Family Based Contingency Management for Adolescent Alcohol Abuse
Condition: Alcohol Abuse
MeSH terms: Alcoholism
Study type: Interventional

Summary: 
      The goal is to adapt the family-based CM treatment to target primary adolescent alcohol abuse
      and dependence.

      Specific Aim 1 is to provide a preliminary demonstration of the efficacy of a family-based CM
      intervention to treat adolescent alcohol abuse and dependence. CM components include:

        1. an incentive program to enhance the adolescent's engagement in the treatment process and
           engender alcohol abstinence by providing positive reinforcement for documented
           abstinence via breathalyzers administered by parents regularly at home, self and parent
           report, and clinic-based urine drug testing; and

        2. a parent management training program to enhance and maintain the positive effects of the
           incentive program by teaching parents how to effectively use contingency management in
           the home environment to motivate their adolescent to achieve abstinence and improve
           their behavior in other domains.

      A randomized trial will determine whether the CM intervention enhances outcomes when added to
      a standard individual cognitive behavioral therapy (CBT).

      Specific Aim 2 is to determine whether and how treatment interventions modify parental and
      adolescent risk and protective factors using observational and laboratory measures (parenting
      practices, family functioning, risk taking, delay discounting, and child and parent
      psychopathology) and to determine whether these factors are associated with outcomes over
      time.

      Specific Aim 3 is to test gene x environment (treatment) interactions in adolescent substance
      abuse. Findings will extend the scientific evidence for CM and support the ability of parents
      to implement CM at home. Findings that support the CM model's efficacy will make a
      significant contribution to research on the treatment of adolescent alcohol abuse, which has
      lagged behind research on adult substance abuse and on adolescent illicit drug use.
    

Detailed description: 
      Approximately 1.5 million youth ages 12-17 (representing 6.1% of all youth in that age range)
      are in need of treatment for alcohol abuse, yet only 7.2% of those in need of treatment
      received it. Importantly, most youth (90.5%) who were classified as needing treatment based
      on their self report of Adolescent Alcohol Study Plan; v.2; 3/30/12Page 2 of 35 symptoms,
      perceived no need for treatment. Thus, there is a need to develop treatments that target
      populations of alcohol abusing youth who are not highly motivated to change their substance
      use. New outpatient family based and contingency management interventions for adolescent
      marijuana abuse have been developed, yet none of these interventions has specifically
      targeted adolescent alcohol use. It is important to target primary alcohol abuse and
      dependence in adolescence as approximately 20% of treatment-seeking youth report primary
      problems with alcohol. The primary aim of this proposal is to adapt our family-based
      contingency-management treatment to target adolescent alcohol abuse and dependence. This
      project will develop, manualize, and pilot a contingency management intervention that
      includes two components. First, an incentive program will enhance the adolescent's engagement
      in the treatment process and engender alcohol abstinence by providing positive reinforcement
      for documented abstinence via breathalyzers administered by parents regularly at home, self
      and parent report, and clinic based urine drug testing. Second, a parent management training
      program will enhance and maintain the positive effects of the incentive program by teaching
      parents how to effectively use contingency management in the home environment to motivate
      their adolescent to achieve abstinence and improve their behavior in other domains.
    

Intervention name(s): Motivational Enhancement Therapy (MET)/CBT+CM; Motivational Enhancement Therapy (MET)/CBT
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Behavioral Treatment; Behavioral Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment