Alcohol Drinking, Marijuana Smoking
Conditions
Keywords
substance abuse
Brief summary
This study will focus on treating substance abusing incarcerated teens using individually administered Motivational Interviewing (MI) followed by group Cognitive Behavior Therapy (CBT). The control group receives individualized Relaxation Training (RT) followed by group Treatment as Usual (TU). Currently, there is little research regarding effective group treatments for incarcerated teens and this study will address this gap in our knowledge base. We seek to reduce substance use and associated risky behaviors post-release (including driving under the influence, risky sexual behaviors, etc.)
Detailed description
This proposal is in response to RFA-DA-04-008, Group Treatment for Individuals in Drug Abuse or Alcoholism Treatment. Of particular interest to the agencies are group therapies for Conduct Disordered adolescents, reducing the spread of infectious disease, and mechanisms of action. This proposal targets these areas of interest. This study will focus on treating substance abusing incarcerated teens using 2 individually administered Motivational Interviewing (MI) sessions followed by 10 group sessions of Cognitive Behavior Therapy (CBT). MI is conceptualized as preparation for group CBT. The control group receives individualized Relaxation Training (RT) followed by group Treatment as Usual (TU). Currently, t here is little research regarding effective group treatments for incarcerated teens and this study will address this gap in our knowledge base. In this proposed randomized trial, a one-way design (MI/CBT vs RT/TU) will be used to determine whether MI/CBT enhances group therapy participation and reduces substance use and related problems (such as crime, injuries and unprotected sex) post discharge in substance-involved juvenile delinquents. RT/TU is based on the 12-step model and includes psycho-educational components. Participant are followed during incarceration and for 6 months post incarceration. Primary outcome variables include alcohol and marijuana use, as well as related behaviors (illegal activities, sex or injuries while drunk or high). It is hypothesized that in comparison to teens in RT/TU, youth receiving MI/CBT will participate more in therapy (according to teen, facility staff, and counselor ratings) and will show lower levels of substance use and related problems after discharge. Frequently, substance abuse treatment is unavailable to youths in the juvenile justice system, and when treatment is available, it may be provided in group format using untested therapies. A motivation/skills-based intervention (delivered in group format) may prove efficacious in enhancing motivation and in reducing substance abuse and related problems. This study extends previous research by rigorously evaluating group treatment for incarcerated teens. We will examine processes contributing to the efficacy of group MI/CBT, and the influence of race and ethnicity on treatment effects. The development of effective interventions for substance using juvenile offenders has the potential to reduce substance abuse and crime in this population.
Interventions
BEHAVIORALMI/CBT
Motivational Interviewing followed by Cognitive Behavior Therapy
BEHAVIORALRT/SU
Relaxation Training followed by Treatment as Usual
Sponsors
National Institute on Drug Abuse (NIDA)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
University of Rhode Island
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
14 Years to 19 Years
Healthy volunteers
Yes
Inclusion criteria
* Adolescents will be eligible if in the year prior to incarceration they either a) drank alcohol or used marijuana at least once per month or b) binge-drank (\> 5 for boys, \> 4 for girls) during any two week period; or they drank or used marijuana in the four weeks before the offense for which they were incarcerated; or they used alcohol or marijuana in the four weeks before they were incarcerated.
Exclusion criteria
Those teens sentenced for less than 4 months or greater than 12 months, those who are younger than 14 years or older than 19 years, and those for whom have inability to consent/assent (example, language barrier) are not obtained will be excluded from participation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Alcohol Use, Average # of Drinks Per Week | Baseline, 3 months post release and 6 months post release | using Time-Line Follow-back, we collected average # of drinks per week for a 3 month period at Baseline, 3 months and 6 months post release |
| Marijuana Use | Baseline, 3 months post release and 6 month post release | using Time-Line Follow-back, we collected average number of joints per smoking day |
| Crime: General Predatory Aggression | Baseline, 3 months post release and 6 months post release | using the Misbehaviors Questionnaire, we collect 12 items that assess the average number of times crimes involving predatory aggression were committed at Baseline, 3 months and 6 month post release. |
Countries
United States
Participant flow
Pre-assignment details
6 participants withdrew or could not be located prior to treatment assignment.
Participants by arm
| Arm | Count |
|---|---|
| MI/CBT Motivational Interviewing followed by Cognitive Behavior Therapy
MI/CBT: Motivational Interviewing followed by Cognitive Behavior Therapy | 100 |
| RT/TU Relaxation Training followed by Treatment as Usual
RT/SU: Relaxation Training followed by Treatment as Usual | 99 |
| Total | 199 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 21 | 15 |
Baseline characteristics
| Characteristic | MI/CBT | Total | RT/TU |
|---|---|---|---|
| Age, Continuous | 17.05 years STANDARD_DEVIATION 1.01 | 17.08 years STANDARD_DEVIATION 1.04 | 17.11 years STANDARD_DEVIATION 1.08 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 32 Participants | 79 Participants | 47 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 68 Participants | 120 Participants | 52 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 7 Participants | 16 Participants | 9 Participants |
| Race (NIH/OMB) Asian | 6 Participants | 8 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 42 Participants | 81 Participants | 39 Participants |
| Race (NIH/OMB) More than one race | 8 Participants | 14 Participants | 6 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 3 Participants | 7 Participants | 4 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 3 Participants | 2 Participants |
| Race (NIH/OMB) White | 33 Participants | 70 Participants | 37 Participants |
| Region of Enrollment United States | 100 participants | 199 participants | 99 participants |
| Sex: Female, Male Female | 12 Participants | 20 Participants | 8 Participants |
| Sex: Female, Male Male | 88 Participants | 179 Participants | 91 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 100 | 0 / 99 |
| other Total, other adverse events | 0 / 100 | 0 / 99 |
| serious Total, serious adverse events | 0 / 100 | 0 / 99 |
Outcome results
Primary
Alcohol Use, Average # of Drinks Per Week
using Time-Line Follow-back, we collected average # of drinks per week for a 3 month period at Baseline, 3 months and 6 months post release
Time frame: Baseline, 3 months post release and 6 months post release
Population: Individuals dropped out of the project over time, more people were analyzed at Baseline than at each Follow-up assessment.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| MI/CBT | Alcohol Use, Average # of Drinks Per Week | Average # drinks per week at 6 months post release | 7.08 average # of drinks per week | Standard Deviation 13.69 |
| MI/CBT | Alcohol Use, Average # of Drinks Per Week | Average # of drinks per week at Baseline | 11.16 average # of drinks per week | Standard Deviation 19.04 |
| MI/CBT | Alcohol Use, Average # of Drinks Per Week | Average # of drinks per week 3 months post release | 5.16 average # of drinks per week | Standard Deviation 12.27 |
| RT/TU | Alcohol Use, Average # of Drinks Per Week | Average # drinks per week at 6 months post release | 3.57 average # of drinks per week | Standard Deviation 7.57 |
| RT/TU | Alcohol Use, Average # of Drinks Per Week | Average # of drinks per week at Baseline | 10.62 average # of drinks per week | Standard Deviation 17.02 |
| RT/TU | Alcohol Use, Average # of Drinks Per Week | Average # of drinks per week 3 months post release | 3.86 average # of drinks per week | Standard Deviation 9.16 |
Primary
Crime: General Predatory Aggression
using the Misbehaviors Questionnaire, we collect 12 items that assess the average number of times crimes involving predatory aggression were committed at Baseline, 3 months and 6 month post release.
Time frame: Baseline, 3 months post release and 6 months post release
Population: Due to project drop out more people were analyzed at baseline than at both follow up assessments.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| MI/CBT | Crime: General Predatory Aggression | 6 month avg. # times of predatory aggression | 6.35 Average # of times | Standard Deviation 3.72 |
| MI/CBT | Crime: General Predatory Aggression | 3 month post avg. # times of predatory aggression | 2.13 Average # of times | Standard Deviation 2.69 |
| MI/CBT | Crime: General Predatory Aggression | 6 month post avg. # times of predatory aggression | 1.89 Average # of times | Standard Deviation 2.71 |
| RT/TU | Crime: General Predatory Aggression | 6 month avg. # times of predatory aggression | 1.92 Average # of times | Standard Deviation 2.41 |
| RT/TU | Crime: General Predatory Aggression | 3 month post avg. # times of predatory aggression | 1.92 Average # of times | Standard Deviation 2.41 |
| RT/TU | Crime: General Predatory Aggression | 6 month post avg. # times of predatory aggression | 1.44 Average # of times | Standard Deviation 2.03 |
Primary
Marijuana Use
using Time-Line Follow-back, we collected average number of joints per smoking day
Time frame: Baseline, 3 months post release and 6 month post release
Population: Individuals dropped out of the study over time, more people were analyzed at baseline than at follow up assessments
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| MI/CBT | Marijuana Use | # of joints per smoking day at baseline | 5.84 # of joints per smoking day | Standard Deviation 5.57 |
| MI/CBT | Marijuana Use | # of joints per smoking day at 3 months | 2.52 # of joints per smoking day | Standard Deviation 2.37 |
| MI/CBT | Marijuana Use | # of joints per smoking day at 6 months | 2.48 # of joints per smoking day | Standard Deviation 2.16 |
| RT/TU | Marijuana Use | # of joints per smoking day at baseline | 4.98 # of joints per smoking day | Standard Deviation 4.25 |
| RT/TU | Marijuana Use | # of joints per smoking day at 3 months | 2.48 # of joints per smoking day | Standard Deviation 2.49 |
| RT/TU | Marijuana Use | # of joints per smoking day at 6 months | 2.95 # of joints per smoking day | Standard Deviation 3.71 |