Randomized controlled trial of motivational enhancement therapy with nontreatment-seeking adolescent cannabis users: A further test of the teen marijuana check-up.

Abstract

Aims Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Design Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC) or Delayed Feedback Control (DFC). Those assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to 4 optional individual treatment sessions aimed at cessation of cannabis use. Setting High schools in Seattle, WA, USA. Participants 310 self-referred adolescents who smoked cannabis regularly. Measurements Main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. Findings At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to DFC. Frequency of cannabis use was less in MET relative to EFC at 3 months, but did not translate to differences in negative consequences. Reduction in use and problems were sustained at 12-months but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and not different by condition. Conclusions Brief interventions can attract and have positive impacts on adolescent cannabis users, but the mechanisms of the effects are yet to be identified.

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

“…Although the CBT-I approach is well established (especially the A-CRA model; Godley, Garner, Smith, Meyers, & Godley, 2011), it has tested as inferior to FBT-E in more than one trial. Similarly, whereas CBT-G is well-established, there may be little reason to prefer it over MET=CBT given that the latter is anchored in CBT-G and (Kaminer, Burleson, & Goldberger, 2002) Interactional group (Kaminer & Burleson, 1999 (Slesnick et al, 2013) No treatment (Gmel et al, 2012) Educational control (Walker et al, 2011) [MET] TAU (Baer et al, 2007) Waitlist (Walker et al, 2006) (Eddy & Chamberlain, 2000;Huey, Henggeler, Brondino, & Pickrel, 2000). Also, Dishion and colleagues (for review, see Dishion & Tipsord, 2011) have found that specific aspects of group process (e.g., reinforcement of deviant behavior, aka ''deviancy training'') can have adverse effects on ASU and delinquency.…”

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

“…Unlike for alcohol use (Moyer, Finney, Swearingen, & Vergun, 2002) and gambling disorders (Hodgins, Stea, & Grant, 2011), to this author's knowledge, cannabis use disorder-specific self-help materials have only been evaluated in one recent study to date with promising results (Fischer et al, 2013). Not only might the provision of these materials be effective in their own right for particular sub-populations (i.e., possibly those with lower levels of cannabis problem severity), but perhaps structured workbooks that are more comprehensive than personalized feedback reports can increase the impact of existing brief interventions and "check up" approaches (Stephens et al, 2004;Walker et al, 2011a).…”

“…Several studies have attempted to extend the reach of our treatments beyond conventional treatment models in a number of ways, including extending the length of treatment (Roffman & Stephens, 2012), offering brief interventions and "check-up" approaches that target users who are ambivalent about change (Fischer et al, 2013;Stephens et al, 2004;Walker et al, 2011a), and leveraging technology (Budney et al, 2011;Gates, Norberg, Copeland, & Digiusto, 2012;Norberg, Wright, Hickey, & Copeland, 2012b).…”

“…Evidence for the efficacy of "check-up" approaches has been promising but unfortunately not ideal among both adults and adolescents, and more research is needed to clarify potential mechanisms of change and to address ways to strengthen these approaches (Roffman & Stephens, 2012;Walker et al, 2011a). Recently in Canada, Fischer et al (2013) tested the feasibility and impact of brief interventions akin to the "check up" approach (i.e., oral and written interventions with non-judgemental information on cannabis-related health risks, concrete suggestions and techniques to modify such risks, and brief motivational components) among frequent cannabis using university students and reported positive outcomes.…”

Cannabis and Young Users—A Brief Intervention to Reduce Their Consumption (CANABIC): A Cluster Randomized Controlled Trial in Primary Care

“…Many randomized controlled trials have tested the efficacy of a brief intervention addressing cannabis use in adolescents, young adults, or both. These trials involved specific populations: students attending high schools, [25][26][27][28] students attending universities, [29][30][31] people visiting addiction centers, 32 people contacting the emergency services, 33,34 or the general public following media calls for participation. [35][36][37][38][39][40] The initial levels of consumption varied greatly, from once a year 19 to weekly 11,13,14,16 to monthly, [20][21][22]25 and qualitative data suggested motivation ranged from a desire to stop 23 to having dependency symptoms.…”