Readiness to Change in Adolescents Screening Positive for Substance Use in Urban Primary Care Clinics

Abstract

Primary care physicians often perceive patients as unlikely to decrease their substance use and suggest this reluctance to change diminishes their willingness to screen and intervene. The literature on readiness to change has primarily focused on adults, and the available studies on adolescents have largely included hospitalized and/or incarcerated youths with severe substance-related difficulties. The present study focused on an urban primary care system’s teenage population, which consists of youths typically engaging in less serious forms of substance use. One hundred sixty-eight of these youths ages 11–20 screened positive for substance use on a self-report questionnaire. These youths then completed the Readiness to Change Questionnaire. Nearly 60% of these positive screens were in the Action Stage, with another 16% in the Contemplation Stage. Depressive symptoms and suicidal ideation were positively associated with later stages of change. Implications for screening, prevention, and early intervention programs for adolescent substance use are discussed.

Factors related to advanced stages of change in a clinical sample of adolescents

“…One factor in particular has been the role of symptom severity and the adolescent's motivation to change with a greater severity of symptoms related to a more advanced stage of change. This finding has been demonstrated with regard to substance abuse (Austin et al, 2010;Breda & Heflinger, 2004;Slesnick et al, 2009) and internalizing symptoms such as depression in conjunction with substance abuse (Duhig & Phares, 2003;Phares & Danforth, 1994;Stevens, McGeehan & Kelleher, 2010). In particular, Smith and Tran (2007) found in a sample of 233 undergraduate hazardous drinkers that higher levels of depression and anxiety were associated with elevated readiness to change current drinking behaviours.…”

Emerging Trends and Innovations in the Identification and Management of Drug Use among Adolescents and Young Adults

“…In a recent study of young people in an urban primary care system, 11% screened positive for an alcohol or drug problem and a majority (76%) reported some willingness to reduce their substance use. 46 Primary Care: In a study conducted at an urban clinic for underserved populations, teens aged 12 to 18 that screened as "high risk" for substance problems received a 15-minute MI intervention (Project CHAT:PC 47 ) or usual care. At 3-month follow-up, teens that received PC reported significantly less marijuana use, lower perceived norms of marijuana use, fewer friends who used marijuana, and lower future intentions to use marijuana compared with teens in the usual care control group.…”