Disorders - Substance Use Disorders
van-der-Pol, T. M., Hoeve, M., Noom, M. J., Stams, G., Doreleijers, T. A. H., van-Domburgh, L., Vermeiren, R.
BACKGROUND: Multidimensional family therapy (MDFT) is a well-established treatment for adolescents showing both substance abuse and/or
antisocial behavior.\rMETHOD: The effectiveness of MDFT in reducing adolescents' substance abuse, delinquency, externalizing and internalizing
psychopathology, and family malfunctioning was examined by means of a (three-level) meta-analysis, summarizing 61 effect sizes from 19 manuscripts (N
= 1,488 participants).\rRESULTS: Compared with other therapies, the overall effect size of MDFT was significant, albeit small in magnitude (d = 0.24,
p < .001), and similar across intervention outcome categories. Moderator analysis revealed that adolescents with high severity problems, including
severe substance abuse and disruptive behavior disorder, benefited more from MDFT than adolescents with less severe conditions.\rCONCLUSIONS: It can
be concluded that MDFT is effective for adolescents with substance abuse, delinquency, and comorbid behavior problems. Subsequently, it is important
to match specific characteristics of the adolescents, such as extent of impairment, with MDFT.
Journal of Child Psychology & Psychiatry & Allied Disciplines, 58(5) : 532-
545
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Spirito, A., Hernandez, L., Marceau, K., Cancilliere, M. K., Barnett, N. P., Graves, H. R., Rodriguez, A. M., Knopik, V. S.
The purpose of this study was to evaluate the efficacy of the Family Check-up (FCU), a parent-focused brief motivational intervention,
in families where parents were concerned about one adolescent's alcohol or marijuana use and the referred adolescent also had a sibling close in
age. The primary goal of the FCU was to provide individualized feedback on specific parenting skills, including monitoring and supervision, limit
setting, and alcohol-related communication. A total of 92 adolescents (37 female) between the ages of 12-19years of age along with a sibling (48
female) between the ages of 11-21years old, were randomized to the FCU or a psychoeducation (PE) comparison condition. Findings indicated that the
FCU did not produce better effects on alcohol and other drug use outcomes than the PE condition, in either the adolescent or sibling. Brief
interventions addressing parenting behaviors may not be sufficient to reduce alcohol use in adolescent drinkers not referred due to an alcohol-
related incident. Future research might be conducted to explore whether brief parent interventions, such as those in the present study, could be
useful as a preventive intervention for parents whose teens report low levels of substance use.
Journal of Substance
Abuse Treatment, 77 : 156-165
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation, Other Psychological Interventions, Personalised feedback, normative feedback
Spoth, R., Redmond, C., Shin, C., Greenberg, M., Feinberg, M., Trudeau, L.
Background: Substance misuse and associated health-risking behaviors are prevalent in emerging adulthood. There is a knowledge gap
concerning the post-high school effects of community-based delivery systems for universal preventive interventions implemented during young
adolescence. This study reports effects of the PROSPER delivery system through age 19, 7.5 years past baseline. Methods: A cohort sequential design
included 28 public school districts randomly assigned to the PROSPER partnership delivery system or usual-programming conditions. PROSPER community
teams implemented a family-focused intervention in 6th grade and a school-based intervention in 7th grade. Outcomes for the age 19, post-high school
report included lifetime, current, and frequency of substance misuse, as well as antisocial and health-risking sexual behaviors. Intent-to-treat,
multi-level analyses of covariance of point-in-time outcomes were conducted, along with analyses of risk-related moderation of intervention effects.
Results: Results showed emerging adults from PROSPER communities reported significantly lower substance misuse across a range of types of substances,
with relative reduction rates of up to 41.0%. No significant findings were observed for associated antisocial and health-risking sexual behavior
indices; or for lifetime rates of sexually transmitted infections. Risk-related moderation effects were non-significant, suggesting generally
comparable outcomes across higher- and lower-risk subgroups of emerging adults. Conclusions: The PROSPER delivery system for brief universal
preventive interventions has potential for public health impact by reducing long-term substance misuse, with positive results extending beyond high
school. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Psychological Medicine, 47(13) : 2246-2259
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Stein, L., Martin, R., Clair-Michaud, M., Lebeau, R., Hurlbut, W., Kahler,
C., Monti, P., Rohsenow, D.
Objective: To
compare Relaxation Training plus Substance-Education/12-Steps (RT/SET) versus Motivational Interviewing plus Cognitive Behavior Therapy (MI/CBT) in
reducing risk behaviors among incarcerated youth. Method: Participants (N = 199) were 65% non-White, 10% girls, with average age of 17.1 years. Two
individual sessions of MI (or RT) were followed by 10 group sessions of CBT (or SET). Youth were randomized to condition with follow-ups at 3- and 6
-months after release. Major outcomes included alcohol, marijuana and predatory crime. Results: Percent heavy drinking days was lower after RT/SET (p
= 0.033). MI/CBT tended to result in less alcohol-related predatory aggression at 3 mo (p = 0.072), but within RT/SET this aggression decreased from
3 to 6 mo (p = 0.007). Both groups showed significant predatory crime decrease over time (p = 0.044). Effects for marijuana were not significant.
Conclusions: RT/SET is a viable intervention for incarcerated youth and it is relatively simple to implement. On the other hand, MI and CBT are
supported by a large body of research and cannot be discarded based on one clinical trial. More work is needed in this area. Public Health
Significance: It is critical to reduce substance use and crime in incarcerated youth using methods that are relatively easily disseminated.
Relaxation Training plus Substance Education/ 12-Steps appears to reduce heavy drinking. More work is needed to increase treatment effects.
Alcoholism: Clinical and Experimental Research, 41
(Supplement 1) : 90A
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Relaxation
Trudeau, K. J., Black, R. A., Kamon, J.
L., Sussman, S.
Background: An Internet-based relapse prevention supplement to
adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base
is lacking. Objective: To assess the efficacy of the online Navigating my Journey (NmJ) program. Methods: 129 adolescent-aged participants (ages 13-
23) receiving substance abuse treatment participated in a randomized parallel group study comparing two conditions: experimental (NmJ) versus
attention control (viewed wellness articles from the Nemours Foundation at their discretion). Participants in the experimental condition were asked
to complete 12 core lessons over 3 months. Lesson content was developed to teach evidence-based relapse prevention skills. Data were collected at
four time points: baseline, 1-month follow up, 3-month follow up, and 6-month follow up. Results: We used a linear mixed modeling approach to test
for differences between conditions on each outcome. Participants in the experimental condition reported a significantly greater increase in
motivation to reduce or not misuse drugs from baseline to 3-month follow up and from baseline to 6-month follow up, compared to the control
participants. Participants in the experimental condition also reported a greater decrease in drug use score from baseline to 3-month follow up,
compared to the control participants. An analysis of age as a potential moderator suggested that the intervention may be more effective for older
adolescents. Greater use of the program was associated with greater self-efficacy and lower self-reported substance use over time. Conclusions:
Relapse prevention treatment with adolescents may be facilitated by theory-based online interventions. (PsycINFO Database Record (c) 2019 APA, all
rights reserved)
Child & Youth Care Forum, 46(3) : 437-
454
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Relapse prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Technology, interventions delivered using technology (e.g. online, SMS)
Romero, E., Rodriguez, C., Villar, P., Gomez-Fraguela, X. A.
The aim of this study is to evaluate the long-term effects of a manualised program which intervenes on children with early-onset
conduct problems, their families and teachers. The program evaluation involved 14 primary schools which were randomly assigned to the intervention
(45 participating families) and control (30 families) conditions during 2007-2008. After a screening process which identified children with
significant conduct problems both at home with their family and at school, the program was implemented in eight schools. Seven years later, 58
families (37 from the intervention group and 21 from the control group), with characteristics equivalent to those of the study's entire initial
group, were contacted again. With measures administered to the children and their parents, comparisons through multivariate analyses of variance
between intervention and control groups supported the program's efficacy in reducing both conduct problems and relations with antisocial peers.
Furthermore, the program fostered social and communication skills. As regards drug use, the intervention group showed less favourable attitudes
towards drugs, lower intention of drug use, lower frequency of tobacco use and lower intensity of alcohol use. These results support the usefulness
of multicomponent programs for conduct problems as a way to prevent, in the long term, unfavourable developmental trajectories, where drug use is a
key element.
Adicciones, 29(3) : 150-
162
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Sanchez, Z. M., Valente, J. Y., Sanudo, A., Pereira, A. P. D., Cruz, J. I., Schneider,
D., Andreoni, S.
A randomized controlled trial was conducted in 2014 with 7th
and 8th grade students from 72 public schools in 6 Brazilian cities. This trial aimed to evaluate the effects of an adapted European school-based
drug prevention program Unplugged, called #Tamojunto in Brazil, which was implemented by the Ministry of Health as part of public policy. The
experimental group (n = 3340) attended 12 classes in the #Tamojunto program, and the control group (n = 3318) did not receive a school prevention
program. Baseline data were collected prior to program implementation, and follow-up data were collected 9 months later, allowing a matching of 4213
adolescents in both waves. The substances examined were alcohol, tobacco, marijuana, inhalants, cocaine, and crack. Multilevel analyses were used to
evaluate the changes in consumption of each drug between time points and between groups. The intervention and control groups had similar baseline
characteristics. The mean age of the adolescents was 12.5 +/- 0.7 years, and 51.3% were female. The program seemed to increase alcohol use initiation
(first alcohol use); students in the experimental group had a 30% increased risk of initiating alcohol use during the 9-month follow-up (aRR = 1.30,
95% confidence interval (95%CI) 1.13-1.49, p < 0.001) compared to the control group. The opposite was found for the first inhalant use: the risk of
using inhalants for the first time after baseline was lower in the experimental group (aRR = 0.78, 95%CI 0.63-0.96, p = 0.021) than the control
group. The results of the #Tamojunto program suggest that the content and lessons regarding alcohol may enhance curiosity about its use among
adolescents. We suggest a re-evaluation of the expansion of the #Tamojunto program in schools while analyzing why the program's effects were
inconsistent with those of previous European studies.
Prevention
Science, 18(7) : 772-782
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kelly, J. F., Kaminer, Y., Kahler, C. W., Hoeppner, B., Yeterian, J., Cristello, J. V., Timko, C.
BACKGROUND AND AIMS: The integration of 12-Step philosophy and
practices is common in adolescent substance use disorder (SUD) treatment programs, particularly in North America. However, although numerous
experimental studies have tested 12-Step facilitation (TSF) treatments among adults, no studies have tested TSF-specific treatments for adolescents.
We tested the efficacy of a novel integrated TSF.\rDESIGN: Explanatory, parallel-group, randomized clinical trial comparing 10 sessions of either
motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT; n = 30) or a novel integrated TSF (iTSF; n = 29), with follow-up assessments
at 3, 6 and 9 months following treatment entry.\rSETTING: Out-patient addiction clinic in the United States.\rPARTICIPANTS: Adolescents [n = 59; mean
age = 16.8 (1.7) years; range = 14-21; 27% female; 78% white].\rINTERVENTION AND COMPARATOR: The iTSF integrated 12-Step with motivational and
cognitive-behavioral strategies, and was compared with state-of-the-art MET/CBT for SUD.\rMEASUREMENTS: Primary outcome: percentage days abstinent
(PDA); secondary outcomes: 12-Step attendance, substance-related consequences, longest period of abstinence, proportion abstinent/mostly abstinent,
psychiatric symptoms.\rFINDINGS: Primary outcome: PDA was not significantly different across treatments [b = 0.08, 95% confidence interval (CI) = -
0.08 to 0.24, P = 0.33; Bayes' factor = 0.28).\rSECONDARY OUTCOMES: during treatment, iTSF patients had substantially greater 12-Step attendance,
but this advantage declined thereafter (b = -0.87; 95% CI = -1.67 to 0.07, P = 0.03). iTSF did show a significant advantage at all follow-up points
for substance-related consequences (b = -0.42; 95% CI = -0.80 to -0.04, P < 0.05; effect size range d = 0.26-0.71). Other secondary outcomes did not
differ significantly between treatments, but effect sizes tended to favor iTSF. Throughout the entire sample, greater 12-Step meeting attendance was
associated significantly with longer abstinence during (r = 0.39, P = 0.008), and early following (r = 0.30, P = 0.049), treatment.\rCONCLUSION:
Compared with motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT), in terms of abstinence, a novel integrated 12-Step
facilitation treatment for adolescent substance use disorder (iTSF) showed no greater benefits, but showed benefits in terms of 12-Step attendance
and consequences. Given widespread use of combinations of 12-Step, MET and CBT in adolescent community out-patient settings in North America, iTSF
may provide an integrated evidence-based option that is compatible with existing practices.
Addiction, 112(12) : 2155-2166
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions
Kim, H. K., Buchanan, R., Price, J. M.
Substance use problems are highly prevalent among youth in foster care. Such problems in adolescence have long-lasting
implications for subsequent adjustment throughout adulthood and even across generations. Although several programs have demonstrated positive results
in reducing substance use in at-risk youth, few studies have systemically examined how such programs work for foster youth and whether they are
effective for both genders. This study examined the efficacy of KEEP SAFE, a family-based and skill-focused program designed to prevent substance use
and other related health risking behaviors among youth in foster care. We hypothesized that improving the caregiver-youth relationship would lead to
later reductions in youths' involvement with deviant peers, which subsequently would lead to less substance use, and that this mechanism would work
comparably for both genders. A sample of 259 youth (154 girls, ages 11-17 years) in foster care and their caregivers participated in a randomized
controlled trial and was followed for 18 months post-baseline. Results indicated that the intervention significantly reduced substance use in foster
youth at 18 months post-baseline and that the intervention influenced substance use through two processes: youths' improved quality of relationships
with caregivers at 6 months post-baseline and fewer associations with deviant peers at 12 months post-baseline. This suggests that these two
processes may be fruitful immediate targets in substance use prevention programs for foster youth. We also found little gender differences in direct
and mediating effects of the intervention, suggesting KEEP SAFE may be effective for both genders in foster care. (PsycINFO Database Record (c) 2017
APA, all rights reserved)
Prevention Science, 18(5) : 567-
576
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kulis, S. S., Ayers, S. L., Harthun, M.
L.
This article describes a small efficacy trial of the Living in 2 Worlds(L2W) substance use
prevention curriculum, a culturally adapted version of keepin' it REAL (kiR) redesigned for urban American Indian (AI) middle school students.
Focused on strengthening resiliency and AI cultural engagement, L2W teaches drug resistance skills, decision making, and culturally grounded
prevention messages. Using cluster random assignment, the research team randomized three urban middle schools with enrichment classes for AI
students. AI teachers of these classes delivered the L2W curriculum in two schools; the remaining school implemented kiR, unadapted, and became the
comparison group. AI students (N = 107) completed a pretest questionnaire before they received the manualized curriculum lessons, and a posttest (85%
completion) 1 month after the final lesson. We assessed the adapted L2W intervention, compared to kiR, with paired t tests, baseline adjusted general
linear models, and effect size estimates (Cohen's d). Differences between the L2W and kiR groups reached statistically significant thresholds for
four outcomes. Youth receiving L2W, compared to kiR, reported less growth in cigarette use from pretest to posttest, less frequent use of the Leave
drug resistance strategy, and less loss of connections to AI spirituality and cultural traditions. For other substance use behaviors and antecedents,
the direction of the non-significant effects in small sample tests was toward more positive outcomes in L2W and small to medium effect sizes. Results
suggest that evidence-based substance use prevention programs that are culturally adapted for urban AI adolescents, like L2W, can be a foundation for
prevention approaches to help delay initiation and slow increases in substance use. In addition to study limitations, we discuss implementation
challenges in delivering school-based interventions for urban AI populations. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Primary Prevention, 38(1-2) : 137-
158
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kurtz, S. P., Buttram, M. E., Pagano, M. E., Surratt, H. L.
Background: Efficacious interventions to reduce drug use and its consequences for club drug using populations are not apparent in the
literature. We tested interviewer- (CAPI) and self-administered (ACASI) comprehensive health and social risk assessments as distinct interventions
compared to waitlist control. Methods: 750 men and women ages 18-39 with multidrug use and heterosexual behavior were randomized in equal proportions
to the three conditions. Instrumentation included well-tested measures of drug use, risky sex, mental distress and substance dependence. Results: The
sample was 56% male; mean age = 25. Reported risk behaviors and health consequences did not differ by assessment modality. Adjusted HLM analyses
showed a significant main effect of assigned condition on all outcomes. CAPI participants had greater reductions in drug use, risky sex, mental
distress and substance dependence symptoms, and greater increases in abstinence, compared to ACASI intervention or control participants at 12 months,
except that the CAPI and ACASI conditions had similar efficacy for reductions in drug use. Effect sizes for CAPI versus ACASI participants were d =
0.2-0.3, and between CAPI and controls d = 0.2-0.4. Effect sizes for improved outcomes between ACASI compared to controls were small to non-
significant. Conclusions: The study established the therapeutic benefit of interviewer interaction in reducing risky behavior among this young drug
using population. The study demonstrated the efficacy and acceptability of a low threshold intervention in reducing drug use, sexual risk and related
co-morbidities among a not-in-treatment young adult population that exhibits severe and complex levels of drug use, but that is also highly resistant
to intervention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Substance Abuse Treatment, 78 : 64-
73
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any)
Letourneau, E. J., McCart, M. R., Sheidow, A.
J., Mauro, P. M.
There is a need for interventions that
comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a
validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of
RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA
included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by
caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6-
and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were
not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future
development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future
interventions.
Journal of Substance Abuse Treatment, 72 : 56-
65
- Year: 2017
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Case management