Adolescent Brief Intervention Research Articles

5.59 Promoting Substance Use Disorder Screening and Brief Interventions for Adolescents and Destigmatization of Substance Use Disorders and Their Treatment in a Local School District Behavioral Health Program

5.59 Promoting Substance Use Disorder Screening and Brief Interventions for Adolescents and Destigmatization of Substance Use Disorders and Their Treatment in a Local School District Behavioral Health Program

Improving capacity to identify, assess, and manage adolescents engaging in non-suicidal self-injury using patient avatars

Purpose We developed and evaluated a training comprising a didactic and virtual practice session with human-guided patient avatars to increase pediatric residents’ competence to identify and assess non-suicidal self-injury (NSSI) and suicide risk. Methods Thirty pediatric residents at three children’s hospitals in Florida participated in the training and completed pre-, one-month post-, and three-months post-training surveys. One-way repeated measures ANOVA with post-hoc comparisons determined changes in confidence, comfort, behavioral intentions, attitudes, knowledge, and behavior over time. Qualitative responses provided feedback on the training, especially the novel practice session with adolescent patient avatars. Results Three-months post-training residents expressed significantly greater confidence in talking to adolescents who self-injure, applying the SOARS method to assess self-injury, and assessing functions/reasons for self-injury; reported feeling significantly more comfortable asking about self-injury, well-equipped to handle the emotional aspects of self-injury, and comfortable treating adolescents who self-injure; reported greater behavioral intentions to talk to adolescents about self-injury, assess an adolescent’s stage of change for stopping self-injury, and provide brief interventions for adolescents who self-injure; and used SOARS to evaluate current NSSI with a greater proportion of adolescent patients. Qualitative feedback expressed positive perceptions, especially related to the virtual-reality role-play session. Conclusions Incorporating an interactive, human-guided virtual experience using role-playing and feedback with patient avatars represents a viable option comparable to using typical standardized patients to expand the scalability of NSSI trainings for pediatric residents, especially when they occur virtually.

Adapting substance use brief interventions for adolescents: perspectives of adolescents living with adults in substance use disorder treatment.

BackgroundBrief interventions (BIs) have shown potential to reduce both alcohol and drug use. Although BIs for adults have been studied extensively, little is known about how to adapt them to meet the needs and preferences of adolescents. This article examines adolescents’ preferences to consider when adapting BIs for use with adolescents.MethodsEighteen adolescents (age 9–17 years) living in Los Angeles County with adults receiving substance use disorder treatment were interviewed and asked about their perspectives on how to adapt a BI originally developed for adults for use with adolescents. Questions focused on adolescents’ preferences for who should deliver BIs, how BIs should be delivered, and what content they would want to be included in BIs. Interviews were recorded, transcribed, and coded using summative content analysis.ResultsAdolescents did not express any discernable opinions concerning who delivers BIs or what content they would want to be included, but they did share perspectives on how BIs should be delivered. Most adolescents did not endorse incorporating text messaging or social media into BIs. Instead they preferred having BIs delivered face-to-face or over the telephone. They reported that they did not want BIs to incorporate text messaging or social media due to concerns about trust, the quality of information they would receive, and challenges communicating in writing instead of speaking.ConclusionAlthough the study has limitations because of its small sample size, findings indicate that adolescents may not want text messaging or social media to be incorporated into BIs for substance use. These findings warrant further research and consideration, particularly as work to enhance BIs for adolescents continues.

A clinical instrument to guide brief interventions for adolescents with substance use concerns

ABSTRACTBackground: Adolescent substance use is an important public health problem in New Mexico and the United States. The New Mexico Department of Health school-based health centers (SBHCs) universally administer a validated screen, the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble), for adolescent substance use concerns; however, quality assurance efforts revealed that SBHC providers needed more information at the point of screening to initiate brief interventions for students with positive CRAFFT screens. The CHISPA (Cocaine, Heroin, IV drugs, Synthetic pot, Pot, Alcohol) was developed to gather specific information on recent substance use experience to guide brief interventions. This paper describes the development and initial reliability and validity of data obtained using the CHISPA instrument. Methods: In 2015, 99 high school–aged SBHC users in Albuquerque, New Mexico, completed the CRAFFT and CHISPA twice over 2 weeks using standard test-retest methods. Using the CHISPA, students reported for the prior 3 months substances used, frequency of use, and signs of addiction or acute danger (adverse events). Results: Retest reliability for the CRAFFT score was 0.82. CHISPA retest reliabilities were 0.75 for alcohol use; 0.91 for having used any substances; 0.92 for number of substances used; 0.81 for frequency of substance use; and 0.79 for number of adverse events. CRAFFT scores correlated with CHISPA measures of number of substances used at 0.62; with frequency of substance use at 0.58; and with number of adverse events at 0.64. Conclusions: CHISPA measures show preliminary evidence of reliability and validity. SBHC providers and other providers in primary care settings who use the CRAFFT screen may benefit from using the CHISPA to define recent substance use experience to guide brief interventions for adolescents with substance use concerns. The CHISPA instrument is currently being tested in electronic form in selected SBHCs in the state of New Mexico.

Clinical Guidelines for the Detection, Prevention, and Early Intervention of Adolescent Substance Use

Objective: Mental health care providers are in a unique position to detect, prevent, and offer brief interventions for adolescents with substance use problems. While substance use and mental health disorders commonly co-occur, few pediatric mental health professionals possess the necessary training to identify and treat substance use issues. The goal of this paper is to provide guidance for mental health professionals working with adolescents on how to detect, intervene, and refer adolescents for substance use treatment. Method: A series of clinical case examples and vignettes provide scenarios for helping educate providers in screening for substance use, preventing/delaying substance use initiation, delivering brief early interventions, and motivating adolescents for specialized substance use treatment when necessary. Conclusions: The importance of discussing substance use with each adolescent, being attuned to common warning signs of substance use, taking caution in prescribing medications with abuse potential, importance of family involvement, and use of motivational interviewing techniques are discussed. Keywords: adolescents, guidelines, health care providers, prevention, screening, substance use, treatment.

Web-based screening and brief intervention for poly-drug use among teenagers: study protocol of a multicentre two-arm randomized controlled trial

BackgroundMid to late adolescence is characterised by a vulnerability to problematic substance use since the consumption of alcohol and illicit drugs is frequently initiated and increased in this life period. While the detrimental long- and short-term effects of problematic consumption patterns in adolescence pose a major public health concern, current prevention programs targeting alcohol- and other substance-using adolescents are scarce. The study described in this protocol will test the effectiveness of a web-based brief intervention aimed at reducing problematic alcohol use and promoting abstinence from illegal drugs in adolescents with risky substance use aged 16 to 18 years old in four EU-countries.Methods/designTo determine the effectiveness of our web-BI, we apply a two-arm randomized controlled trial (RCT) study design, with baseline assessment at study entry and a three month follow-up assessment. Adolescents aged 16 to 18 years from Belgium, the Czech Republic, Germany, and Sweden will be randomly assigned to either the fully electronically delivered brief intervention group (N = 400) or an assessment only control group (N = 400) depending on their screening for risky substance use (using the CRAFFT). Recruitment, informed consent, randomization, intervention and follow-up will be implemented online. Primary outcomes are reductions in frequency and quantity of use of alcohol and drugs other than alcohol over a 30 day period, as well as consumption per typical occasion. Secondary outcomes concern changes in substance use related cognitions including the constructs of the Theory of Planned Behaviour, implementation intentions, and stages of change. Moreover the study addresses a number of moderator variables, including age of first use, general psychopathology and quality of parent–child relationship.DiscussionThe trial is expected to contribute to the growing literature on theory- and web-based brief interventions for adolescents. We will explore the potential of using web-based technologies as means of delivering preventive interventions. In doing so we are among the first to target the relevant group of young poly-drug users in Europe.Trial registrationCurrent Controlled Trials ISRCTN95538913

Do paediatricians provide brief intervention for adolescents who smoke?

This study aimed to describe the self-reported practice of paediatricians in brief interventions for adolescents who smoke. We also aimed to compare practice with confidence, skills and knowledge of brief intervention and nicotine replacement therapy after a targeted training programme. Medical staff at The Children's Hospital at Westmead completed a questionnaire of clinical practice and confidence in brief intervention for smoking cessation. Data were analysed comparing self-reported practice with confidence, skill and knowledge of brief interventions, based on Fiore's 5A's approach (Ask about smoking at every opportunity, Assess willingness to quit, Advise patients to quit smoking, Assist quit attempts and Arrange follow up). Fifty-seven clinicians completed questionnaires, 55 (96%) recognised the importance of asking adolescents about smoking. Thirty-one (54%) identified adolescent smokers all or most of the time, increasing to 50 (88%) if their presenting condition was associated with smoking. Twenty-five (44%) clinicians assessed the stage of change, 33 (58%) advised the adolescent to quit smoking, nine (16%) assisted quit attempts and 10 (17.5%) arranged follow up. Clinicians more confident in brief intervention skills, motivational interviewing and relapse prevention were more likely to use the 5A's (P<0.05). Training increased clinician's confidence in brief intervention skills and knowledge of nicotine replacement therapy (P<0.01); however, there was no statistically significant change in clinical practice 1 month post training. Training paediatricians in brief intervention skills, motivational interviewing and relapse prevention can increase the use of 5A's brief intervention in clinical practice, potentially increasing quit attempts in adolescents who smoke.

The Behavior-Image Model: a paradigm for integrating prevention and health promotion in brief interventions

This paper describes the Behavior-Image Model (BIM), an emerging and innovative paradigm for planning brief interventions for adolescents that fuse the prevention of harmful behaviors with the promotion of healthy habits. We discuss the components of the BIM as a new paradigm for creating multiple behavior health interventions, as well as the empirical and conceptual underpinnings of the model, and present Project Sport as an illustration of how the BIM may be applied to construct a brief multi-behavior intervention. The BIM posits that selected salient images of others and ourselves may be used to cast gain- and loss-framed messages coupling and motivating health-promoting and health-risk behaviors within single interventions. This content in turn activates prototypes and future self-images through the processes of social and self-comparison, leading to improvements in risk and protective factors and subsequent change in targeted health-promoting and health-risk behaviors. Recommendations are offered for conducting future research integrating health-risk and health-promoting behaviors in both brief and non-brief interventions for adolescents and adults.

Assessment and Brief Interventions for Adolescents with Substance Abuse

Assessment and Brief Interventions for Adolescents with Substance Abuse

Motivational enhancement and other brief interventions for adolescent substance abuse: foundations, applications and evaluations.

To present a comprehensive review of the use of motivational enhancement and other brief interventions for substance use in adolescents. In this paper, we review the major theoretical foundations and influences of brief interventions (including motivational interviewing), consider developmental issues in its application for adolescents, discuss methodological issues in the design and implementation of brief interventions, including the assessment of treatment fidelity, evaluate and interpret the latest findings on brief interventions for adolescents and young people and discuss the issue of translating and exporting effective research into practice. Results from recent clinical trials using motivational interventions indicate that these approaches result in decreases in substance-related negative consequences and problems, decrements in substance use and increased treatment engagement, with results particularly strong for those with heavier substance use patterns and/or less motivation to change. While results are promising, more research is needed to examine the essential elements of motivational interventions, for whom they work best, and their impact on developmental transitions during adolescence.

Tobacco Cessation and Youth: The Feasibility of Brief Office Interventions for Adolescents

Background.The prevalence of tobacco use among adolescents remains high and the great majority of adult smokers begin smoking prior to the age of 18. While there have been a number of primary prevention projects in communities and schools, less attention has been given to smoking cessation for adolescents. This paper reviews the literature on the theory and practice of cessation as applicable to adolescents.Methods.The relevant literature was culled from a MEDLINE search and supplemented with secondary searches from those articles.ResultsThere have been few studies on brief interventions for adolescent smoking cessation in health care settings. However, there are several models for smoking cessation that are either applicable to or designed for adolescents. Pharmacologic treatments are also beginning to be used.Conclusions.There is a great need for the development and evaluation of models for adolescent smoking cessation in health care settings. Recent developments, however, give cause for optimism in helping adolescent smokers in tobacco cessation.