Charles Golembeske

Enhancing Substance Abuse Treatment Engagement in Incarcerated Adolescents.

The purpose of this study was to determine whether motivational interviewing (MI), compared with an attention control condition (relaxation training [RT]) enhances substance abuse treatment engagement in incarcerated adolescents. At the start of incarceration, adolescents were randomly assigned to individually administered MI or RT. Subsequently, therapists and adolescents (N = 130) rated degree of adolescent participation in the facilitys standard care group-based treatments targeting crime and substance use. All adolescents received the facility standard care treatment after their individual MI or RT session. MI statistically significantly mitigated negative substance abuse treatment engagement. Other indicators of treatment engagement were in the expected direction; however, effect sizes were small and nonsignificant. These findings are significant, given concerns regarding the deleterious effects of treating delinquent adolescents in groups and the potential for adolescents to reinforce each others negative behavior, which in turn may lead to escalated substance use and other delinquent behaviors after release.

Effects of Motivational Interviewing for Incarcerated Adolescents on Driving Under the Influence after Release

Motivational Interviewing (MI) to reduce alcohol and marijuana-related driving events among incarcerated adolescents was evaluated. Adolescents were randomly assigned to receive MI or Relaxation Training. Follow-up assessment showed that, as compared to RT, adolescents who received MI had lower rates of drinking and driving, and being a passenger in a car with someone who had been drinking. Effects were moderated by levels of depression. At low levels of depression, MI evidenced lower rates of these behaviors; at high levels of depression, effects for MI and RT were equivalent. Similar patterns were found for marijuana-related risky driving, but effects were non-significant.

Randomized Clinical Trial of Motivational Enhancement of Substance Use Treatment Among Incarcerated Adolescents: Post-Release Condom Non-Use

ABSTRACT Evaluated impact of motivational enhancement (ME) of substance abuse treatment compared to relaxation training (RT) on sex without condoms (overall and involving substance use) 3 months following release among incarcerated adolescents. This randomized clinical trial involved 114 incarcerated adolescents from the Northeast. Regression analyses determined if treatment condition, baseline levels of depressive symptoms, and their interaction predicted condom non-use 3 months post-release, controlling for baseline condom non-use. Among those who reported fewer baseline depressive symptoms, those in ME condition reported significantly less condom non-use, in general and involving marijuana use compared with those in RT condition. Periods of incarceration represent opportunities to help juvenile detainees reduce behaviors that impact their health and the health of those with whom they interact in the Community.

Co-Occurring Sexual Risk and Substance Use Behaviors Among Incarcerated Adolescents

Incarcerated adolescents report greater sexual risk than do nonincarcerated peers. High-risk sexual behavior is associated with substance use. To determine how much sexual risk is combined with substance use, 167 incarcerated adolescents reported on their sexual risk behavior in the year before incarceration that involved alcohol or marijuana. For each risk behavior, marijuana use was more likely than was alcohol use. Marijuana use was more common for higher risk behaviors than for lower risk behaviors. Periods of incarceration provide opportunities for intervening on HIV-relevant risk behaviors among adolescents. The context of substance use within high-risk sexual situations ought to be a focus of interventions for incarcerated adolescents.

Motivational interviewing to reduce substance-related consequences: Effects for incarcerated adolescents with depressed mood

BACKGROUND The impact of depressed mood on Motivational Interviewing (MI) to reduce risky behaviors and consequences in incarcerated adolescents was examined in this brief report. METHODS Adolescents (N=189) were randomly assigned to receive MI or Relaxation Training (RT). RESULTS At 3-month follow-up assessment, MI significantly reduced risks associated with marijuana use, with a trend towards reducing risks associated with alcohol use. There was also a trend for depressive symptoms to be associated with reduced risks after release. Interaction effects were non-significant, indicating no moderating effects for depressed mood on treatment outcome. CONCLUSIONS MI may be a useful treatment for incarcerated adolescents in order to reduce risks and consequences associated with substance use after release.

Ethnicity as a moderator of motivational interviewing for incarcerated adolescents after release

Motivational interviewing (MI) has been found to be an effective treatment for substance using populations, including incarcerated adolescents. Although some studies suggest MI is more successful with individuals from minority backgrounds, the research remains mixed. The current study investigated the impact of ethnicity on treatment in reducing alcohol and marijuana use among incarcerated adolescents. Adolescents (14-19 years of age) were recruited from a state juvenile correctional facility and randomly assigned to receive MI or relaxation therapy (RT) (N=147; 48 White, 51 Hispanic, and 48 African American; 126 male; 21 female). Interviews were conducted at admission to the facility and 3 months after release. Results suggest that the effects of MI on treatment outcomes are moderated by ethnicity. Hispanic adolescents who received MI significantly decreased total number of drinks on heavy drinking days (NDHD) and percentage of heavy drinking days (PHDD) as compared to Hispanic adolescents who received RT. These findings suggest that MI is an efficacious treatment for an ethnic minority juvenile justice-involved population in need of evidence-based treatments.

Validity and Reliability of the Alcohol Expectancy Questionnaire-Adolescent, Brief.

ABSTRACT The purpose of this study was to evaluate a brief version of the Alcohol Expectancy Questionnaire-Adolescent (AEQ-A; Brown, Christiansen, & Goldman, 1987). The original AEQ-A was reduced to seven items (called the AEQ-AB). Principal Components Analysis (PCA) was performed and two factors emerged (General Positive Effects and Potential Negative Effects) accounting for 46% of the variance. Internal consistencies are comparable to those of the original AEQ-A (0.50). Scales correlate with criterion variables such as average drinks per week and average number of drinks per heavy drinking day (p < 0.05). It is concluded that this questionnaire may be useful to clinicians providing brief assessment and intervention. Cross-validation in other samples and other settings is recommended.

Validation of the Marijuana Effect Expectancy Questionnaire-Brief

ABSTRACT The purpose of this study was to evaluate a brief version of the Marijuana Effect Expectancy Questionnaire (MEEQ; Schafer & Brown, 1991). The original MEEQ was reduced to 6 items (MEEQ-B). Principal component analysis (PCA) was performed and two factors were identified (positive effects and negative effects) accounting for 52.3% of the variance. Internal consistencies (0.42 to 0.60) were slightly lower than those of the original MEEQ. The negative effect expectancy scale correlated with criterion variables that assess marijuana use (p ≤ .05). This measure is a helpful tool for clinicians to use when assessing youth expectancies. Replication across different samples of adjudicated youth is recommended.

Use of the Adolescent SASSI in a Juvenile Correctional Setting

The Substance Abuse Subtle Screening Inventory-Adolescent (SASSI-A) is used in evaluation and treatment planning for incarcerated juveniles. Validity of the SASSI-A in a juvenile correctional facility was examined using archival data. Findings generally support the validity of SASSI-A substance use scales. However, there is concern regarding the potential for ethnic bias in this setting. Cut-scores suggest that the SASSI-A may best be used for detecting problematic alcohol consumption using the Face Valid Alcohol Scale 3. Future studies should more closely investigate whether the three underlying dimensions of the SASSI-A are useful in treatment planning. Results are presented in light of the relatively new SASSI-A2.

Validation of a measure to assess alcohol- and marijuana-related risks and consequences among incarcerated adolescents

Few measures exist to assess risky behaviors and consequences as they relate to substance use in juvenile delinquents. This study sought to validate such a measure on a racially and ethnically diverse sample (N=175). Results indicate that alcohol-related risky behaviors and consequences comprise a single scale as do marijuana-related risky behaviors and consequences. Furthermore, results suggest that the retention of common items for both scales produces reliable and valid scales and maintains parsimony. Internal consistencies were more than adequate (0.72-0.83) and test-retest stabilities, even across several months were acceptable (0.52-0.50). The scales evidenced a high degree of concurrent and predictive incremental validity in predicting conduct disorder, dependence symptoms, and consumption patterns. Researchers can use these scales to measure a generalized construct tapping risks and consequences as related to alcohol and marijuana use. Ease of use may make these scales appealing to clinicians who can provide feedback to clients regarding risky behaviors involving alcohol and marijuana.