Abstract

BackgroundCurrent treatments for adolescents with substance use disorder (SUD) have had only limited success. In recent years, research has underlined the role of self-regulatory processes and impulsivity in the development and maintenance of SUD in adolescents. Mindfulness has gained much attention due to its capacity to influence self-regulatory processes, particularly in adult populations. Initial studies have shown the potential of mindfulness-based approaches in younger SUD patients. The aim of the present clinical trial is to evaluate the added treatment effect of a mindfulness-based group psychotherapy (“Mind it!”) for adolescents with SUD in comparison to the current standard treatment. Moreover, we seek to explore the feasibility of the intervention and possible mediators of treatment effects.Methods/designThere will be N = 340 participants aged between 13 and 19 years who are receiving child or adolescent psychiatric or psychotherapeutic inpatient or day treatment targeting their SUD and who have reported substance use 30 days before detoxification and do not show acute psychotic or suicidal symptoms at baseline. The study is a prospective randomized controlled multi-center trial in which patients are assessed: (1) after completing a prior detoxification phase (t0), (2) at 4 weeks (t1), (3) at 8 weeks (t2), and (4) at 6 months after t2 (t3). Participants in the intervention group will receive mindfulness-based group psychotherapy in addition to their existing treatment regime. The primary outcome is substance use in the past 30 days at follow-up based on the Timeline Followback self-report. Secondary outcomes include craving, severity of dependence, and abstinence motivation. Mindfulness, impulsivity, and emotion regulation will be analyzed as possible mediators of treatment effects.DiscussionThis trial is expected to provide evidence of the added effect of a novel, safe, and feasible treatment option for adolescents with SUD.Trial registrationGerman Register of Clinical Studies, DRKS00014041. Registered on 17 April 2018.

Highlights

  • Current treatments for adolescents with substance use disorder (SUD) have had only limited success

  • Prevalence rates of SUDs in children and adolescents from population-based samples have not yet been measured in Germany, but some previous research allows for estimates: 10 to 15% of German males aged 14–24 were found to have alcohol dependence or misuse according to DSM-IV criteria

  • Previous studies have shown that mindfulness-based interventions are safe and feasible for adolescent substance users [35, 44]

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Summary

Introduction

Current treatments for adolescents with substance use disorder (SUD) have had only limited success. Research has underlined the role of self-regulatory processes and impulsivity in the development and maintenance of SUD in adolescents. Adolescence is a vulnerable period for the development of substance use disorders (SUDs). Prevalence rates of SUDs in children and adolescents from population-based samples have not yet been measured in Germany, but some previous research allows for estimates: 10 to 15% of German males aged 14–24 were found to have alcohol dependence or misuse according to DSM-IV criteria. National health report data show that 34% of patients with substance dependence are younger than 25 years [5] and about 35,000 patients under 20 years receive costly inpatient treatment due to diagnoses relating to “mental or behavioral disorders due to psychoactive substance use” (ICD-10, chapter F10-F19). SUDs in children and adolescents are an enormous public health burden

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