Disorders - Substance Use Disorders
Tanner-Smith, Emily E., Jo-Wilson, Sandra, Lipsey, Mark W.
Meta-analysis was used to synthesize research on the effects
of outpatient treatment on substance use outcomes for adolescents with substance use disorders. An extensive literature search located 45 eligible
experimental or quasi-experimental studies reporting 73 treatment - comparison group pairs, with many of the comparison groups also receiving some
treatment. The first analysis examined 250 effect sizes for the substance use outcomes of adolescents receiving different types of treatment relative
to the respective comparison groups. As a category, family therapy programs were found to be more effective than their comparison conditions, whereas
no treatment programs were less effective. However, not all treatment types were compared with each other in the available research, making it
difficult to assess the comparative effectiveness of the different treatments. To provide a more differentiated picture of the relative improvement
in substance use outcomes for different treatments, a second analysis examined 311 pre - post effect sizes measuring changes in substance use for
adolescents in the separate treatment and comparison arms of the studies. The adolescents in almost all types of treatment showed reductions in
substance use. The greatest improvements were found for family therapy and mixed and group counseling. Longer treatment duration was associated with
smaller improvements, but other treatment characteristics and participant characteristics had little relationship to the pre - post changes in
substance use. Based on these findings family therapy is the treatment with the strongest evidence of comparative effectiveness, although most types
of treatment appear to be beneficial in helping adolescents reduce their substance use. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
(journal abstract)
Journal of Substance Abuse Treatment, 44(2) : 145-
158
- Year: 2013
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Santis, R., Hidalgo, C. G., Jaramillo, A., Hayden, V., Armijo, I., Lasagna, A.
Only a small fraction of drug users worldwide enter treatment each year. We evaluated the efficacy of a systemic family outreach
intervention (SFOI) for young, untreated drug users, using a quasi-experimental design in which the experimental group (EG) received SFOI and the
control group (CG) received traditional outreach work (OW). Both pre- and post-treatment, we administered the Addiction Severity Index-6 (ASI-6), the
Family Environment Scale (FES), and tests of parental practices and risky behavior. Post-treatment, there was a fivefold improvement on the ASI-6 and
a significant worsening on the conflict sub-scale of the FES in the EG as compared with the CG. SFOI was more efficacious than OW in reducing drug
use in the drug user's home environment. The increased conflict in the EG might be explained by parents' increased awareness of abnormal behaviors
and implementation of strategies to protect their children. (copyright) 2013 Elsevier Inc.
Journal of Substance Abuse Treatment, 44(1) : 61-
70
- Year: 2013
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Spoth, Richard, Redmond, Cleve, Shin,
Chungyeol, Greenberg, Mark, Feinberg, Mark, Schainker, Lisa
Objective: To examine the
effects of a delivery system for evidence-based preventive interventions through 12th grade, 6.5 years past baseline. Method: A cohort sequential
design included 28 public school districts randomly assigned to the partnership delivery system or usual-programming conditions. At baseline, 11,960
students participated. Partnerships supported community teams that implemented a family-focused intervention in 6th grade and a school-based
intervention in 7th grade. Outcome measures included lifetime, current misuse, and frequencies of misuse, for a range of substances. Intent-to-treat,
multilevel analyses of covariance of point-in-time misuse and analyses of growth in misuse were conducted. Results: Results showed significantly
lower substance misuse in the intervention group at one or both time points for most outcomes, with relative reduction rates of up to 31.4%. There
was significantly slower growth in misuse in the intervention group for 8 of the 10 outcomes. In addition, risk moderation results indicated that
there were significantly greater intervention benefits for higher- versus lower-risk youth, for the misuse of 6 of the 10 substances at 11th grade,
illicit substances at 12th grade, and growth in the misuse of illicit substances. Conclusion: Partnership-based delivery systems for brief universal
interventions have potential for public health impact by reducing substance misuse among youth, particularly higher-risk youth. (PsycINFO Database
Record (c) 2014 APA, all rights reserved). (journal abstract)
Preventive Medicine, 56(3-4) : 190-196
- Year: 2013
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Spoth, Richard, Trudeau, Linda, Shin,
Chungyeol, Ralston, Ekaterina, Redmond, Cleve, Greenberg, Mark, Feinberg, Mark
Objectives: We examined long-term prescription drug misuse outcomes in 3 randomized controlled trials
evaluating brief universal preventive interventions conducted during middle school.; Methods: In 3 studies, we tested the Iowa Strengthening Families
Program (ISFP); evaluated a revised ISFP, the Strengthening Families Program: For Parents and Youth 10-14 plus the school-based Life Skills Training
(SFP 10-14 + LST); and examined the SFP 10-14 plus 1 of 3 school-based interventions. Self-reported outcomes were prescription opioid misuse (POM)
and lifetime prescription drug misuse overall (PDMO).; Results: In study 1, ISFP showed significant effects on POM and PDMO, relative reduction rates
(RRRs; age 25 years) of 65%, and comparable benefits for higher- and lower-risk subgroups. In study 2, SFP 10-14 + LST showed significant or
marginally significant effects on POM and PDMO across all ages (21, 22, and 25 years); higher-risk participants showed stronger effects (RRRs = 32%-
79%). In study 3, we found significant results for POM and PDMO (12th grade RRRs = 20%-21%); higher-risk and lower-risk participants showed
comparable outcomes.; Conclusions: Brief universal interventions have potential for public health impact by reducing prescription drug misuse among
adolescents and young adults.;
American Journal of Public
Health, 103(4) : 665-672
- Year: 2013
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Slesnick,
Natasha, Erdem, Gizem, Bartle-Haring, Suzanne, Brigham, Gregory S.
Objectives: To examine the efficacy of 3 theoretically distinct interventions among
substance-abusing runaway adolescents and to explore individual differences in trajectories of change.; Method: Adolescents (N = 179) between the
ages of 12 and 17 were recruited from a runaway shelter in a midwestern city. The sample included 94 females (52.5%) and 85 males (47.5%); the
majority of the adolescents were African American (n = 118, 65.9%). Adolescents were randomly assigned to the Community Reinforcement Approach (CRA,
n = 57), Motivational Interviewing (MI, n = 61), or Ecologically-Based Family Therapy (EBFT, n = 61). Substance use was assessed at baseline, 3, 6,
9, 12, 18, and 24 months via Form 90 and urine screens.; Results: Hierarchical linear modeling revealed statistically significant improvement in
frequency of substance use among runaways in all 3 treatment groups, with a slight increase at posttreatment. Latent trajectory profile analysis
explored individual differences in change trajectories and yielded a 3-class model. The majority of adolescents (n = 136, 76%) showed reductions in
substance use over time, with a slight increase at follow-up (Class 1: Decreasing). Twenty-four (13.4%) adolescents had shown high levels of
substance use over time with patterns of increase and decrease (Class 2: Fluctuating high users), and 19 (10.6%) decreased but returned to baseline
levels by 2 years postbaseline (Class 3: U shaped). Few differences among treatment conditions were noted; within the \"decreasing\" group,
adolescents in MI treatment showed a quicker decline in their substance use but a faster relapse compared with those receiving EBFT.; Conclusions:
These findings suggest that CRA, EBFT, and MI are viable treatments for runaway substance-abusing adolescents.; PsycINFO Database Record (c) 2013
APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 81(4) : 600-
614
- Year: 2013
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Motivational interviewing, includes Motivational Enhancing Therapy
Shek, D. T.
L., Yu, L.
The present study investigated the
longitudinal impact of the Project PATHS, a large-scale curriculum-based positive youth development program in Hong Kong, on the development of
adolescents' risk behavior over a period of five years. Using a longitudinal randomized controlled design, eight waves of data were collected from
19 experimental schools in which students participated in the Project PATHS (N=2,850 at Wave 8) and 24 control schools without joining the Project
PATHS (N=3,640 at Wave 8). At each wave, students responded to measures assessing their current risk behaviors, including delinquency, use of
different types of drug, and their intentions of participating in risk behaviors in the future. Results demonstrated that adolescents receiving the
program exhibited significantly slower increases in delinquent behaviors and substance use as compared to the control participants. During two years
after the completion of the program, differences in youth risk behaviors in the two groups still existed. These results suggest that the Project
PATHS has long-term effect in preventing adolescent problem behavior through promoting positive youth development. (copyright) 2012 Daniel T. L. Shek
and Lu Yu.
Scientific World
Journal, 2012 :
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Spoth, Richard L., Trudeau, Linda S., Guyll, Max, Shin,
Chungyeol
Purpose: An earlier randomized controlled study found that a
universal, family-focused preventive intervention produced protective shield effects - reduced adolescent exposures to illicit substance
opportunities - among adolescents in grade 12. This study examined a follow-up assessment of the sample during young adulthood. Methods: A randomized
controlled trial evaluated the Iowa Strengthening Families Program that was implemented in 22 rural schools (N = 446 families) when the participants
were in grade six. Measures included adolescent exposure to illicit substance use and young adult lifetime substance use (age 21; N = 331). Growth
curve modeling examined indirect intervention effects through growth factors of adolescent exposure. Results: Findings from this study confirm
protective shield effects that mediate long-term reduction of illicit substance use (ß = -.14, p = .02, Relative Reduction Rate = 28.2%).
Conclusions: The benefits of decreasing exposure to substance use during adolescence through universal interventions were supported, with positive
effects extending into young adulthood. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Adolescent Health, 50(4) : 414-
417
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Shek, D. T. L., Ma, C. M. S.
The present study
examined the longitudinal impact of Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) on adolescent developmental
outcomes in Hong Kong. Using a longitudinal randomized group design, seven waves of data were collected from 24 experimental schools (n = 4049 at
wave 1) in which students participated in the Tier 1 Program of Project P.A.T.H.S. and 24 control schools (n = 3797 at wave 1). Results based on
individual growth curve modeling generally showed that, relative to the control participants, participants in the experimental group had: (a) a
higher level of positive development; (b) a lower level of substance abuse; and (c) a lower level of delinquent behavior. Participants who regarded
the program to be beneficial also showed higher levels of positive development and lower levels of problem behavior than did the control school
students. The present findings suggest that Project P.A.T.H.S. is effective in promoting positive development and preventing adolescent problem
behavior in Chinese adolescents in Hong Kong. (copyright) 2012 by Walter de Gruyter.
International Journal of Adolescent Medicine & Health, 24(3) : 231-244
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Teesson, Maree, Newton, Nicola C., Barrett,
Emma L.
Issues: To reduce the occurrence and costs related to substance use and
associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show
minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review
the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for
alcohol and other drugs.; Approach: Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites
and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and
other drug use in schools.; Key Findings: Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and
tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in
alcohol, cannabis and tobacco use at follow up.; Conclusion: Existing school-based prevention programs have shown to be efficacious in the Australian
context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use
is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective.;
© 2012 Australasian Professional Society on Alcohol and other Drugs.
Drug & Alcohol
Review, 31(6) : 731-736
- Year: 2012
- Problem: Substance Use Disorders (any), Alcohol
Use, Cannabis Use
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Winters,
Ken C., Fahnhorst, Tamara, Botzet, Andria, Lee, Susanne, Lalone, Britani
This randomized
controlled trial evaluated the use of two brief intervention conditions for adolescents (aged 12 - 18 years) who have been identified in a school
setting as abusing alcohol and other drugs. Adolescents and their parents (N = 315) were randomly assigned to receive either a two-session
adolescent-only (BI-A), two-session adolescent and additional parent session (BI-AP), or assessment-only control condition (CON). Interventions were
manually guided and delivered in a school setting by trained counselors. Adolescents and parents were assessed at intake and at 6 months following
the completion of the intervention. Analyses of relative (change from intake to 6 months) and absolute (status at 6 months) outcome variables
indicated that for the most part, adolescents in the BI-A and BI-AP conditions showed significantly more reductions in drug use behaviors compared
with the CON group. In addition, youth receiving the BI-AP condition showed significantly better outcomes compared with the BI-A group on several
variables. Problem-solving skills and use of additional counseling services mediated outcome. The value of a school-based brief intervention for
students is discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Substance Abuse Treatment, 42(3) : 279-
288
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy
Sussman, Steve, Sun, Ping, Rohrbach,
Louise A., Spruijt-Metz, Donna
Objective: The present study tested the efficacy of motivational interviewing-based booster sessions for Project Toward No Drug Abuse (TND),
a 12-session school-based curriculum targeting youth at risk for drug abuse. In addition, generalization of effects to risky sexual behavior was
assessed. The 1-year outcomes evaluation of the project is presented. Method: A total of 24 schools were randomized to one of three conditions:
standard care control (SCC), TND classroom program only (TND-only), and TND plus motivational interviewing booster (TND + MI). A total of 1186
participants completed baseline and 1-year follow-up surveys. Following the classroom program, youth in the TND + MI condition received up to 3
sessions of MI in person or by telephone. Effects were examined on 30-day cigarette, alcohol, marijuana, and hard drug use, as well as measures of
risky sexual behavior (number of sex partners, condom use, having sex while using drugs or alcohol). Results: Collapsed across the 2 program
conditions, results showed significant reductions in alcohol use, hard drug use, and cigarette smoking relative to controls. These effects held for
an overall substance use index. The MI booster component failed to achieve significant incremental effects above and beyond the TND classroom
program. No effects were found on risky sexual behavior. Conclusions: While the program effects of previous studies were replicated, the study failed
to demonstrate that an adequately implemented MI booster was of incremental value at 1-year follow-up. (PsycINFO Database Record (c) 2012 APA, all
rights reserved) (journal abstract)
Health Psychology, 31(4) : 476-
485
- Year: 2012
- 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, Other Psychological Interventions
Burrow-Sanchez, J. J., Wrona, M.
Studies comparing empirically supported substance abuse treatments versus their culturally
accommodated counterparts with participants from a specific ethnic minority group are lacking in the literature. To address this gap, this pilot
study was conducted to compare the feasibility and relative efficacy of an empirically supported standard version of cognitive-behavioral substance
abuse treatment (S-CBT) to a culturally accommodated version (A-CBT) with a sample of Latino adolescents. This study was guided by a Cultural
Accommodation Model for Substance Abuse Treatment (CAM-SAT). Thirty-five Latino adolescents (mean age = 15.49) were randomly assigned to one of two
12-week group-based treatment conditions (S-CBT = 18; A-CBT = 17) with assessments conducted at pretreatment, posttreatment and 3-month follow-up.
Results indicated similar retention and satisfaction rates for participants in both treatment conditions. In addition, participants in both
conditions demonstrated significant decreases in substance use from pre- to posttreatment with slight increases at 3-month follow-up; however,
substance use outcomes were moderated by two cultural variables: ethnic identity and familism. Implications of these findings within the context of
conducting clinical trials with Latino adolescents are discussed. (copyright) 2012 American Psychological Association.
Cultural Diversity & Ethnic Minority Psychology, 18(4) : 373-383
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)