Rebecca Lebeau-Craven

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.

Predictors of motivation to change after medical treatment for drinking-related events in adolescents.

Characteristics associated with intention to change drinking were examined in 254 adolescents treated in an emergency department for alcohol. Younger age, living at home, lower baseline level of drinking and drinking problems, greater depression, having penalties for breaking family drinking rules, higher injury severity, being frightened, and being admitted to the hospital predicted greater intention to change drinking at the time of the event. Baseline characteristics related to being in the action stage of change 3 months later were younger age; lower drinking; having penalties for breaking family drinking rules; injury severity; and number of anticipated consequences, including being in trouble with parents. This study has implications for brief interventions that capitalize on potential teachable moments with problem-drinking adolescents.

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.

Prevalence of alcohol and drug use in an adolescent training facility

This study investigates substance use and crimes among incarcerated adolescents. Chart reviews were conducted between 1997–2000 with 186 adolescent, male offenders, including information on demographics, substance use, and crimes. Results indicate that use of alcohol (88.7%) and marijuana (95.7%) was highly prevalent. The most widely committed crimes included possession of a controlled substance (31.8%), receiving stolen goods (17.8%), and violation of probation (17.2%). Significant differences were observed across racial/ethnic groups; White nonHispanic adolescents were more likely to use cocaine, hallucinogens, and heroin than adolescents of other races. Future research examining relationships between criminal behavior, substance use, and cultural variations in use patterns and delinquency will allow more relevant intervention and prevention strategies in this population.

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 and Relapse Prevention for DWI: A Pilot Study

Driving while impaired is a serious national health problem, and there is a need to develop effective treatments for persons arrested for Driving While Intoxicated (DWI). Motivation for changing substance use behaviors may be critical for avoiding further infractions. Once motivated, the client may more readily develop skills that enhance efficacy to cope with situations leading to DWI. Motivational Interviewing (MI; Miller & Rollnick, 1991) was delivered to DWI-involved clients to enhance motivation to change. It was followed by Relapse Prevention (RP; Marlatt & Gordon, 1985) to develop coping skills. Clients rated MI/RP more favorably than standard care, evidenced improved coping skills, and showed general improvement at the end of the four-week treatment. This pilot study (N = 25) indicates that more well controlled clinical trials are warranted to study the effectiveness of MI/RP in treating persons engaged in DWI

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.

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.