Skills and Motivation at the Rhode Island Training School (Project SMART) - 1
Condition: Alcoholic, Marijuana Misuse
MeSH terms: Marijuana Abuse
Study type: Interventional
Phase: Phase 2

Summary: 
      This study will focus on treating substance abusing incarcerated teens using individually
      administered Motivational Interviewing (MI) followed by group Cognitive Behavior Therapy
      (CBT). The control group receives individualized Relaxation Training (RT) followed by group
      Treatment as Usual (TU). 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.).
    

Detailed description: 
      This proposal is in response to RFA-DA-04-008, Group Treatment for Individuals in Drug Abuse
      or Alcoholism Treatment. Of particular interest to the agencies are group therapies for
      Conduct Disordered adolescents, reducing the spread of infectious disease, and mechanisms of
      action. This proposal targets these areas of interest. This study will focus on treating
      substance abusing incarcerated teens using 2 individually administered Motivational
      Interviewing (MI) sessions followed by 10 group sessions of Cognitive Behavior Therapy (CBT).
      MI is conceptualized as preparation for group CBT. The control group receives individualized
      Relaxation Training (RT) followed by group Treatment as Usual (TU). Currently, there is
      little research regarding effective group treatments for incarcerated teens and this study
      will address this gap in our knowledge base.

      In this proposed randomized trial, a one-way design (MI/CBT vs. RT/TU) 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/TU 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/TU, 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.
    

Intervention name(s): MI/CBT; RT/TU
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment
Keywords: substance abuse