Affect Management for HIV Prevention with Adolescents in Therapeutic Schools: The Immediate Impact of Project Balance

Brown, Larry K.; Houck, Christopher D.; Donenberg, Geri R.; Emerson, Erin; Donahue, Kelly L.; Misbin, Jesse

doi:10.1007/s10461-013-0599-5

Cited by 15 publications

(29 citation statements)

References 30 publications

(28 reference statements)

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“…While neither examined transition to sex, both demonstrated that those who received emotion regulation training reported fewer sexual risk behaviors at 1-month (Brown et al, 2013) and 6-month (Brown et al, 2011) assessments. The present study found similar behavioral benefits of focused emotion regulation interventions on reducing targeted sexual behavior.…”

Section: Discussionmentioning

confidence: 94%

“…In the context of research connecting emotions to sexual behavior among adolescents (Houck et al, 2014; Shrier, Koren, Ancja, & de Moor, 2010), these relationships may exist because adolescents’ difficulties with emotion regulation increase the likelihood of impulsive self-soothing behaviors, such as sex. Interventions targeting emotion regulation in times of sexual decision making may assist young people in delaying onset of sexual activity (Brown et al, 2013). …”

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confidence: 99%

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The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors.

Houck¹,

Barker²,

Hadley³

et al. 2016

Health Psychology

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Objective Sexual activity often begins in early adolescence, and adolescents with mental health symptoms are at greater risk for sexual activity and other health risks. This study aimed to evaluate a developmentally targeted intervention designed to enhance early adolescents’ emotion regulation competencies as a strategy for reducing health risk behaviors, including sexual initiation. Method Adolescents 12 to 14 years old (N = 420; 53% male) with mental health symptoms participated in either an Emotion Regulation (ER) or Health Promotion (HP) intervention consisting of twelve after-school sessions. Participants completed questionnaires on laptop computers at baseline, 2-, 6-, and 12-month follow-ups. Results Time to event analyses were used to compare intervention conditions on rate of initiation to vaginal sex. Results showed that participants in the Emotion Regulation (ER) condition were less likely to transition into vaginal sexual activity by one-year follow-up than those in the Health Promotion (HP) condition (adjusted hazard ratio = 0.58, 95% CI: 0.36 to 0.94, p = .01). However, those who were sexually active did not report differences in sexual risk behaviors (e.g., condomless sex). Participants in the ER condition were significantly less likely to report violence behaviors and showed improvement on a behavioral measure of emotion identification, however they did not differ from HP participants on self-reports of emotional competence. Conclusions Emotion regulation strategies can be used to delay sexual initiation among early adolescents with mental health symptoms and may have an important role in health education.

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Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors.

Houck¹,

Barker²,

Hadley³

et al. 2016

Health Psychology

Self Cite

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“…The PATH program was adapted from an efficacious adolescent-only group based intervention developed for teens attending a therapeutic day school (Project BALANCE); the Project BALANCE curriculum focuses on teaching youth how to regulate their emotions in risky situations so that they can better negotiate sexual safety and reduce their HIV risk (Brown et al, 2013). Interventions centered on improving child and adolescent affect regulation have been successful in preventing mental health and behavioral problems (Bell & McBride, 2010).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of a family-based HIV prevention intervention for substance using juvenile offenders

Tolou‐Shams

Dauria

Conrad

et al. 2017

Journal of Substance Abuse Treatment

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Approximately 80% of all arrested youth are diverted from detention and supervised in the community through probation, specialty courts and other community-based diversion efforts. Justice-involved youth have greater psychiatric impairment, substance use and sexual risk behaviors than their non-justice-involved peers. Family-based interventions to address mental health, substance use and recidivism have been successful in improving these youth outcomes; but the lack of integration of HIV/STI prevention is notable given the co-occurrence of substance use, delinquency and sexual risk-taking behaviors among justice-involved youth. Moreover, emotion dysregulation may be an important and understudied underlying construct of these co-occurring risk behaviors for justice-involved youth. Study participants were 47 caregiver-youth dyads enrolled in a juvenile drug court program. As part of a pilot efficacy trial, dyads were randomized to a 5-session family-based integrated substance use and HIV/STI prevention intervention that relied on affect management strategies for risk reduction or an adolescent-only psychoeducation condition matched for time and attention. Data collected at baseline and 3 months post-intervention suggest that a family-based integrated affect management substance use and HIV prevention pilot intervention may lead to justice-involved youths’ enhanced motivation to change their marijuana use, decreased marijuana use and decreased risky sexual behavior over time. Future research is required to replicate these pilot trial findings and should also examine family-level mediators and moderators of treatment response, particularly with respect to HIV prevention efforts for these youth.

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“…3 Dealing with emotionally charged situations may prove to be difficult for adolescents due to incomplete development of cognitive and planning capacities. 4 In addition, deficits in emotion regulation and affect management among adolescents with psychiatric disorders make navigating this stage more difficult. Adolescents who lack skills to effectively manage and express their emotions are more likely to engage in risky sexual behavior in order to cope with stressful and negative emotions.…”

Section: Introductionmentioning

confidence: 99%

The Role of Affect Management for HIV Risk Reduction for Youth in Alternative Schools

Brown

Whiteley

Houck

et al. 2017

Journal of the American Academy of Child & Adolescent Psych

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Objective Adolescents in alternative schools for behavioral and emotional problems have an earlier sexual onset and higher rates of sexual risk than their peers. They also often have difficulty managing strong emotions, which can impair sexual decision-making. Human immunodeficiency virus (HIV) prevention programs for these adolescents may be most effective if skills for coping with strong emotions during sexual situations are included. Method This paper reports the 6-month outcomes of a three-arm randomized controlled trial comparing an HIV prevention intervention with affect management (AM) to a standard, skills-based HIV prevention intervention (SB), and a general health promotion intervention (HP). HP was similar to a general health class, and SB was based on previous effective HIV prevention programs used with community adolescents, while AM included affect management skills in addition to effective HIV prevention skills. Youth (n=377) in two US cities were ages 13 to 19 and attending alternative schools for behavioral and emotional problems. Results Multiple logistic regression analyses, adjusted for the baseline scores, age, and gender, found adolescents in AM were significantly less likely to report being sexually active at follow-up (80% vs. 91%, adjusted odds ratio [AOR] =0.28, CI=0.08–0.96) and more consistently using condoms than those in HP at follow-up (62%, vs. 39%, AOR=3.42, CI=1.10–10.63). Conclusion Affect management techniques tested in this project, focused on sexual situations, are similar to those that are used in dialectical behavioral therapy (DBT) and in clinical practice. These data suggest that these techniques might decrease risk behaviors and improve the health of adolescents with emotional/behavioral problems.

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Affect Management for HIV Prevention with Adolescents in Therapeutic Schools: The Immediate Impact of Project Balance

Cited by 15 publications

References 30 publications

The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors.

The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors.

Outcomes of a family-based HIV prevention intervention for substance using juvenile offenders

The Role of Affect Management for HIV Risk Reduction for Youth in Alternative Schools

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