The effects of Brief Strategic Family Therapy (BSFT) on parent substance use and the association between parent and adolescent substance use.

BACKGROUND: The effects of family therapy for adolescent substance use on parent substance use have not been explored.

OBJECTIVES: To determine the effects of Brief Strategic Family Therapy® (BSFT®) on parent substance use, and the relationship between parent substance use and adolescent substance use.

DESIGN: 480 adolescents and parents were randomized to BSFT or Treatment as Usual (TAU) across eight outpatient treatment programs.

METHODS: Parent substance use was assessed at baseline and at 12months post-randomization. Adolescent substance use was assessed at baseline and monthly for 12months post-randomization. Family functioning was assessed at baseline, 4, 8, and 12months post-randomization.

RESULTS: Parents in BSFT significantly decreased their alcohol use as measured by the ASI composite score from baseline to 12months (χ(2)(1)=4.46, p=.04). Change in family functioning mediated the relationship between Treatment Condition and change in parent alcohol use. Children of parents who reported drug use at baseline had three times as many days of reported substance use at baseline compared with children of parents who did not use or only used alcohol (χ(2)(2)=7.58, p=.02). Adolescents in BSFT had a significantly lower trajectory of substance use than those in TAU (β=-7.82, p<.001) if their parents used drugs at baseline.

CONCLUSIONS: BSFT is effective in reducing alcohol use in parents, and in reducing adolescents' substance use in families where parents were using drugs at baseline. BSFT may also decrease alcohol use among parents by improving family functioning.