Family Check-Up for Adolescents and Siblings

A total of 175 adolescents, 12 to 18 years old, will be drawn from multiple sites to compare
the experimental condition, The Family Check Up(FCU; Dishion & Kavanagh, 2003) to a
family-based psychoeducational program.

The Family Check-Up is a selective intervention program that focuses on parents. Its goal is
to provide individualized feedback to motivate parents to make improvements in their
parenting practices. A unique strength of the FCU is that feedback is individualized and
tailored to specific parenting skills as they typically pertain to an identified adolescent
in the family. We propose to evaluate the efficacy of the FCU when applied to both an
adolescent identified patient (IP) and a sibling close in age. Our rationale for including a
sibling close in age derives from a strong empirical base which has shown that: 1) sibling
resemblance for alcohol use is high and environmental factors shared by siblings account for
substantial portions of variance in adolescent alcohol use; and 2) specific interactional
dynamics of the sibling relationship (collusion) are related to teen alcohol use. Dr.
Dishion has found that in high-risk families, sibling collusion accounts for variance in
problem behavior after controlling for involvement with deviant peers. This connection
between ineffective parenting strategies and sibling relationship dynamics in combination
creates increased risk for alcohol use by siblings close in age. This notion serves as a
foundation to examine the efficacy of a sibling-enhanced FCU intervention with respect to:
1) improvement in parental communication and monitoring; 2) reduction of sibling interactive
behaviors that are associated with alcohol use; and 3) reduction of alcohol use in IP
adolescents as well as siblings who are currently using alcohol. We will test specified
mediators of FCU efficacy in reducing levels of alcohol use at both the parenting level and
at the level of sibling dynamics. In order to determine whether other types of family-based
interventions might be just as helpful as the more intensive FCU, efficacy of the
sibling-enhanced FCU will be compared to a parenting psychoeducational program.

Inclusion Criteria:

- Participants will be 12 to 18 years old, inclusive, living at home with at least one
parent or guardian.

- Participants will have a teenage sibling within 3 years of age of the identified
adolescent patient. Siblings can be either biological or unrelated siblings in
blended families, as long as they live in the same home as the parents targeted in
the intervention conditions. The adolescent must have experienced a recent (within 1
month) alcohol-related event (ED admission, school disciplinary action, grounding by
parents, legal action). The adolescent must also screen in by reaching the clinical
cutoff score on the Adolescent Drinking Index.

Exclusion Criteria:

- Alcohol positive adolescents with substance dependence diagnosis requiring a higher
level of care; 18 year olds living on their own.