Comparing the effectiveness of three substance use interventions for youth with and without homelessness experiences prior to treatment.

Abstract

Objective: Many adolescents and young adults receiving substance use treatment have experienced or are at risk for homelessness. It is unknown whether specific treatment approaches are more or less effective for youth experiencing homelessness (YEH) compared to stably housed youth. The present study compared the effectiveness of the Adolescent Community Reinforcement Approach, Motivational Enhancement Therapy combined with Cognitive–Behavioral Therapy (MET/CBT), and Treatment as Usual (TAU) for these two groups. Further subgroup differences were investigated by age, sex, and sexual and gender minority status. Method: YEH (n = 855) and a matched sample of stably housed youth (n = 855) were drawn from the Global Appraisal of Individual Needs, a nationwide substance use treatment data set. Multiple-group latent change score modeling was used to examine change in substance use frequency and related problems at baseline, 3-, 6-, and 12-month follow-ups. Results: Results indicated significant declines in substance use frequency and problems during treatment for all intervention groups. The TAU group showed the greatest declines in substance use problems during treatment and the greatest declines in frequency post-treatment. Compared to stably housed youth, YEH entered treatment with greater substance use and problems, and had greater declines in substance use in the MET/CBT group only. Other differences were found by age and sex. Conclusions: Overall, all three substance use interventions appear to be effective in reducing substance use and related problems. TAU and MET/CBT may be particularly effective for YEH in treatment settings. Implications for future research and practice are discussed.

Adolescent: provider connectedness and STI risk reduction following a brief alcohol intervention: findings from a randomized controlled trial

“…Of critical current public health importance is that present rates of oftentimes preventable STIs are escalating quickly among young people, despite several decades of declining rates of STIs in this age group ( Feldstein Ewing and Bryan, 2020 ). Motivational interviewing (MI) has gained traction as an HIV/STI prevention intervention approach that is well-positioned to access and engage otherwise difficult-to-reach youth through settings such as pediatric/medical, juvenile justice, and school based-health centers ( Vallabhan et al, 2017 ; D’Amico et al, 2018 ; Feldstein Ewing et al, 2022 ; Thompson et al, 2020 ; DiGuiseppi et al, 2021 ; Gaume et al, 2021 ; Miller et al, 2021 ; Sanchez-Puertas et al, 2022 ). Across settings, brief (often 1–2 session) HIV/STI prevention intervention programs such as MI have gained support for their capacity to reach and engage youth, often by meeting them where they are both physically and socioemotionally.…”