve core adolescent treatment targets may facilitate the refinement and scalability of caregiver-involved interventions. Caregiving is dynamic, varying by context, affect, and adolescent behavior. Caregiver-involved treatments seek to change momentary interactions between caregivers and their adolescents. Accordingly, this protocol outlines a dyadic ecological momentary assessment (EMA) study to examine caregiving practices during AUD+CODs treatment and their associations with adolescent core treatment targets (e.g., alcohol craving, motivation to reduce or stop drinking, alcohol and other substance use, internalizing and externalizing symptoms).

Objective:

This paper aims to describe the methods for examining momentary caregiving practices and adolescent core treatment targets during adolescent outpatient AUD+CODs treatment.

Methods:

We will recruit 75 caregiver-adolescent dyads from outpatient mental health clinics providing AUD+CODs treatment. Eligible families will have an adolescent who (1) is 13-18 years-old, (2) meets Diagnostic and Statistical Manual (DSM)-5 alcohol use disorder diagnostic criteria, (3) is enrolled in outpatient treatment at the time of recruitment, and (4) who has a legal guardian (e.g., caregiver) willing to participate in the study. Caregivers and adolescents will complete an eligibility screening followed by a baseline assessment during the second week of treatment whenever possible. During the baseline assessment, caregivers and adolescents will receive formal training in EMA procedures. Next, caregivers and adolescents will complete a 15-week EMA burst design consisting of three 21-day EMA periods with 3-week breaks between each period. Throughout the study, participants will also complete weekly reports regarding the skills learned or practiced during therapy. There are three overarching aims to the proposed study: (1) Examine momentary caregiving practices (e.g., support, monitoring, substance use communication quality, alcohol-specific caregiving practices) and their associations with core treatment targets, (2) examine how these associations change over the course of treatment, and (3) examine whether caregiver report of learning or practicing parenting- or family-focused behaviors in treatment sessions is associated with changes in the use of caregiving practices in daily life.

Results:

No data have been collected for proposed study. Data collection is anticipated to begin in the fall of 2024.

Conclusions:

Examining momentary caregiving practices using EMA has important implications for refining and scaling caregiver-involved interventions for AUD+CODs so families who would benefit from caregiver-involved treatments can have access to them.