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Gimenez PV, Salomón T, Peltzer RI, Cremonte M, Conde K. The Role of Personalized Normative Feedback in the Efficacy of Brief Intervention Among Argentinian University Students: A Randomized Controlled Trial. Subst Use Misuse 2024:1-8. [PMID: 38919022 DOI: 10.1080/10826084.2024.2369165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Background: Personalized Normative Feedback (PNF) aims to modify misperceptions about peer consumption that influence one's drinking. PNF is usually a component in Brief Interventions delivered to university students. Despite this, whether PNF contributes to improving the effect of brief interventions is unclear. Objectives: This randomized controlled trial aimed to determine the role of PNF as an active ingredient in a face-to-face motivational brief intervention. Results: Participants were students from an Argentinian university (n=806; M=20.14; SD=3.17; 63.2% women) who presented at least one binge drinking episode in the last 12 months. Students were randomly assigned to 1) a Brief Intervention, 2) a Brief Intervention with PNF, or 3) an evaluation-only control group. The follow-up was three months later. After controlling sex and age, General Linear Models showed that both the brief intervention and the brief intervention with PNF reduced the quantity and frequency of alcohol consumption, binge drinking, and alcohol problems compared to the control condition. No differences were found between the brief intervention and the brief intervention with PNF. Also, treating eight students with brief intervention and 10 with brief intervention with PNF was necessary to benefit one student. Conclusions: In conclusion, this study demonstrates that brief intervention reduces alcohol consumption among Latin American university students and that PNF might not be an active ingredient of its effectiveness in this population. However, PNF could benefit students with specific characteristics, like those who overestimate their peers' drinking, highlighting the need to study moderators of effectiveness further.
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Affiliation(s)
- Paula Victoria Gimenez
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Tomás Salomón
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Raquel Inés Peltzer
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Mariana Cremonte
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
| | - Karina Conde
- Institute of Basic, Applied Psychology and Technology (IPSIBAT), National Scientific and Technical Research Council (CONICET), National University of Mar del Plata (UNMdP), Mar del Plata, Argentina
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D’Amico EJ, Houck JM, Pedersen ER, Klein DJ, Rodriguez A, Tucker JS. Understanding effects of the group process on drinking outcomes for emerging adults experiencing homelessness. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:556-566. [PMID: 38411540 PMCID: PMC10939735 DOI: 10.1111/acer.15272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND There is little research on group process for motivational interviewing-based group interventions with young people. We examine how change talk, group climate and cohesion, and facilitator empathy among emerging adults experiencing homelessness affect their drinking outcomes. METHODS Data come from a clinical trial at three drop-in centers serving emerging adults experiencing homelessness in Los Angeles County and focus on those who received the intervention (n = 132). Participants completed baseline, 3-, 6-, and 12-month follow-up surveys. They were predominantly male and non-white. Group sessions were digitally recorded and coded for percentage change talk (PCT), group climate and cohesion, and facilitator empathy. RESULTS Because baseline alcohol use was significantly higher at site 1 than sites 2 and 3, we examined associations separately by site. At 6 months, higher PCT was associated with fewer drinks per drinking day for sites 2 and 3, whereas higher PCT was associated with more drinks per drinking day for site 1. There were no effects of PCT at 12 months. Higher group cohesion scores were associated with fewer drinking days at 6 months; higher facilitator empathy was associated with fewer maximum drinks in a day at both 6 and 12 months. Group climate was not associated with drinking outcomes. CONCLUSIONS These findings highlight the importance of measuring multiple factors in the group process to understand outcomes. What is "uttered" during group and what is observed provide different methods to evaluate the group process and allow us to better bridge the gap between research and practice.
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Affiliation(s)
| | - Jon M. Houck
- Mind Research Network, 2425 Ridgecrest Dr. SE, Albuquerque NM 87108
| | - Eric R. Pedersen
- University of Southern California, Department of Psychiatry and Behavioral Sciences, Keck School
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Tucker JS, D'Amico EJ, Rodriguez A, Garvey R, Pedersen ER, Klein DJ. A randomized controlled trial of a brief motivational interviewing-based group intervention for emerging adults experiencing homelessness: 12-Month effects on substance use and sexual risk behavior. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209114. [PMID: 37355155 PMCID: PMC10530378 DOI: 10.1016/j.josat.2023.209114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
INTRODUCTION Few brief evidence-based risk reduction programs for emerging adults experiencing homelessness focus on the interrelated problems of substance use and sexual risk behavior. This study examines outcomes from a 12-month evaluation of AWARE, a brief Motivational Interviewing (MI)-based group risk reduction intervention for this population. METHODS In a cluster randomized crossover trial, N = 276 18-25-year-olds received AWARE or usual care at drop-in centers serving homeless youth in Los Angeles County. We evaluated intervention effects on substance use and condomless sex (primary outcomes), as well as drinking consequences and protective strategies, number of casual partners, self-efficacy, and motivation for change (secondary outcomes). RESULTS AWARE participants self-reported reductions in their alcohol use and negative consequences from drinking, and an increase in use of drinking protective strategies. AWARE participants also reported an initial decrease in drug use other than marijuana, followed by a slight uptake later on, as well as an initial increase in importance of cutting down on other drug use followed by a decrease. Control group participants did not show change in these outcomes. Among those who reported casual sex partners at both baseline and 12-month surveys, exploratory analyses indicated that AWARE participants had a 29 % decline in condomless sex with casual partners compared to a 6 % decline for control group participants. CONCLUSIONS Findings build on our pilot work by demonstrating that AWARE has long-term benefits on drinking among emerging adults experiencing homelessness. Further work should seek to strengthen its long-term effectiveness in reducing drug use in this population.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA.
| | | | | | - Rick Garvey
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
| | - Eric R Pedersen
- University of Southern California, Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, 250 Alcazar Street, Suite 2200, Los Angeles, CA 90033, USA
| | - David J Klein
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
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Ana EJS, LaRowe SD, Gebregziabher M, Morgan-Lopez AA, Lamb K, Beavis KA, Bishu K, Martino S. Randomized controlled trial of group motivational interviewing for veterans with substance use disorders. Drug Alcohol Depend 2021; 223:108716. [PMID: 33873028 PMCID: PMC9011162 DOI: 10.1016/j.drugalcdep.2021.108716] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Motivational interviewing delivered in a group format is understudied yet promising as a treatment for substance use disorders (SUD). We evaluated the efficacy of group motivational interviewing (GMI) relative to a treatment-control (TCC) for enhancing treatment and self-help engagement and decreasing alcohol and drug use among veterans with SUD and co-existing psychiatric disorders. METHOD Veterans (n = 118) with alcohol use disorder were recruited within an outpatient SUD treatment program and randomized to GMI or TCC upon program entry. Alcohol use, SUD treatment, and 12-step session attendance were primary outcomes. Drug use days was the secondary outcome. Participants were assessed at baseline and at one-and three-month follow-up. RESULTS Significant differences were observed between GMI and TCC for binge drinking at both one (RR = .74; 95 % CI [.58, .94]) and three-month follow-up (RR = .74; 95 % CI [.59, .91]). At three-month follow-up, significant differences between treatment conditions were observed for alcohol use days (RR = .79; 95 % CI [.67, .94]), number of SUD treatment sessions (RR = 2.53; 95 % CI [1.99, 3.22]), and 12-step sessions attended (RR = 1.64; 95 % CI [1.35-1.98]). Similarly, we observed significant effects for GMI on reducing alcohol consumption in standard drinks (RR = .49; 95 % CI [.25, .95]). Drug use days declined at each follow-up, with no significant differences between treatment conditions. CONCLUSIONS GMI delivered at SUD treatment program entry enhanced treatment session and 12-step group attendance and lowered alcohol consumption among outpatient Veterans. Future research should study how GMI works and its effectiveness in SUD treatment settings.
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Affiliation(s)
- Elizabeth J. Santa Ana
- Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, 109 Bee St., Charleston, SC, 29401 USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., Charleston, SC, 29425 USA
| | - Steven D. LaRowe
- Mental Health Service Line, James H. Quillen VAMC, 53 Memorial Ave, Johnson City, TN, 37684 USA
| | - Mulugeta Gebregziabher
- Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, 109 Bee St., Charleston, SC, 29401 USA,Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St., Charleston, SC, 29425 USA
| | - Antonio A. Morgan-Lopez
- Behavioral Health Research Division, RTI International, Research Triangle Park, 3040 E Cornwallis Rd, Morrisville, NC, 27709 USA
| | - Kayla Lamb
- Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, 109 Bee St., Charleston, SC, 29401 USA
| | - Katherine A. Beavis
- Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, 109 Bee St., Charleston, SC, 29401 USA
| | - Kinfe Bishu
- Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, 109 Bee St., Charleston, SC, 29401 USA,Department of Medicine, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC, 29425
| | - Steve Martino
- Yale University School of Medicine, Department of Psychiatry, 40 Temple St., New Haven, CT, 06510 USA,VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516 USA
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Child Sex Trafficking: Strategies for Identification, Counseling, and Advocacy. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2021; 43:113-125. [PMID: 33432250 PMCID: PMC7787704 DOI: 10.1007/s10447-020-09420-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/13/2022]
Abstract
The human rights violation of sex trafficking continues to occur in the United States at alarming rates. Although sex trafficking affects individuals across various demographic groups, this crime disproportionately affects children. Counselors who work with children and adolescents are uniquely positioned to identify, support, and advocate on behalf of sex trafficked youth who may experience barriers to emotional and physical wellness. Extant literature on counseling sex trafficking survivors remain scarce and illuminate the need for victim identification, trauma-informed interventions, and advocacy strategies that support the unique needs of child sex trafficking survivors. To address these disparities, this article describes victim identification techniques, outlines trauma-focused interventions for counseling sex trafficked youth, and presents advocacy strategies. The implications for counseling child sex trafficking survivors are illuminated through a case study.
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Tucker JS, D'Amico EJ, Pedersen ER, Rodriguez A, Garvey R. Study protocol for a group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among young adults experiencing homelessness. Addict Sci Clin Pract 2020; 15:26. [PMID: 32723349 PMCID: PMC7390162 DOI: 10.1186/s13722-020-00201-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/17/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Young people experiencing homelessness have alarmingly high rates of alcohol and other drug (AOD) use, which is associated with sexual risk behaviors such as unprotected sex, trading sex, and sex with multiple casual partners. Few risk reduction programs for this population have been developed and rigorously evaluated, particularly those that address both of these interrelated behaviors, use a collaborative and non-judgmental approach, and are feasible to deliver in settings where homeless young people seek services. This paper describes the protocol of a study evaluating a four-session Motivational Interviewing (MI)-based group risk reduction intervention for this population. The protocol has been shown to be efficacious in pilot work over 3 months with 200 homeless young adults [1]. The current study seeks to refine the intervention protocol and evaluate the program on a larger scale. METHODS/DESIGN In a cluster-cross-over randomized controlled trial, 18-25 year olds will receive the AWARE risk reduction program (n = 200) or standard care (n = 200) at one of three drop-in centers serving homeless youth in the Los Angeles area. We will evaluate intervention effects on primary outcomes of AOD use and sexual risk behavior, as well as secondary outcomes of health-related quality of life and social stability, over a 12-month period. DISCUSSION This project has the potential to fill a significant gap in prevention services by demonstrating that a brief intervention, feasible to deliver within settings where young people experiencing homelessness typically seeks services, can significantly reduce the interrelated problems of AOD use and sexual risk behavior. Trial registration ClinicalTrials.gov Identifier: NCT03735784. Registered November 18, 2018, https://clinicaltrials.gov/ct2/show/record/NCT03735784 (retrospectively registered).
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States.
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States
| | - Eric R Pedersen
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States.,Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, 250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA, 02116, United States
| | - Rick Garvey
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States
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D’Amico EJ, Parast L, Osilla KC, Seelam R, Meredith LS, Shadel WG, Stein BD. Understanding Which Teenagers Benefit Most From a Brief Primary Care Substance Use Intervention. Pediatrics 2019; 144:peds.2018-3014. [PMID: 31296568 PMCID: PMC6746575 DOI: 10.1542/peds.2018-3014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The primary care (PC) setting provides an opportunity to address adolescent alcohol and marijuana use. We examined moderators of effectiveness for a PC brief motivational intervention on adolescents' alcohol and marijuana use and consequences 1 year later. METHODS We conducted a randomized controlled trial in 4 PC clinics from April 2013 to November 2015 and followed adolescents using Web-based surveys. We examined whether demographic factors and severity of use moderated 12-month outcomes. Adolescents aged 12 through 18 were screened by using the National Institute on Alcohol Abuse and Alcoholism Screening Guide. Those identified as at risk were randomly assigned to the intervention (CHAT) or to usual care (UC). RESULTS The sample (n = 294) was 58% female, 66% Hispanic, 17% African American, 12% white, and 5% multiethnic or of other race with an average age of 16 years. After controlling for baseline values of outcomes, teens in CHAT who reported more negative consequences from drinking or had an alcohol use disorder at baseline reported less alcohol use, heavy drinking, and consequences 1 year later compared with teens in UC. Similarly, teens in CHAT with more negative consequences from marijuana use at baseline reported less marijuana use 1 year later compared with teens in UC; however, teens in CHAT who reported fewer marijuana consequences at baseline reported greater marijuana use 1 year later compared with teens in UC. CONCLUSIONS A brief intervention can be efficacious over the long-term for adolescents who report problems from alcohol and marijuana use. Findings emphasize the importance of both screening and intervention in at-risk adolescents in PC.
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Snycerski S, Laraway S, Gregg J, Capriotti M, Callaghan GM. Implications of Behavioral Narratology for Psychotherapy, Help-Seeking Behavior, and Substance Use. Perspect Behav Sci 2018; 41:517-540. [PMID: 31976409 PMCID: PMC6701505 DOI: 10.1007/s40614-018-00182-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Susan Snycerski
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Sean Laraway
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Jennifer Gregg
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
| | - Matthew Capriotti
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
- Department of Medicine, Division of Nephrology, University of California, San Francisco, CA USA
| | - Glenn M. Callaghan
- Department of Psychology, San José State University, San José, CA 95192-0120 USA
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Wendt DC, Gone JP. Complexities with group therapy facilitation in substance use disorder specialty treatment settings. J Subst Abuse Treat 2018; 88:9-17. [PMID: 29606227 DOI: 10.1016/j.jsat.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/08/2018] [Accepted: 02/10/2018] [Indexed: 11/17/2022]
Abstract
In spite of increased attention to research-based interventions for substance use disorders (SUDs), a formidable research-practice gap impedes the implementation of evidence-based treatments (EBTs). An underappreciated dimension of this gap is a mismatch in treatment modality: Whereas clinical trial and implementation research has focused primarily on individual therapy, the majority of SUD specialty treatment is in group format, with open-enrolling groups being most common. This study aims to narrow this research-practice gap by exploring clinicians' perspectives on complexities with group therapy facilitation in SUD specialty treatment settings. Semi-structured interviews were conducted with 13 group clinicians from among three outpatient SUD specialty clinics-diverse in their operational structures, treatment philosophies, clientele, and services-located in the same Midwestern U.S. metropolitan area. Interview questions addressed organizational characteristics, services provided, group therapy curricula, and use of EBTs or other structured treatments. Clinicians emphasized the importance of having flexibility in facilitating groups, through built-in group processes and clinicians' own adaptions and accommodations; this flexibility was especially emphasized for the use of EBTs or manualized interventions. Clinicians also had difficulties with group facilitation generally, as evidenced by their reported difficulty in managing complex group dynamics, their limited group therapy experience and training, and their reliance on educational groups. We discuss specific strategies for improved innovation and implementation of EBTs for SUD group therapy.
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Affiliation(s)
- Dennis C Wendt
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA.
| | - Joseph P Gone
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA.
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Osilla KC, Watkins KE, D'Amico EJ, McCullough CM, Ober AJ. Effects of motivational interviewing fidelity on substance use treatment engagement in primary care. J Subst Abuse Treat 2018; 87:64-69. [PMID: 29471928 DOI: 10.1016/j.jsat.2018.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Primary care (PC) may be an opportune setting to engage patients with opioid and alcohol use disorders (OAUDs) in treatment. We examined whether motivational interviewing (MI) fidelity was associated with engagement in primary care-based OAUD treatment in an integrated behavioral health setting. METHODS We coded 42 first session therapy recordings and examined whether therapist MI global ratings and behavior counts were associated with patient engagement, defined as the patient receiving one shot of extended-release injectable naltrexone or any combination of at least two additional behavioral therapy, sublingual buprenorphine/naloxone prescriptions, or OAUD-related medical visits within 30days of their initial behavioral therapy visit. RESULTS Autonomy/support global ratings were higher in the non-engaged group (OR=0.28, 95%CI: 0.09-0.93; p=0.037). No other MI fidelity ratings were significantly associated with engagement. CONCLUSION We did not find positive associations between MI fidelity and engagement in primary care-based OAUD treatment. More research with larger samples is needed to examine how providing autonomy/support to patients who are not ready to change may affect engagement. PRACTICE IMPLICATIONS Training providers to strategically use MI to reinforce change as opposed to the status quo is needed. This may be especially important in primary care where patients may not be specifically seeking help for their OAUDs.
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Affiliation(s)
- Karen Chan Osilla
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | | | | | | | - Allison J Ober
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA
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D’Amico EJ, Tucker JS, Pedersen ER, Shih RA. Understanding Rates of Marijuana Use and Consequences Among Adolescents in a Changing Legal Landscape. CURRENT ADDICTION REPORTS 2017; 4:343-349. [PMID: 29201592 PMCID: PMC5686234 DOI: 10.1007/s40429-017-0170-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW There is not one answer to address whether marijuana use has increased, decreased, or stayed the same given changes in state legalization of medical and non-medical marijuana in the USA. RECENT FINDINGS Evidence suggests some health benefits for medical marijuana; however, initiation of marijuana use is a risk factor for developing problem cannabis use. Though use rates have remained stable over recent years, about one in three 10th graders report marijuana use, most adolescents do not view the drug as harmful, and over 650,000 youth aged 12 to 17 struggle with cannabis use disorder. SUMMARY Although the health benefits of medical marijuana are becoming better understood, more research is needed. Intervention and prevention programs must better address effects of marijuana, acknowledging that while there may be some benefits medically, marijuana use can affect functioning during adolescence when the brain is still developing.
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Affiliation(s)
| | - Joan S. Tucker
- RAND Corporation, 1776 Main St., Santa Monica, CA 90407-2138 USA
| | - Eric R. Pedersen
- RAND Corporation, 1776 Main St., Santa Monica, CA 90407-2138 USA
| | - Regina A. Shih
- RAND Corporation, 1200 South Hayes St., Arlington, VA 22202-5050 USA
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12
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D'Amico EJ, Houck JM, Tucker JS, Ewing BA, Pedersen ER. Group motivational interviewing for homeless young adults: Associations of change talk with substance use and sexual risk behavior. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017. [PMID: 28627914 DOI: 10.1037/adb0000288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Homeless young adults exhibit high rates of alcohol and other drug (AOD) use and sexual risk behaviors. This study is a secondary analysis of data collected in a randomized clinical trial of AWARE, a new 4 session group motivational interviewing intervention. AWARE mainly focused on alcohol use and sexual risk behavior given focus group feedback. We used sequential coding to analyze how the group process affected both AOD use and sexual risk behavior at 3-month follow up among homeless young adults by examining facilitator behavior and participant change talk (CT) and sustain talk (ST). We analyzed 57 group session digital recordings of 100 youth (69% male, 74% heterosexual, 28% non-Hispanic white, 23% African American, 26% Hispanic, 23% multiracial/other; mean age 21.75). Outcomes included importance and readiness to change AOD use and risky sexual behavior, AOD use and consequences, number of partners and unprotected sex, and condom self-efficacy. Sequential analysis indicated that facilitator open-ended questions and reflections of CT increased Group CT. Group CT was associated with a lower likelihood of being a heavy drinker 3 months later; Group ST was associated with decreased readiness and confidence to change alcohol use. There were no associations with CT or ST for drug use or risky sexual behavior. Facilitator speech and peer responses were related to CT and ST during the group sessions with this high risk population, which were then associated with individual changes for alcohol use. Further research is needed to explore associations with drug use and sexual risk behavior. (PsycINFO Database Record
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Affiliation(s)
| | - Jon M Houck
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico
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Carpenter KM, Amrhein PC, Bold KW, Mishlen K, Levin FR, Raby WN, Evans SM, Foltin RW, Nunes EV. Derived relations moderate the association between changes in the strength of commitment language and cocaine treatment response. Exp Clin Psychopharmacol 2016; 24:77-89. [PMID: 26914460 PMCID: PMC7289513 DOI: 10.1037/pha0000063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The psycholinguistic analysis of client-counselor interactions indicates that how individuals talk about their substance use is associated with treatment outcome. However, the processes by which client speech influences out-of-session behaviors have not been clearly delineated. This study investigated the relationships between deriving relations-a key behavioral process by which language and cognition may come to influence behavior, shifts in the strength of client talk in favor of change, and treatment outcome among 75 cocaine-dependent participants (23% Female). Participants were trained to relate cocaine words, nonsense syllables, and negative-consequence words and were then assessed for a derived relation of equivalence before starting treatment. The DARN-C coding system was used to quantify the strength of participant speech during an early cognitive behavior therapy counseling session. Cocaine use during treatment was the outcome of interest. The analyses (a) characterized the process of deriving relations among individuals seeking help for their misuse of cocaine, (b) tested the relationships between shifts in the strength of participants' speech in favor of change and treatment outcome, and (c) tested if deriving equivalence relations moderated the relationship between shifts in the strength of in-session speech and treatment response. Results indicated that a minority of participants derived equivalence relations, however increases in the strength of commitment language predicted less cocaine use during treatment only among those who did. The findings suggest deriving relations may be an important process by which changes in the strength of commitment language comes to influence substance use.
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Davis JP, Houck JM, Rowell LN, Benson JG, Smith DC. Brief Motivational Interviewing and Normative Feedback for Adolescents: Change Language and Alcohol Use Outcomes. J Subst Abuse Treat 2015; 65:66-73. [PMID: 26710670 DOI: 10.1016/j.jsat.2015.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/30/2015] [Accepted: 10/22/2015] [Indexed: 10/22/2022]
Abstract
Few studies have investigated the impact of adolescent change language on substance use treatment outcomes and even fewer have examined how adolescents respond to normative feedback. The purpose of this study was to understand the influence normative feedback has on adolescent change language and subsequent alcohol and cannabis use 3months later. We examined how percent change talk (PCT) was associated with subsequent alcohol and drug use outcomes. Adolescents (N=48) were randomly assigned to receive brief motivational interviewing (MI) or MI plus normative feedback (NF). Audio recordings were coded with high interrater reliability. Adolescents with high PCT who received MI+NF had significantly fewer days of alcohol and binge drinking at follow up. There were no differences between groups on cannabis use or treatment engagement. Findings indicate that NF may be useful for adolescents with higher amount of change talk during sessions and may be detrimental for individuals with higher sustain talk.
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Affiliation(s)
- Jordan P Davis
- University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Jon M Houck
- University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, NM, USA
| | - Lauren N Rowell
- University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, NM, USA
| | - Jennifer G Benson
- University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, Albuquerque, NM, USA
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15
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Ewing BA, Tucker JS, Miles JN, Shih RA, Kulesza M, Pedersen ER, D’Amico EJ. Early Substance Use and Subsequent DUI in Adolescents. Pediatrics 2015; 136:868-75. [PMID: 26438702 PMCID: PMC4943221 DOI: 10.1542/peds.2015-1143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Little is known about risk factors in early adolescence that lead to driving under the influence (DUI) and riding with a drinking driver (RWDD). In a diverse group of adolescents, we longitudinally explored the influence of alcohol and marijuana (AM) use, AM beliefs, and peer and family factors (including familism) on DUI/RWDD in high school. METHODS We conducted 3 surveys 2 years apart of 1189 students recruited from 16 middle schools in Southern California. We used multivariable models to evaluate the effects of AM use, AM beliefs, and peer and family factors at ages 12 and 14 on DUI/RWDD at age 16. RESULTS At age 12, adolescents with more positive beliefs about marijuana (odds ratio [OR] = 1.63, 95% confidence interval [CI]: 1.20-2.20) and more ability to resist marijuana offers (OR = 1.89, 95% CI: 1.22-2.92) had significantly higher risk of DUI/RWDD 4 years later. At age 14, youth with more past month alcohol use (OR = 2.10, 95% CI: 1.07-4.11), positive beliefs about marijuana (OR = 1.67, 95% CI: 1.31-2.13), exposure to peer AM use (alcohol: OR = 1.01, 95% CI: 1.00-1.02; marijuana: OR = 2.41, 95% CI: 1.28-4.53), and family marijuana use (OR = 1.54, 95% CI: 1.12-2.11) had higher risk of DUI/RWDD at age 16. CONCLUSIONS Findings indicate a need to target adolescents as young as sixth grade at multiple levels to help prevent DUI/RWDD in high school. Given recent changes in legislation in several states, research should begin to focus on the distinction between DUI/RWDD of AM.
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Affiliation(s)
- Brett A. Ewing
- RAND Corporation, Santa Monica, California; and,Address correspondence to Brett A. Ewing, MS, RAND Corporation, 1776 Main St, Santa Monica, CA 90407-2138. E-mail:
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16
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Clair-Michaud M, Martin RA, Stein LAR, Bassett S, Lebeau R, Golembeske C. The Impact of Motivational Interviewing on Delinquent Behaviors in Incarcerated Adolescents. J Subst Abuse Treat 2015; 65:13-9. [PMID: 26517954 DOI: 10.1016/j.jsat.2015.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 11/25/2022]
Abstract
The impact of Motivational Interviewing (MI) on risky behaviors of incarcerated adolescents and adults has been investigated with promising results. Findings suggest that MI reduces substance use, improves motivation and confidence to reduce use, and decreases risky behaviors. The current study investigated the impact of MI on general, alcohol-related, and marijuana-related delinquent behaviors in incarcerated adolescents. Participants in the study were incarcerated adolescents in a state correctional facility in the Northeast region and were assessed as part of a larger randomized clinical trial. Adolescents were randomly assigned to receive MI or relaxation therapy (RT) (N=189) treatment. Delinquent behaviors and depressive symptomatology were measured using the Delinquent Activities Scale (DAS; Reavy, Stein, Paiva, Quina, & Rossi, 2012) and the Center for Epidemiological Studies-Depression scale (CES-D; Radloff, 1991) respectively. Findings indicate that depression moderated treatment effects. Compared to RT, MI was better at reducing predatory aggression and alcohol-related predatory aggression 3 months post-release when depressive symptoms were low. Identifying an efficacious treatment for these adolescents may benefit society in that it may decrease crimes against persons (i.e., predatory aggression) post release.
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Affiliation(s)
- Mary Clair-Michaud
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Rd., Kingston, RI 02881; The Rhode Island Training School, 300 New London Avenue, Cranston, RI 02920.
| | - Rosemarie A Martin
- Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Providence, RI 02912
| | - Linda A R Stein
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Rd., Kingston, RI 02881; The Rhode Island Training School, 300 New London Avenue, Cranston, RI 02920; Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Providence, RI 02912
| | - Shayna Bassett
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Rd., Kingston, RI 02881
| | - Rebecca Lebeau
- Cancer Prevention Research Center, University of Rhode Island, 130 Flagg Rd., Kingston, RI 02881
| | - Charles Golembeske
- The Rhode Island Training School, 300 New London Avenue, Cranston, RI 02920
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