Substance Use Prevention in Teen Psychiatric Patients

Study Overview
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Brief Summary
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The earlier a child initiates alcohol and other drug (AOD) use, the greater the risk of long-range problems. This association persists despite changes in national substance use rates over time, indicating its stability and viability as a target for prevention. At the same time, parent monitoring of youth behavior tends to decrease during the adolescent years, creating a source of risk for not only the early onset of AOD use but also escalation. Thus, programs are needed in parenting behaviors and family relationships that are protective in helping pre-adolescent youth to avoid initiation of AOD use and abuse. This is particularly true of children with psychiatric disorders who are at higher risk for developing AOD disorders than nonpsychiatrically disturbed children. The primary goal of this study is to test the effectiveness of a family-centered intervention to reduce the risk of AOD use among pre-adolescent children with a history of emotional/behavioral problems. In this application, the families of 80 youths aged 12-14 years, who have not yet begun AOD use but have been referred for mental health care due to psychiatric symptomatology, will be randomly assigned to receive either an individually tailored family program or standard care. The experimental intervention, which is based on the Family Check-Up model (Dishion & Kavanagh, 2003), provides a thorough assessment of family strengths and weaknesses as they relate to future risk for AOD use as well as emotional/behavioral problems, and utilizes principles of motivational interviewing to encourage families to change. Follow-up interviews will be conducted at 6 and 12 months after baseline to assess changes in parenting, AOD use, and other risky behaviors.

Detailed Description
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The earlier a child initiates alcohol and other drug (AOD) use, the greater the risk of long-range problems. This association persists despite changes in national substance use rates over time, indicating its stability and viability as a target for prevention. At the same time, parent monitoring of youth behavior tends to decrease during the adolescent years, creating a source of risk for not only the early onset of AOD use but also escalation. Thus, programs are needed in parenting behaviors and family relationships that are protective in helping pre-adolescent youth to avoid initiation of AOD use and abuse. This is particularly true of children with psychiatric disorders who are at higher risk for developing AOD disorders than nonpsychiatrically disturbed children. The primary goal of this study is to test the effectiveness of a family-centered intervention to reduce the risk of AOD use among pre-adolescent children with a history of emotional/behavioral problems. In this application, the families of 80 youths aged 12-14 years, who have not yet begun AOD use but have been referred for mental health care due to psychiatric symptomatology, will be randomly assigned to receive either an individually tailored family program or standard care. The experimental intervention, which is based on the Family Check-Up model (Dishion & Kavanagh, 2003), provides a thorough assessment of family strengths and weaknesses as they relate to future risk for AOD use as well as emotional/behavioral problems, and utilizes principles of motivational interviewing to encourage families to change. Follow-up interviews will be conducted at 6 and 12 months after baseline to assess changes in parenting, AOD use, and other risky behaviors.

Official Title
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Substance Abuse Prevention for Preadolescents With Psychiatric Disorders

Conditions
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Adolescent Substance Use

Intervention / Treatment
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* Behavioral: Family Check-up
* Behavioral: Parent psychoeducation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: the target child is between the ages of 12-14 years old at the start of the project and living at home with at least one parent/guardian the target child must be receiving services at a mental health clinic and must screen in with a t- score of 70 or above on one of the DSM-oriented scales (ADHD, ODD, CD, anxiety problems, and affective problems) on the Child Behavior Checklist (i.e. reach the clinical cut-off) the child must not report prior AOD use, and parental consent and child assent are obtained. Exclusion Criteria: the target child is actively psychotic, and the family is not able to speak and understand English or Spanish well enough to complete study procedures.

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Family Check-up<br>Two session motivational intervention to improve parent monitoring and communication with respect to adolescent risk behavior especially substance use | Behavioral: Family Check-up<br>* Two session motivational intervention to improve parent monitoring and communication with respect to adolescent risk behavior especially substance use<br>* Other names: Parent Motivational Interviewing;|
| Active Comparator: Psychoeducation<br>Two sessions of psychoeducation for parents regarding adolescent risk behaviors especially substance use | Behavioral: Parent psychoeducation<br>* Two sessions of psychoeducation for parents regarding adolescent risk behaviors. especially substance use<br>* Other names: Family psychoeducation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Parental monitoring/communication | Self-report and observational ratings of parent-child interactions with respect to limit setting, communication, and monitoring | 3 months | 
| Parental monitoring/communication | Self-report and observational ratings of parent-child interactions with respect to limit setting, communication, and monitoring | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| marijuana use | frequency and quantity of marijuana use in the prior 30 days | 3 months | 
| marijuana use | frequency and quantity of marijuana use in the prior 30 days | 6 months | 
| alcohol use | frequency and quantity of alcohol use in the prior 30 days | 3 months | 
| alcohol use | frequency and quantity of alcohol use in the prior 30 days | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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substance use, adolescents, initiation