Mary Clair

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.

A Web-Based Study of Gamma Hydroxybutyrate (GHB): Patterns, Experiences, and Functions of Use

GHB (gamma hydroxybutyrate) was developed as a general anesthetic. Due to dosing difficulty and side effects, regular use was discontinued. Medical uses include treating sleep and alcohol disorders. In the 1990s, it was promoted as a supplement and taken to improve mood and sex. GHB and its analogs (gamma butyrolactone and butanediol) were widely available until federal regulations were put into effect with mounting evidence of adverse events. This survey (N = 61) study was conducted to assess patterns, experiences, and functions of use. Much of what is understood regarding GHB treatment is based on hospital case studies for overdose and withdrawal. Not enough is known about prevention, reducing use and associated problems, or relapse. We know little about specific drug effect expectancies, triggers, coping skills, and consequences of use (positive/negative). While the drug treatment literature has a wealth of information to draw upon, GHB-specific information may greatly assist relapse prevention. 

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.

Preliminary Web-Based Measures Development for GHB: Expectancies, Functions, and Withdrawal

Background: Much of what is understood regarding gamma hydroxybutyrate (GHB) treatment is based on hospital case studies for overdose and withdrawal, and there are currently no measures developed specifically for GHB or its analogs (e.g., gamma butyrolactone and 1,4-butanediol) to assess drug effect expectancies, reasons for starting use, withdrawal effects, and knowledge and opinions about use. Objectives: This pilot study (N = 61) was conducted to begin measures development to assess experiences, functions of use, and opinions regarding use as indicated by respondents taking a Web-based survey. Methods: Minimum average partial correlation and parallel analysis procedures are employed to create scales. Results: Scales were developed to assess expectancies, reasons for use, withdrawal, and knowledge/opinions of use with median α = .79 and that account for 8.69–24.17% of the variance. Conclusion: Scales have relatively good psychometric properties and replication is needed. Scientific Significance: GHB-specific measures may greatly assist in furthering our understanding of protective and risk factors for use, and withdrawal phenomena.

Gender, ethnicity and race in incarcerated and detained youth: services and policy implications for girls.

OBJECTIVE While work has been conducted on gender differences to inform gender-specific programming, relatively little work has been done regarding racial and ethnic differences among incarcerated and detained girls in particular. This is an important gap, considering gender, race, and ethnicity may be important factors in responding to the needs of incarcerated and detained girls within the Risk-Needs-Responsivity (RNR) model. We hypothesize girls will show relatively more pathology than boys, and that White girls will show relatively more pathology as compared to girls of other groups. Implications of findings for services delivery and policy are presented. METHOD Data were collected on N = 657 youth using structured interview and record review. Analyses included χ2 and t tests. RESULTS As compared to boys, girls were older at first arrest yet younger during most lock-up, received poorer grades, experienced more family difficulty, and more were lesbian/bisexual. As compared to minority girls, White girls began hard drugs at a younger age, had more conduct disorder symptoms, and more frequently experienced parental difficulty and abuse. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Age-appropriate programming that addresses family difficulty and sexuality is needed for girls. As compared to White girls, reentry planning may more readily rely on family support for minority girls. Systems should consider use of actuarial methods in order to reduce bias in making placement decisions. (PsycINFO Database Record

Adolescent Substance Treatment Engagement Questionnaire for Incarcerated Teens

BACKGROUND Treatment engagement is often measured in terms of treatment retention and drop out, resource utilization, and missed appointments. Since persons may regularly attend treatment sessions but not pay close attention, actively participate, or comply with the program, attendance may not reflect the level of effort put into treatment. Teens in correctional settings may feel coerced to attend treatment, making it necessary to develop measures of treatment involvement beyond attendance. This study describes the development and validation of the Adolescent Substance Treatment Engagement Questionnaire (ASTEQ), Teen and Counselor versions. METHODS The psychometric properties of the ASTEQ were examined in a sample of incarcerated teens (N = 205) and their counselors. Principal component analysis was conducted on teen and counselor versions of the questionnaire. RESULTS Scales of positive and negative treatment engagement were found, reflecting both overt behaviors (joking around, talking to others) and attitudes (interest in change). Significant correlations with constructs related to treatment attitudes and behaviors, and misbehaviors (including substance use) demonstrate good concurrent and predictive validity. Teen and counselor ratings of engagement produced validity correlations in the medium effect size range. CONCLUSIONS These measures comprise a valid and reliable method for measuring treatment engagement for incarcerated teens.

Facilitating Grant Proposal Writing in Health Behaviors for University Faculty A Descriptive Study

Grant proposal writing in the behavioral sciences is important for fiscal reasons and scientific reasons at many universities. This report describes a grant proposal–writing seminar series provided to University faculty (N = 20) and explores factors facilitating and impeding writing. Summary statistics are provided for quantitative data. Free responses were sorted by independent raters into meaningful categories. As a consequence of the training, 45% planned to submit within 18 months; 80% of grant proposals targeted NIH. At 1-year follow-up, 40% actually submitted grants. Factors impeding grant proposal writing included competing professional demands; factors facilitating writing included regularly scheduled feedback on written proposal sections and access to expert collaborators. Obtaining grants generates financial resources, facilitates training experiences, and vastly contributes to the growth and dissemination of the knowledge base in an area.

Measuring Behaviors of Individual Adolescents During Group-Based Substance Abuse Intervention

BACKGROUND Group treatment is delivered in youth correctional facilities, yet groups may be iatrogenic. Few measures with demonstrated psychometric properties exist to track behaviors of individuals during groups. The authors assessed psychometrics for the Group Process-Individual Level measure (GP-IL) of group treatment. METHODS N = 152 teens were randomized to 1 of 2 groups (10 sessions each). Adolescents, counselors, and observers rated teen behaviors at sessions 3 and 10. GP-IL assesses reinforcement for deviancy and positive behaviors, member rejection, and counselor connection and praise. RESULTS Internal consistency and 1-month stability were demonstrated. Concurrent validity is supported by correlations with measures expected to be associated with group behavior (e.g., coping skills). Counselors and observers rated more deviancy during interactive skills-building groups versus didactic psychoeducational groups (P ≤ .005). Scales evidenced incremental validity. CONCLUSIONS GP-IL offers a sound method of tracking adolescent behaviors for professionals working with groups. Counselors ratings were most reliable and valid overall.