Follow-up results of Supportive versus Behavioral Therapy for illicit drug use

Azrin, Nathan H.; Acierno, Ron; Kogan, E. S.; Donohue, Brad; Besalel, Victoria A.; McMahon, P. T.

doi:10.1016/0005-7967(95)00049-4

Cited by 87 publications

(58 citation statements)

References 15 publications

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“…17 Furthermore, the behavioral therapy group showed more days worked, less alcohol use, and more days in school than did the supportive therapy group. Behavioral therapy use in the treatment of adolescent substance use has been expanded in the context of the family.…”

Section: Behavioral Therapymentioning

confidence: 94%

Evidence-Based Treatments for Alcohol Use Disorders in Adolescents

Deas

2008

Pediatrics

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The author has indicated she has no financial relationships relevant to this article to disclose. ABSTRACTThe prevalence of adolescent alcohol use and its related consequences underscore the need for evidenced-based treatments in this population. During the past decade, much progress has been made in treating adolescent alcohol use disorders with evidenced-based modalities developed specifically for adolescents. Controlled treatment outcome studies that compared Ն1 modality, used random assignment to treatment conditions, and were published between 1990 and 2004 are discussed in this review. Psychosocial treatments such as family-based interventions, motivational enhancement therapy (motivational interviewing), behavioral therapy, and cognitive-behavioral therapy, as well as the limited pharmacotherapy studies, are discussed. All of the studies used assessment tools validated for use in adolescent populations. Overall, great strides have been made in the area of adolescent alcohol treatment, and the treatment modalities presented have more than adequate potential for replication. O VER THE PAST decade, great strides have been made in the treatment of alcohol and other drug (AOD) disorders in adolescents. Before that period, most of the treatments administered for AOD disorders were those used to treat adults, and little or no modifications were made on the basis of developmental considerations for adolescents. Treatment replication was almost nonexistent, because treatments lacked specific protocols or structured delivery. In an attempt to evaluate the effectiveness of adolescent drug treatment, Catalano et al 1 concluded that some treatment is better than no treatment. Recent advances in AOD disorder treatment include treatment modalities designed specifically to treat adolescents, some of which were modified from adult treatments. The awareness that "adolescents are not adults" and that there are developmental differences that may affect treatment, adherence, and outcomes has advanced the field of adolescent alcohol treatment. 2 Treatments have been developed specifically to target AOD disorders in adolescents. This article reviews treatment outcome studies for adolescents with AOD disorders. INCLUSION CRITERIAOverwhelmingly, treatments for AOD disorders in adolescents have involved psychosocial modalities, the bulk of which have not been tested in a controlled, comparative fashion. To identify treatment outcome studies that were conducted in a controlled fashion, comparing Ն1 modality, a computerized literature search was conducted through journal databases, including Medline, PsychInfo, and Current Contents. In addition, the reference lists of the published articles were reviewed. Studies included in this review were those that (1) focused on AOD use disorders in adolescents, (2) evaluated Ն1 treatment modality in a comparative manner, (3) were published between 1990 and 2005, and (4) used random assignment to treatment conditions. This approach was used to highlight evidence-based treatments, to promote the...

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Section: Behavioral Therapymentioning

confidence: 94%

Evidence-Based Treatments for Alcohol Use Disorders in Adolescents

Deas

2008

Pediatrics

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“…Results from randomized trials demonstrated significantly better outcomes for youths in the CM conditions, compared with supportive counseling, for drug use abstinence, mental health and conduct problems, and employment/school attendance (Azrin, Acierno et al, 1996;. To ensure the integrity of CM implementation in these clinical trials, Azrin and colleagues provided intensive and ongoing oversight of the therapy sessions.…”

Section: Contingency Management; Therapist Adherence; Rasch Modelmentioning

confidence: 99%

Developing a Measure of Therapist Adherence to Contingency Management: An Application of the Many-Facet Rasch Model

Chapman

Sheidow

Henggeler

et al. 2008

Journal of Child & Adolescent Substance Abuse

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A unique application of the Many-Facet Rasch Model (MFRM) is introduced as the preferred method for evaluating the psychometric properties of a measure of therapist adherence to Contingency Management (CM) treatment of adolescent substance use. The utility of psychometric methods based in Classical Test Theory was limited by complexities of the data, including: (a) ratings provided by multiple informants (i.e., youth, caregivers, and therapists), (b) data from separate research studies, (c) repeated measurements, (d) multiple versions of the questionnaire, and (e) missing data. Two dimensions of CM adherence were supported: adherence to Cognitive Behavioral components and adherence to Monitoring components. The rating scale performed differently for items in these subscales, and of 11 items evaluated, eight were found to perform well. The MFRM is presented as a highly flexible approach that can be used to overcome the limitations of traditional methods in the development of adherence measures for evidence-based practices. Keywords Contingency Management; therapist adherence; Rasch modelThe Contingency Management (CM) treatment model developed by Azrin and his colleagues (Donohue & Azrin, 2001) has shown promise in treating adolescent substance use in conjunction with family therapy. Results from randomized trials demonstrated significantly better outcomes for youths in the CM conditions, compared with supportive counseling, for drug use abstinence, mental health and conduct problems, and employment/school attendance (Azrin, Acierno et al., 1996;. To ensure the integrity of CM implementation in these clinical trials, Azrin and colleagues provided intensive and ongoing oversight of the therapy sessions. This oversight included (1) extensive training, modeling, and role-playing with corrective feedback to therapists; (2) ongoing audiotape coding with corrective feedback provided to therapists; (3) observation of therapy sessions with corrective feedback; (4) detailed session checklists prompting use of techniques, reviewed weekly with therapists; and (5) weekly written documentation by therapists of techniques used, youth and family participation, and progress toward treatment goals. Notably, fidelity data from session checklists and ratings of audiotapes showed greater than 95% adherence , 1997;Henggeler, Pickrel, & Brondino, 1999;Schoenwald, Sheidow, Letourneau, & Liao, 2003). Likewise, favorable outcomes for other evidence-based practices (e.g., Functional Family Therapy, Program for Assertive Community Treatment) have been attenuated by low therapist fidelity to the corresponding treatment protocols (Weisz, Weersing, & Henggeler, 2005).If achieving desired clinical outcomes relies, in part, on the fidelity of therapist implementation of the treatment model, then attempts to transport evidence-based practices to community settings requires effective measures of treatment fidelity. Although the observational methods used for monitoring and measuring fidelity in the CM trials noted previously were highly...

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“…However, investigators have consistently recommended that these interventions should be modified to handle the unique concerns of MR substance-abusers. The second and third authors of this article have not pub lished treatment outcome data specific to MR substance abusers, however, they have conducted controlled treatment outcome studies in which some cognitively impaired per sons were incidentally included in the study sample (Azrin et al 1996;. That is, persons who were formally diagnosed with mental retardation were excluded from the three aforementioned studies; however, about a dozen persons in these studies were then identified to be cognitively impaired, or in the borderline range of intellectual functioning, according to retrospective school or parent reports.…”

Section: Substance Abuse In the Mentally Retardedmentioning

confidence: 98%

Prevalence and Treatment of Substance Abuse in the Mentally Retarded Population: An Empirical Review

Burgard

Donohue

Azrin

et al. 2000

Journal of Psychoactive Drugs

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This article presents the first comprehensive review of studies of alcohol and illicit substance use in mentally retarded individuals, including prevalence, and recommendations for assessment and treatment. Mentally retarded persons appear to use/abuse alcohol at about the same rate as their noncognitively-impaired counterparts, and illicit drugs at moderately lower rates. However, little is known regarding which assessments and interventions are most effective in this population, given the absence of published treatment outcome studies and case examples. This is particularly disconcerting as detrimental consequences resulting from substance use have been identified in mentally retarded samples. Anecdotal data suggests that treatment for these individuals require modifications of existing empirically-derived substance abuse interventions to accommodate their unique needs.

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Follow-up results of Supportive versus Behavioral Therapy for illicit drug use

Cited by 87 publications

References 15 publications

Evidence-Based Treatments for Alcohol Use Disorders in Adolescents

Evidence-Based Treatments for Alcohol Use Disorders in Adolescents

Developing a Measure of Therapist Adherence to Contingency Management: An Application of the Many-Facet Rasch Model

Prevalence and Treatment of Substance Abuse in the Mentally Retarded Population: An Empirical Review

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