Motivational Interviewing with and without Normative Feedback for Adolescents with Substance Use Problems: A Preliminary Study

Abstract

Background Many adolescents in need of substance use disorder treatments never engage in treatment. Further, the most promising interventions that could be adapted to target treatment engagement often use normative feedback (NF) despite concerns about its appropriateness for adolescents. This preliminary study will inform a larger trial designed to isolate whether NF is an inert, helpful, or harmful active ingredient within pre-treatment Motivational Interviewing (MI) interventions designed to increase treatment engagement. Methods Adolescents (n=48) presenting for treatment intake assessments were randomized to receive MI (n=22) or MI +NF (n=26) immediately following their assessments. Three-month outcomes included the percentage of youth engaged in treatment, the percentage of youth reporting past month binge drinking, and the percentage of days of abstinence. Results Treatments were delivered with high fidelity, and a high proportion of eligible participants were recruited and retained in this study. Participants significantly increased their percentage of days of abstinence by approximately 10% at follow up (d=.32, p =.03), with no significant differences between groups. Fifty-five percent of youth in MI and 41.7% of youth in MI+NF engaged in treatment (OR=.60, ns, 95% CI [.136 – 2.68]). Conclusions Larger trials should test whether NF is an active ingredient in adolescent MI interventions, and also determine the mechanisms through which MI+NF may produce effects.

Brief Motivational Interviewing and Normative Feedback for Adolescents: Change Language and Alcohol Use Outcomes

“…Extant studies document the efficacy of NF interventions for reducing college drinking (Baer et al, 1992; Borsari & Carey, 2000; Collins, Carey, & Sliwinski, 2002; Dimeff & McNeely, 2001; Larimer et al, 2001; Marlatt et al, 1998; Murphy et al, 2004; Neal & Carey, 2004; Neighbors, Lee, Lewis, Fossos, & Larimer, 2007; Walters & Bennett, 2000; Walters & Neighbors, 2005; Walters & Woodall, 2003; Walters, Vader, & Harris, 2007). Only one study, however, has investigated whether a normative feedback component is an active ingredient in brief MI treatment with adolescents and (Smith, Ureche, Davis, & Walters, 2015) randomly assigned youth ( n = 48) to receive MI or MI plus NF. Adolescents receiving NF had lower post-session readiness to change (Smith et al, 2015), lower self-reported treatment engagement ( d = − .31, ns ; Smith et al, 2015), and fewer days of abstinence (−7.9%, ns ) at 3-months, however these effects showed no differences between groups.…”

Cannabis Withdrawal, Posttreatment Abstinence, and Days to First Cannabis Use Among Emerging Adults in Substance Use Treatment

“…Additional research is needed to determine how to best extend the number of days that emerging adults with cannabis withdrawal go until their next use following a treatment intake assessment. There are many possible ways to achieve this, including the following: delivering brief motivational interventions immediately following an intake assessment to build motivation, dealing with immediate substance use risks (Carroll et al, 2006; Smith, Davis, Ureche, & Tabb, 2015; Smith, Ureche, Davis, & Walters, 2015), streamlining admissions processes so individuals have same day sessions during which they could make plans for addressing imminent substance use triggers (Garner, Godley, & Funk, 2002), providing immediate access to electronic interventions that focus on developing initial plans to maintain abstinence for a short time until one’s next appointment (Schaub et al, 2013; Walters et al, 2014), encouraging sedentary cannabis users to increase their physical activity during initial cessation attempts (Irons, Babson, Bergeria, & Bonn-Miller, 2014), or delivering pharmacological treatments for those at risk of cannabis withdrawal (Budney, Vandrey, Hughes, Moore, & Bahrenburg, 2007; B. J. Mason et al, 2012).…”