In Memoriam - Alfred Friedman, 1912 - 2008

Alfred S. Friedman, of Haverford, Pennsylvania, family therapist pioneer and international authority on the study and treatment of substance abuse among young people, died of pneumonia at Bryn Mawr Hospital, at the age of 96.

Dr. Friedman, known by everyone as Al, joined the staff of the Philadelphia Psychiatric Center in 1954. For the next 47 years he worked as a research psychologist at the center, now known as the Belmont Center for Comprehensive Treatment, and was its first director of research. Although he retired officially in 2001, he worked until 2003 to complete projects and close the research center.

In the areas where Al concentrated his efforts, he made and left behind significant achievements.  He was a true pioneer the field of family therapy.  In the late 1950s, he and several other colleagues, sharing the viewpoint that human behavior was best understood in the context of the family, established the Family Institute of Philadelphia, an organization that trained hundreds of family therapists over a period of forty years.  

Al became aware of the increase in the use of illegal drugs, in part, by the number of clients reporting substance use in their outpatient psychotherapy at the Wurzel Clinic.  He then explored opportunities for funding additional treatment through government sources.  As a result, he was able to successfully write grants in the early ‘60’s that funded some of the first drug treatment centers in Philadelphia, located at the Philadelphia Psychiatric Center (now Belmont) and in West Philadelphia.

After the National Institute on Drug Abuse (NIDA) was given more prominence in 1974, Al’s group became one of only 13 research sites across the country to participate in the National Polydrug Study.  This project was the federal government’s first effort to document with hard data the dramatic changes that occurred in drug use and drug use patterns as a result of the social upheaval of the 60’s.  Al’s team, which I joined in December of 1974, collected drug-use pattern data from over 400 non-treatment users – right of the streets of Philadelphia.  And this was just the beginning. . . . .of a 40+ year run of unbroken research funding, books, and publications, conferences and being on the cutting edge of substance abuse treatment research.  We were the only group to ever get into the Philadelphia Public Schools and ask students about their drug use.  That data was later used in the development of the ADAD instrument.

In the 80s and '90s, Al was able to analyze data on 1,000 participants of the National Collaborative Perinatal Project. The project, begun in the early 1960s, tracked children from birth to adulthood. Al’s interests were several: the long-term effects of cocaine on the brain; determining which participants would become drug abusers, and the connection between drug abuse and violence.

Perhaps Al’s most notable achievement was the development of the Adolescent Drug Abuse Diagnosis (ADAD), a comprehensive assessment instrument for adolescents entering treatment, which was he and I published in 1989.  Modeled on the Addiction Severity Index, the ADAD became very widely used as both a clinical assessment and as a research tool.  It was adopted by the State of Hawaii for use in all of its youth-serving programs, in Wayne County (Detroit), Michigan and Santa Clara County, California, as well as in numerous agencies across the country. The ADAD was translated into several languages and became very widely used Europe. It was adopted for use in all youth programs by Sweden.   As a result, a significant research relationship emerged, and David Oberg, a Swedish researcher, became the key collaborator in the creation of the EuroADAD, which is now used in 11 countries in Europe.  

A Swiss psychologist, Monique Bolognini, also consulted with Al and I on a French translation and adaptation of the ADAD.  Dr. Bolognini conducted and published several studies with the ADAD and was instrumental in my presenting on the development of the ADAD at the European Society for Adolescent and Child Psychiatry (ESCAP), Paris, October, 2003.

The last time I saw Al, when some of the long-term friends and colleagues of Al got together for lunch last spring, I talked to him about the revision of the ADAD, the ADAD2.  He was interested and pleased that I continued to work with the ADAD after all these years; when I talked to him about again collaborating with David Oberg and the possibility of presenting the ADAD in Sweden, he recalled the trip he and Sarah had made to Sweden in the early 90-ies. As it turns out, the revised ADAD, the ADAD2, will be presented at the Swedish National ADAD Conference, in October, 2008, in Orebro, Sweden.   

Dr. Friedman wrote many professional articles and books and served on the medical school faculties of the University of Pennsylvania and Thomas Jefferson University.

Arlene Terras