Parent Smart: Effects of a Technology-Assisted Intervention for Parents of Adolescents in Residential Substance Use Treatment on Parental Monitoring and Communication

Becker, Sara J.; Helseth, Sarah A.; Janssen, Tanja; Kelly, Lourah M.; Escobar, Katherine I.; Spirito, Anthony

doi:10.1080/23794925.2021.1961644

Cited by 7 publications

(9 citation statements)

References 51 publications

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“…Parents randomized to Parent SMART will receive a technology-assisted intervention containing three core elements, which were packaged in response to formative feedback described extensively [ 26 ] and tested in the pilot trial [ 27 , 28 ]. All three elements are available in both English and Spanish.…”

Section: Methodsmentioning

confidence: 99%

“…In the pilot trial, 83% of the parents randomized to Parent SMART completed at least two modules, and 33% completed at least five modules. Overall, parents completed a mean of 3.8 modules (SD 2.3, range 1-9 completed modules) [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…The adolescent-reported version only will be used to assess positive (general family communication) and negative (problems with family communication) aspects of parent-adolescent communication. Subscales had good reliability (α=.71-.92) in our pilot [ 28 ] and have been shown to correlate with adolescent engagement in risk behavior [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

“…In the pilot trial, 20% of FAsTasks were double coded with an excellent mean inter-rater reliability of 94%. Moreover, the FAsTask was sensitive to change, with all five subscales demonstrating significant time by treatment condition interactions, favoring Parent SMART+TAU relative to the TAU-only condition in our pilot trial [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…Parent SMART demonstrated excellent acceptability and feasibility, with parents who received Parent SMART reporting significantly higher levels of satisfaction and greater likelihood of recommending the services they had received than those who received residential treatment alone [ 27 ]. In addition, Parent SMART was associated with significant improvements in parental monitoring and communication, measured via both self-report scales and a behavioral intervention task, across both residential settings [ 28 ]. Among adolescents in the acute care setting, Parent SMART was also associated with significant reductions in days of binge drinking and school-related problems; we were underpowered to detect differences in the standard residential care setting, but a number of significant time effects were observed, revealing encouraging reductions in days of substance use, substance-related problems, and high-risk behaviors among adolescents in both conditions [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

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Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Becker¹,

Helseth²,

Kelly³

et al. 2022

JMIR Res Protoc

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Background Adolescents in residential substance use treatment are at extremely high risk for relapse following discharge to the community. Parenting practices, including parental monitoring and parent-adolescent communication, have been established as key predictors of adolescent substance use outcomes and relapse. However, traditional office-based therapy may not be feasible for parents who face structural and systemic barriers. There is a clear need for effective, accessible, and scalable interventions for parents of adolescents receiving residential substance use treatment. In a prior pilot randomized controlled trial, we tested Parent SMART (Substance Misuse among Adolescents in Residential Treatment)—a technology-assisted parenting intervention informed by extensive formative research—as an adjunct to residential treatment as usual (TAU). Parent SMART demonstrated high feasibility and acceptability, as well as evidence of effectiveness in improving parental monitoring and communication. Objective This protocol paper describes a fully-powered randomized controlled pragmatic effectiveness trial of Parent SMART as an adjunct to residential TAU. We hypothesize that families who receive Parent SMART will demonstrate greater improvements in parenting skills, reductions in adolescent substance use, and reductions in adolescent problem behaviors relative to families that receive residential TAU. We will test the exploratory hypothesis that reductions in adolescent substance use will be partially mediated by improvements in parenting skills. Methods Adolescent-parent dyads (n = 220 dyads; 440 total) will be randomized to either residential TAU only or Parent SMART+TAU. Parents randomized to Parent SMART will receive access to a networking forum, an off-the-shelf computer program called Parenting Wisely, and up to four telehealth coaching calls. Multimethod follow-up assessments consisting of self-reported parent and adolescent measures, a parent-adolescent in vivo interaction task, and 8-panel urine screens will be conducted 6, 12, and 24 weeks postdischarge from residential care. Measures will assess parenting skills, adolescent substance use, and adolescent problem behaviors. Analyses will be conducted using latent change score structural equation modeling. Results The trial was funded in August 2021; ethics approval was obtained in August 2020, prior to funding. Due to concerns with the administrative interface in the pilot trial, the Parent SMART networking forum is currently being rebuilt by a different vendor. The programming is scheduled to be completed by December 2021, with recruitment beginning in February 2022. Conclusions The proposed research has the potential to advance the field by serving a high-need, underserved population during a vital treatment juncture; targeting parenting practices (putative mediators) that have been shown to predict adolescent substance use outcomes; addressing barriers to accessing continuing care; and testing a highly scalable intervention model. Trial Registration ClinicalTrials.gov NCT05169385; https://clinicaltrials.gov/ct2/show/NCT05169385 International Registered Report Identifier (IRRID) PRR1-10.2196/35934

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Becker¹,

Helseth²,

Kelly³

et al. 2022

JMIR Res Protoc

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Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study

2022

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Despite intensive treatment, adolescents discharged from residential treatment (RT) often do not maintain treatment gains in the community. Providing support and education to caregivers through parent training may ameliorate the loss of treatment gains. Successful parent training programs have been delivered to this population; however, these interventions were delivered in-person, posing significant barriers affecting reach, access, and engagement. A convergent mixed methods design was used to assess the acceptability, appropriateness, and feasibility of a web-based parent training in a sample of parents ( N = 20) with adolescents admitted to RT. Parents completed two interviews and an end-of-program survey. Parents completed at least 80% of the assigned modules and felt that PW was easy to use and that the features facilitated learning. Parents reported practicing the skills in their daily lives and found it beneficial to have a partner to practice with. Consistent with previous studies, parents perceived the delivery method as a strength because the web-based delivery circumvented multiple known barriers to in-person interventions. A large subset of parents related to the scenarios, while a small subset of parents felt the modules were challenging to relate to because of the severity of their adolescent’s mental health challenges. Overall, findings indicate that web-based parent training programs may be an acceptable, appropriate, and feasible adjuvant evidence-based support. However, tailoring the intervention content is necessary to create a more relatable intervention that captures the breadth and severity of mental health challenges adolescents in RT face.

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Parent Smart: Effects of a Technology-Assisted Intervention for Parents of Adolescents in Residential Substance Use Treatment on Parental Monitoring and Communication

Cited by 7 publications

References 51 publications

Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Parent SMART (Substance Misuse in Adolescents in Residential Treatment): Protocol of a Randomized Effectiveness Trial of a Technology-Assisted Parenting Intervention

Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study

From parenting skills to adolescent treatment needs: Questions elicited by parents of adolescents discharged from residential treatment

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