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Motivation and Skills for THC/ETOH+ Teens in Jail Principal Investigators: Dr. L.A.R. Stein & Dr. Rosemarie Ann Martin Funding Source: NIDA ($3,776,805) Terms: September, 2004 – August, 2011 This study will focus on treating substance abusing incarcerated teens using two individually administered Motivational Interviewing (MI) sessions followed by ten group sessions of Cognitive Behavior Therapy (CBT). Motivational Interviewing is conceptualized as preparation for group CBT. The control group receives two individualized Relaxation Training (RT) sessions followed by ten group sessions of Substance Education Training (SET). Currently, there is little research regarding effective group treatments for incarcerated teens and this study will address this gap in our knowledge base. We seek to reduce substance use and associated risky behaviors post-release (including driving under the influence, risky sexual behaviors, etc.). In this proposed randomized trial, a one-way design (MI/CBT vs. RT/SET) will be used to determine whether MI/CBT enhances group therapy participation and reduces substance use and related problems (such as crime, injuries and unprotected sex) post discharge in substance-involved juvenile delinquents. RT/SET is based on the 12-step model and includes psycho-educational components. Participants are followed during incarceration and for 6 months post incarceration. Primary outcome variables include alcohol and marijuana use, as well as related behaviors (illegal activity, sex or injuries while drunk or high). It is hypothesized that in comparison to teens in RT/SET, youth receiving MI/CBT will participate more in therapy (according to teen, facility staff, and counselor ratings) and will show lower levels of substance use and related problems after discharge. Frequently, substance abuse treatment is unavailable to youths in the juvenile justice system, and when treatment is available, it may be provided in group format using untested therapies. A motivation/skills-based intervention (delivered in group format) may prove efficacious in enhancing motivation and in reducing substance abuse and related problems. This study extends previous research by rigorously evaluating group treatment for incarcerated teens. We will examine processes contributing to the efficacy of group MI/CBT, and the influence of race and ethnicity on treatment effects. The development of effective interventions for substance using juvenile offenders has the potential to reduce substance abuse and crime in this population. Eligibility:
Motivation and Skills for Detained Teen Smokers Principal Investigators: Dr. L.A.R. Stein & Dr. Rosemarie Ann Martin Funding Source: NIDA ($3,776,805) Terms: September, 2007 – August, 2014 (Study in Progress) Detailed Description:This study will focus on treating tobacco using detained teens. Using urn randomization, the teen will be administered one individual treatment in either Motivational Interviewing (MI) or Relaxation Training (RT). This will be followed by two group sessions in either Cognitive Behavior Therapy (CBT) or Self-Help Programming (SHP). Currently, there is little known about mechanisms of smoking cessation in adolescents. We seek to increase our understanding of effective smoking interventions for under studied adolescents. This is a randomized clinical trial using a 2x2 between groups design to investigate MI vs. RT and CBT vs. SHP. We will study main effects for treatment as well as whether the combination of MI/CBT is more effective than the other treatment combinations in enhancing quit rates among teens. Participants are followed-up twice while detained, and for 12 months post incarceration. The moderating and mediating effects of motivation, anger, and self efficacy will also be examined. Eligibility:
Criminal Justice and Drug Abuse Treatment Studies-2 Principal Investigators: Dr. L.A.R. Stein & Dr. Peter Friedmann Funding Source: NIDA ($3,500,000) Terms: February, 2009 – March, 2014 (Study in Progress) Detailed Description:The Criminal Justice Drug Abuse Treatment Studies is a five‐year research cooperative funded by National Institute of Drug Abuse. The purpose of the CJDATS II is to conduct research studies on effective organizational and professional change strategies to implement evidence based approaches to treating drug abuse within criminal justice settings. The focus of the research to be conducted in CJDATS II is on organizational and personnel strategies that promote the adoption and utilization of innovative, evidence based approaches to the treatment and management of offenders. As such, the focus of this research is on the correctional organization and its employees, programs, and referral linkages rather than on the offenders. In contrast to clinical research that seeks to document the effects of treatment strategies on service recipients, the focus of the research in CJDATS II is upon effective program implementation strategies. The focus is on three primary areas: 1) substance abuse assessment and case planning, 2) medicated assisted approaches to opioid addiction, 3) continuity of care for HIV and AIDS infected offenders. Eligibility:
Contraceptive Awareness and Reproductive Education for Teens Principal Investigator: Dr. LAR Stein Team Members: (Study in Progress)
Detailed Description: Eligibility:
Enhancement and Screening for Youth Principal Investigator: Dr. LAR Stein Team Members: (Study in Progress)
Detailed Description: This proposal is in response to RFA-AA-12-008, Evaluation of NIAAA’s Alcohol Screening Guide for Children and Adolescents. Of particular interest to the agency are evaluation of the Screener in clinical and/or other settings to predict alcohol-related consequences including use disorder; its use as an initial screen for drug use, cigarette smoking, conduct disorder, and unprotected sex; and its performance in making predictions concurrently and prospectively. This proposal targets these areas of interest. In addition, we will study implementation of the Brief Intervention (BI) associated with the Screener. There is a great need for both screening and BI in juvenile probation settings as many of these youths have great need but are underserved. Many probation departments are turning to BI to work with probationers and parolees. Screening and BI has demonstrated efficacy in these settings, and yet no randomized control trials have been conducted to evaluate effectivess in juvenile probation settings. The long-term objective of this research is to enhance detection and service delivery to underserved youth. Probation Officers (POs; n=40) are randomized to Screener (S), Screener+BI (SBI), or coaching (CSBI). Youths (N=1000) are randomized to 1 of these 3 conditions, and all receive usual services (US). US consist of regular check-in with PO and access to referral services as needed (counseling, academic tutoring, etc.). Research staffers conduct in-depth assessment at baseline, 6- and 12-months. Sensitivity, specificity, and positive and negative predictive powers (SN, SP, PP, NP) are calculated to predict alcohol risk and consequences, as well as other risky behaviors concurrently and prospectively across age-groups. A 1-way design (S vs SBI vs CSBI) will be used to determine whether SBI and CSBI enhance youth services-use and reduce risks (e.g., alcohol use, risky sex). We examine moderators of outcomes (youth age, PO characteristics) and whether coaching (an important consideration in implementation science) in use of BI improves outcomes. This study will be the first randomized controlled trial evaluating the effectiveness of SBI in a juvenile probation setting. This study has significance in that juvenile probationers are at high risk for alcohol use and other problem behaviors; the justice setting offers a key opportunity to identify and access services for youths who are often otherwise undetected and underserved. Importantly, this trial would be the first in this setting to evaluate both the 2-question Screener and use of BI as presented in NIAAA's Practice Guide. It is crucial to evaluate the Guide in a variety of settings where youth at risk for alcohol problems may benefit from it. Eligibility:
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Project Teen C.A.R.E.
