Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Pilot randomized trial of a technology-assisted parenting intervention

Becker, Sara J.; Helseth, Sarah A.; Janssen, Tanja; Kelly, Lourah M.; Escobar, Katherine I.; Souza, Timothy; Wright, Thomas G.; Spirito, Anthony

doi:10.1016/j.jsat.2021.108457

Cited by 19 publications

(22 citation statements)

References 52 publications

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“…Based on the participants enrolled in the pilot trial [ 27 ], parents are expected to be predominantly biological mothers (about 80%), with the remainder comprised of biological fathers, adopted parents, and other legal guardians. For adolescent characteristics, we expect approximately 10% of adolescents to identify their gender as nonbinary, with the remainder identifying as male (45%) or female (45%).…”

Section: Methodsmentioning

confidence: 99%

“…Parents randomized to Parent SMART will receive a technology-assisted intervention containing three core elements, which were packaged in response to formative feedback described extensively [ 26 ] and tested in the pilot trial [ 27 , 28 ]. All three elements are available in both English and Spanish.…”

Section: Methodsmentioning

confidence: 99%

“…We previously tested the Parent SMART intervention via a pilot randomized controlled trial with 61 parent-adolescent dyads across two residential programs (one acute care and one standard residential care) [ 27 ]. Results of the pilot trial met or exceeded all of the recruitment, retention, acceptability, feasibility, and fidelity benchmarks established a priori as evidence that the intervention was worthy of further study in a larger trial.…”

Section: Introductionmentioning

confidence: 99%

“…Results of the pilot trial met or exceeded all of the recruitment, retention, acceptability, feasibility, and fidelity benchmarks established a priori as evidence that the intervention was worthy of further study in a larger trial. Parent SMART demonstrated excellent acceptability and feasibility, with parents who received Parent SMART reporting significantly higher levels of satisfaction and greater likelihood of recommending the services they had received than those who received residential treatment alone [ 27 ]. In addition, Parent SMART was associated with significant improvements in parental monitoring and communication, measured via both self-report scales and a behavioral intervention task, across both residential settings [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Parent SMART was associated with significant improvements in parental monitoring and communication, measured via both self-report scales and a behavioral intervention task, across both residential settings [ 28 ]. Among adolescents in the acute care setting, Parent SMART was also associated with significant reductions in days of binge drinking and school-related problems; we were underpowered to detect differences in the standard residential care setting, but a number of significant time effects were observed, revealing encouraging reductions in days of substance use, substance-related problems, and high-risk behaviors among adolescents in both conditions [ 27 ]. Building upon this prior work, the current protocol describes a fully-powered, randomized controlled trial testing the effectiveness of Parent SMART as an adjunct to residential TAU on parenting skills, adolescent substance use, and problems commonly related to substance use such as school truancy, externalizing behavior, sexual risk behavior, and criminal involvement [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Becker¹,

Helseth²,

Kelly³

et al. 2022

JMIR Res Protoc

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Background Adolescents in residential substance use treatment are at extremely high risk for relapse following discharge to the community. Parenting practices, including parental monitoring and parent-adolescent communication, have been established as key predictors of adolescent substance use outcomes and relapse. However, traditional office-based therapy may not be feasible for parents who face structural and systemic barriers. There is a clear need for effective, accessible, and scalable interventions for parents of adolescents receiving residential substance use treatment. In a prior pilot randomized controlled trial, we tested Parent SMART (Substance Misuse among Adolescents in Residential Treatment)—a technology-assisted parenting intervention informed by extensive formative research—as an adjunct to residential treatment as usual (TAU). Parent SMART demonstrated high feasibility and acceptability, as well as evidence of effectiveness in improving parental monitoring and communication. Objective This protocol paper describes a fully-powered randomized controlled pragmatic effectiveness trial of Parent SMART as an adjunct to residential TAU. We hypothesize that families who receive Parent SMART will demonstrate greater improvements in parenting skills, reductions in adolescent substance use, and reductions in adolescent problem behaviors relative to families that receive residential TAU. We will test the exploratory hypothesis that reductions in adolescent substance use will be partially mediated by improvements in parenting skills. Methods Adolescent-parent dyads (n = 220 dyads; 440 total) will be randomized to either residential TAU only or Parent SMART+TAU. Parents randomized to Parent SMART will receive access to a networking forum, an off-the-shelf computer program called Parenting Wisely, and up to four telehealth coaching calls. Multimethod follow-up assessments consisting of self-reported parent and adolescent measures, a parent-adolescent in vivo interaction task, and 8-panel urine screens will be conducted 6, 12, and 24 weeks postdischarge from residential care. Measures will assess parenting skills, adolescent substance use, and adolescent problem behaviors. Analyses will be conducted using latent change score structural equation modeling. Results The trial was funded in August 2021; ethics approval was obtained in August 2020, prior to funding. Due to concerns with the administrative interface in the pilot trial, the Parent SMART networking forum is currently being rebuilt by a different vendor. The programming is scheduled to be completed by December 2021, with recruitment beginning in February 2022. Conclusions The proposed research has the potential to advance the field by serving a high-need, underserved population during a vital treatment juncture; targeting parenting practices (putative mediators) that have been shown to predict adolescent substance use outcomes; addressing barriers to accessing continuing care; and testing a highly scalable intervention model. Trial Registration ClinicalTrials.gov NCT05169385; https://clinicaltrials.gov/ct2/show/NCT05169385 International Registered Report Identifier (IRRID) PRR1-10.2196/35934

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Becker¹,

Helseth²,

Kelly³

et al. 2022

JMIR Res Protoc

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Mind it! A mindfulness-based group psychotherapy for substance use disorders in adolescent inpatients

Legenbauer,

Baldus,

Jörke

et al. 2024

Eur Child Adolesc Psychiatry

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Cannabis use disorder (CUD) is the most frequent reason for psychiatric inpatient substance use disorder (SUD) treatment among 15–19-year-olds in Germany. Despite effective treatment programs, relapse rates remain high. Thus, existing multi-component programs (TAU) need to be enhanced with SUD-specific elements. Mindfulness-based interventions (MBI) seem promising as they can positively influence SUD-related behaviors (e. g. craving). Given limited research in adolescents, this randomized controlled trial investigated the extent to which MBI-based group therapy (Mind it!) as an add-on treatment to TAU led to fewer cannabis use days after 6 months in 84 adolescent inpatients with CUD. Additionally, craving, severity of CUD, and changes in mindfulness were monitored (pre-, post-, and follow-up (FU) assessments). The results revealed a significant reduction in cannabis use days in both groups at 6-month FU (d = − 0.72 and = − 0.75). Although minor additional benefits of Mind it! were evident post-treatment, specifically reduction of craving and SUD severity, by the 6-month mark, TAU exhibited a more substantial decrease in SUD severity (d = 0.78), and reward craving (d = 0.28) compared to Mind it!. Regarding self-regulation skills (mindfulness), Mind it! demonstrated superiority over TAU after 6-month FU (d = 0.27). Therapists judged the MBI as feasible. (Serious) adverse events were unrelated to Mind it!. There was a systematic dropout among Mind it! participants. Primarily, the results emphasize the effectiveness of TAU in reducing cannabis use. MBI also seem feasible for youth, but results remain inconsistent and unstable over time. Importantly, enhanced adherence to reduce dropouts is needed.Trial registration: German Clinical Trials Register, DRKS00014041. Registered on 17 April 2018.

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Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study

2022

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Despite intensive treatment, adolescents discharged from residential treatment (RT) often do not maintain treatment gains in the community. Providing support and education to caregivers through parent training may ameliorate the loss of treatment gains. Successful parent training programs have been delivered to this population; however, these interventions were delivered in-person, posing significant barriers affecting reach, access, and engagement. A convergent mixed methods design was used to assess the acceptability, appropriateness, and feasibility of a web-based parent training in a sample of parents ( N = 20) with adolescents admitted to RT. Parents completed two interviews and an end-of-program survey. Parents completed at least 80% of the assigned modules and felt that PW was easy to use and that the features facilitated learning. Parents reported practicing the skills in their daily lives and found it beneficial to have a partner to practice with. Consistent with previous studies, parents perceived the delivery method as a strength because the web-based delivery circumvented multiple known barriers to in-person interventions. A large subset of parents related to the scenarios, while a small subset of parents felt the modules were challenging to relate to because of the severity of their adolescent’s mental health challenges. Overall, findings indicate that web-based parent training programs may be an acceptable, appropriate, and feasible adjuvant evidence-based support. However, tailoring the intervention content is necessary to create a more relatable intervention that captures the breadth and severity of mental health challenges adolescents in RT face.

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Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Pilot randomized trial of a technology-assisted parenting intervention

Cited by 19 publications

References 52 publications

Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Mind it! A mindfulness-based group psychotherapy for substance use disorders in adolescent inpatients

Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study

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