Disorders - Substance Use Disorders
Schaeffer, C. M., Henggeler, S. W., Ford, J. D., Mann, M., Chang, R., Chapman, J. E.
Juvenile offenders with substance use problems are at high risk for deleterious long-term outcomes. This study evaluated the capacity of a promising vocational and employment training program in the building sector (i.e., Community Restitution Apprenticeship-Focused Training, CRAFT) to mitigate such outcomes through enhanced employment and education. Participants were 97 high-risk juvenile offenders (mean age = 15.8. years) randomized to CRAFT versus education as usual (EAU) intervention conditions. Multi-method procedures measured employment, education, substance use, mental health, and criminal outcomes through a 30-month post-baseline follow-up. CRAFT was significantly more effective than EAU at increasing rates of youth employment and GED attendance. Intervention effects were not observed, however, for months employed, hours worked, or hourly wage. Measures of youth substance use, mental health symptoms, and criminal activity showed no favorable or iatrogenic effects. The potential of CRAFT was modestly supported, and suggestions were made for future research. © 2013 Elsevier Inc.
Journal of Substance Abuse Treatment, 46(2) : 134-143
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Individual placement and support (IPS), vocational interventions
Rohde, P., Waldron, H. B., Turner, C. W., Brody, J., Jorgensen, J.
Objective: We evaluated 3 methods of integrating interventions for depression (Adolescent Coping With Depression Course; CWD) and substance use disorders (Functional Family Therapy; FFT), examining (a) treatment sequence effects on substance use and depression outcomes and (b) whether the presence of major depressive disorder (MDD) moderated effects. Method: Participants were 170 adolescents (ages 13-18; 22% female; 61% non-Hispanic White) with comorbid depressive disorder (54% MDD, 18% dysthymia) and substance use disorders who were randomized to (a) FFT followed by CWD (FFT/CWD), (b) CWD followed by FFT (CWD/FFT), or (c) coordinated FFT and CWD (CT). Acute treatment (24 treatment sessions provided over 20 weeks) and 6- and 12-month follow-up effects are presented for substance use (percentage of days of substance use; Timeline Followback) and depression (Childrenâs Depression Rating Scale-Revised). Results: FFT/CWD achieved better substance use outcomes than CT at posttreatment, and 6- and 12-month follow-ups; substance use effects for CWD/FFT were intermediate. For participants with baseline MDD, the CWD/FFT sequence resulted in lower substance use than either FFT/CWD or CT. Depressive symptoms decreased significantly in all 3 treatment sequences with no evidence of differential effectiveness during or following treatment. Attendance was lower for the second of both sequenced interventions. A large proportion of the sample received treatment outside the study, which predicted better outcomes in the follow-up. Conclusions: Depression reductions occurred early in all 3 treatment sequences. Of the examined treatment sequences, FFT/CWD appeared most efficacious for substance use reductions but addressing depression early in treatment may improve substance use outcomes in the presence of MDD. (PsycINFO Database Record (c) 2014 APA, all rights reserved). © 2014 American Psychological Association.
Journal of Consulting & Clinical Psychology, 82(2) : 342-348
- Year: 2014
- Problem: Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Family therapy, Other service delivery and improvement interventions
Schuler, M. S., Griffin, B-A., Ramchand, R., Almirall, D., McCaffrey, D. F.
Objective: The purpose of this study was to compare the relative effectiveness of three treatment modalities for adolescent substance use: biological drug screening (BDS), Motivational Enhancement Therapy-Cognitive Behavioral Therapy (MET/CBT5), and BDS combined with MET/CBT5, relative to no treatment.; Method: This study comprised 5,186 adolescents (70% male) enrolled in substance use treatment and tracked through the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment's database (BDS = 1,110; MET/CBT5 = 784; BDS combined with MET/CBT5 = 2,539; no treatment = 753). Outcomes of interest were substance use frequency and severity of substance use problems at 3, 6, and 12 months, as measured by the Global Appraisal of Individual Needs survey. Propensity score weighting was used to adjust for pretreatment covariate imbalances between groups. Weighted generalized linear models were used to estimate the impact of treatment on outcomes at 3, 6, and 12 months.; Results: BDS, alone or in combination with MET/CBT5, was associated with improved substance use and substance problems outcomes. Relative to youth reporting no treatment services, the BDS group reported significantly lower substance use at all visits, with the observed difference increasing over time. BDS alone was associated with significantly fewer substance problems than bds combined with met/cbt5 at all visits and significantly lower use at 12 months.; Conclusions: Our results demonstrate significant improvement on substance use outcomes associated with BDS and offer preliminary evidence that BDS, particularly standalone BDS, may be an effective form of drug treatment for adolescents. Further work, including randomized studies, should explore the optimal format of administering BDS to adolescents to achieve maximum effectiveness.;
Journal of Studies on Alcohol & Drugs, 75(2) : 358-370
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other service delivery and improvement interventions
Skarstrand, E., Sundell, K., Andreasson, S.
Background: Adolescents' alcohol consumption is a public health concern in Sweden as well as in many other countries. Underage drinking is associated with increased risks of alcohol-related injuries, risky sexual behaviours and dependence later in life. Different strategies have been used in the effort to prevent this behaviour, and to postpone the onset of alcohol. The Strengthening Families Programme 10-14 (SFP 10-14) from the USA has been highlighted as one of the more effective prevention programmes. The aim of the present article was to evaluate the effectiveness of a culturally adapted Swedish version of the SFP 10-14. Methods: This was a cluster randomized controlled trial including 587 sixth-grade students (age 12) and their parents in 19 elementary schools in Stockholm. Schools were randomly assigned to either control (9 schools, 216 students) or to the family skills training intervention (10 schools, 371 students). The SFP Swedish version consisted of two parts with seven and five sessions, respectively, held separately for youths and parents except two joint family sessions. Measures of students' self-reported episodes of drunkenness, smoking, illicit drug use and other norm-breaking behaviours were collected at baseline (March 2003) and at three subsequent yearly surveys. Data were analysed using multilevel models with an intention-to-treat approach. Results: No preventive effects were found for smoking, alcohol and illicit drug use and other norm-breaking behaviours, nor did moderators affect the outcome. Conclusion: The Swedish version of the SFP 10-14 was not effective in preventing youths' substance use in a Swedish context. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
European Journal of Public Health, 24(4) : 578-584
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
Sandler, I., Wolchik, S. A., Cruden, G., Mahrer, N. E., Ahn, S., Brincks, A., Brown, C. H.
This review presents findings from an overview of meta-analyses of the effects of prevention and promotion programs to prevent mental health, substance use, and conduct problems. The review of 48 meta-analyses found small but significant changes that reduce depression, anxiety, antisocial behavior, and substance use. Furthermore, the results were sustained over time. Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in future meta-analyses, and methodological issues in synthesizing findings across preventive interventions are discussed.;
Annual Review of Clinical Psychology, 10 : 243-273
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
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Stage: Universal prevention
, At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
Spoth, R., Trudeau, L., Redmond, C., Shin, C.
Objective: For many substances, more frequent and problematic use occurs in young adulthood; these types of use are predicted by the timing of initiation during adolescence. We replicated and extended an earlier study examining whether delayed substance initiation during adolescence, resulting from universal preventive interventions implemented in middle school, reduces problematic use in young adulthood. Method: Participants were middle school students from 36 Iowa schools randomly assigned to the Strengthening Families Program: For Parents and Youth 10-14 (Molgaard, Spoth, & Redmond, 2000) plus Life Skills Training (LST; Botvin, 1995, 2000), LST-only, or a control condition. Self-report questionnaires were collected at 11 time points, including 4 during young adulthood. The intercept (average level) and rate of change (slope) in young adult frequency measures (drunkenness, alcoholrelated problems, cigarettes, and illicit drugs) across ages 19-22 were modeled as outcomes influenced by growth factors describing substance initiation during adolescence. Analyses entailed testing a 2-step hierarchical latent growth curve model; models included the effects of baseline risk, intervention condition assignment, and their interaction. Results: Analyses showed significant indirect intervention effects on the average levels of all young adult outcomes, through effects on adolescent substance initiation growth factors, along with Intervention × Risk interaction effects favoring the higher risk subsample. Additional direct effects on young adult use were observed in some cases. Relative reduction rates were larger for the higher risk subsample at age 22, ranging from 5.8% to 36.4% on outcomes showing significant intervention effects. Conclusions: Universal preventive interventions implemented during early adolescence have the potential to decrease the rates of substance use and associated problems into young adulthood.
Journal of Consulting & Clinical Psychology, 82(6) : 949-963
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
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
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Stage: Universal prevention
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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
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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
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
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Thomas, Roger E., Lorenzetti, Diane L., Spragins, Wendy
Background: Use of alcohol and illicit drugs by adolescents is an important problem worldwide.; Objective: To undertake a systematic review of mentoring in preventing/reducing adolescents' alcohol and drug use.; Data Sources: We searched 8 multidisciplinary electronic databases, the gray literature, and reference lists of included studies.; Study Eligibility Criteria, Participants, and Interventions: Randomized controlled trials (RCTs) of mentoring in adolescents to prevent/reduce alcohol or drug use.; Results: Six RCTs were included in this review. Four RCTs provided evidence on mentoring and alcohol use. The 2 that could be pooled showed less alcohol use by mentored youth. Six RCTs on mentoring and drug use were identified, 2 of which provided some evidence of the effect of mentoring in reducing drug use.; Limitations: Only 1 RCT was at low risk of bias for randomization. None of the studies stated they concealed allocation. Of the 6 included studies, 1 was at high risk and 5 at unclear risk for attrition.; Conclusions and Implications Of Key Findings: Four RCTs provided evidence on mentoring and alcohol use, and the 2 that could be pooled showed less use by mentored youth. The 6 RCTs that provided evidence on drug use could not be pooled. Two did provide some evidence that mentoring is associated with less drug use. Very few well-designed studies evaluate the effects of mentoring on adolescent drug and alcohol use.; Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Academic Pediatrics, 13(4) : 292-299
- Year: 2013
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
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
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)