Motivation for reducing substance use among minority adolescents: Targets for intervention

Close peer networks can affect adolescents’ health behaviors by altering their social environments, and thus their risk for and protection against substance use involvement. We tested a 20 minute intervention named Peer Network Counseling that integrates Motivational Interviewing and peer network strategies with 119 urban adolescents who reported occasional or problem substance use. Adolescents presenting at primary care clinic were randomized to intervention or control conditions and followed for 6 months. Mixed-effect latent growth models were used to evaluate intervention effects on trajectories of alcohol and marijuana use, offers to use substances, and moderation models to test for interactions between intervention condition and peer network characteristics. A significant intervention effect was found for boys for offers to use alcohol from friends (p<.05), along with a trend significant effect for alcohol use (p<.08). Intervention was more effective in reducing marijuana use, vs. control, for participants with more peer social support (p<.001) and with more peer encouragement for prosocial behavior (school, clubs, sports, religious activities); however, intervention did not affect these network characteristics. Results provide support to continue this line of research to test brief interventions that activate protective peer network characteristics among at-risk adolescents, while also raising some interesting gender-based intervention questions for future research.

Section: Introductionmentioning

confidence: 63%

Peer Network Counseling with Urban Adolescents: A Randomized Controlled Trial with Moderate Substance Users

Mason

Light

Campbell

et al. 2015

“…Demographic and baseline covariates— including gender, age, race-ethnicity, drug use severity, legal pressure, and mental health treatment—were selected based on indications that these factors have the potential to influence the treatment process (e.g., Austin, Hospital, Wagner, & Morris, 2010; Barnett et al, 2002; Catalano, Hawkins, Wells, Miller, & Brewer, 1990; Crowley, Mikulich, MacDonald, Young, & Zerbe, 1998; Fickenscher et al, 2006; Melnick, De Leon, Hawke, Jainchill, & Kressel, 1997; Rivers, Greenbaum, & Goldberg, 2001; Wise, Cuffe, & Fischer, 2001). Without controlling for these influences, it may be more difficult to associate outcomes to TRIP.…”

Section: Methodsmentioning

confidence: 99%

The Effectiveness of the Treatment Readiness and Induction Program (TRIP) for Improving During-Treatment Outcomes

Knight

Joe

Crawley

et al. 2016

Treatment engagement is a primary pathway to change. Because motivation consistently predicts engagement and sustained recovery following treatment, targeted efforts at improving problem recognition (i.e., a significant ingredient in motivation) during early weeks of treatment are critical. The purpose of this study is to compare the effectiveness of Standard Operating Practice (SOP) versus SOP plus an 8-session Treatment Readiness and Induction Program (TRIP; delivered in the first weeks of treatment) on cognitive indicators and treatment engagement among youth in 5 residential substance use treatment settings. Structural Equation Modeling (SEM) documented higher problem recognition, decision making, and treatment engagement (participation, satisfaction, counselor rapport) among youth receiving TRIP (compared to SOP only), even when controlling for background characteristics such as age, race-ethnicity, gender, baseline drug use severity, etc. Findings suggest that TRIP is an effective induction tool that directly impacts targeted constructs (i.e., problem recognition, decision making), and also directly affects indicators of engagement.

“…Because participants were not randomly assigned to these respective groups, it is important to control for potential baseline differences between the participant groups on factors that might possibly affect the study’s outcomes. Demographic and baseline covariates – including gender, age, race-ethnicity, drug use severity, previous juvenile-justice involvement, and prior treatment – were selected based on indications that these factors have the potential to influence the degree to which a client is motivated in the treatment process (Austin, Hospital, Wagner, & Morris, 2010; Barnett et al, 2002; Catalano, Hawkins, Wells, Miller, & Brewer, 1990; Crowley, Mikulich, MacDonald, Young, & Zerbe, 1998; Fickenscher et al, 2006; Melnick, De Leon, Hawke, Jainchill, & Kressel, 1997; Rivers, Greenbaum, & Goldberg, 2001; Wise, Cuffe, & Fischer, 2001). Without controlling for these influences, it may be more difficult to associate outcomes to TRIP.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change

Becan

Knight

Crawley

et al. 2015

Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (Time 1) and 35 days after admission (Time 2). The design consisted of a comparison sample (n = 281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n = 238). Repeated measures ANCOVAs were conducted using each Time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation.