Assessing conduct disorder: a new measurement approach

A randomized clinical trial of motivational interviewing plus skills training vs. Relaxation plus education and 12-Steps for substance using incarcerated youth: Effects on alcohol, marijuana and crimes of aggression

BACKGROUND

Motivational Interviewing plus Cognitive Behavior Therapy (MI/CBT) has been used to reduce adolescent substance use, but has rarely been applied in youth correctional settings. This trial compared MI/CBT against Relaxation Training plus Substance-Education/12-Steps (RT/SET) to reduce substance use and crime among incarcerated youth.

METHODS

Participants (N = 199) were incarcerated juveniles (64.8 % non-White, 10.1 % girls, mean age of 17.1 years). Two individual sessions of MI (or RT) were followed by 10 group sessions of CBT (or SET). Youth were randomized to condition with follow-ups at 3- and 6-months after release. Major outcomes included alcohol, marijuana and crimes involving aggression.

RESULTS

A marginal treatment by time interaction was found for percent heavy drinking days, with follow-up tests indicating less alcohol use in RT/SET than MI/CBT at 6 months, and increased use within MI/CBT from 3 to 6 months. A significant treatment by time interaction was found for alcohol-related predatory aggression, with follow-up tests indicating fewer youth engaged in this behavior from 3 to 6 months within RT/SET, and weak evidence favoring MI/CBT over RT/SET at 3 months. General predatory aggression decreased from 3 to 6-months for both treatments.

CONCLUSIONS

Although weak evidence was found favoring MI/CBT with respect to alcohol-related predatory aggression, results generally support RT/SET in reducing percent heavy drinking days.

Gender, ethnicity and race in incarcerated and detained youth: services and policy implications for girls

OBJECTIVE

While work has been conducted on gender differences to inform gender-specific programming, relatively little work has been done regarding racial and ethnic differences among incarcerated and detained girls in particular. This is an important gap, considering gender, race, and ethnicity may be important factors in responding to the needs of incarcerated and detained girls within the Risk-Needs-Responsivity (RNR) model. We hypothesize girls will show relatively more pathology than boys, and that White girls will show relatively more pathology as compared to girls of other groups. Implications of findings for services delivery and policy are presented.

METHOD

Data were collected on N = 657 youth using structured interview and record review. Analyses included χ2 and t tests.

RESULTS

As compared to boys, girls were older at first arrest yet younger during most lock-up, received poorer grades, experienced more family difficulty, and more were lesbian/bisexual. As compared to minority girls, White girls began hard drugs at a younger age, had more conduct disorder symptoms, and more frequently experienced parental difficulty and abuse.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Age-appropriate programming that addresses family difficulty and sexuality is needed for girls. As compared to White girls, reentry planning may more readily rely on family support for minority girls. Systems should consider use of actuarial methods in order to reduce bias in making placement decisions. (PsycINFO Database Record

Measuring behaviors of individual adolescents during group-based substance abuse intervention

BACKGROUND

Group treatment is delivered in youth correctional facilities, yet groups may be iatrogenic. Few measures with demonstrated psychometric properties exist to track behaviors of individuals during groups. The authors assessed psychometrics for the Group Process-Individual Level measure (GP-IL) of group treatment.

METHODS

N = 152 teens were randomized to 1 of 2 groups (10 sessions each). Adolescents, counselors, and observers rated teen behaviors at sessions 3 and 10. GP-IL assesses reinforcement for deviancy and positive behaviors, member rejection, and counselor connection and praise.

RESULTS

Internal consistency and 1-month stability were demonstrated. Concurrent validity is supported by correlations with measures expected to be associated with group behavior (e.g., coping skills). Counselors and observers rated more deviancy during interactive skills-building groups versus didactic psychoeducational groups (P ≤ .005). Scales evidenced incremental validity.

CONCLUSIONS

GP-IL offers a sound method of tracking adolescent behaviors for professionals working with groups. Counselors ratings were most reliable and valid overall.