The goal of this study is to assess the efficacy of a new intervention based on motivation
enhancement therapy among adolescents with a history of substance use.
In many parts of the U.S., adolescent substance abuse treatment is scarce. Several studies
have shown that brief interventions increase the likelihood of patients' completion of
referrals to alcohol counseling or treatment. Other studies have shown a direct effect of
brief interventions on patients' alcohol consumption. Although brief interventions have been
widely recommended for adolescents, fewer studies have been conducted in this age group. If
the current study confirms the effectiveness of the Motivational Enhancement Therapy
approach, this will add another outpatient treatment option for adolescent patients with
The specific aims of this study are to:
1. Test the effect of the brief intervention on drug use. We hypothesize that, among 12-18
year old medical patients who use drugs, the experimental intervention administered by
a trained clinician will be at least 25% more effective than "standard care"
(assessment/referral only) in decreasing drug use as measured by a 90-day Timeline
Followback (TLFB) calendar.
2. Test the effect of the brief intervention in increasing engagement in substance abuse
treatment. We hypothesize that, among 12-18 year old patients who are referred to drug
counseling or other treatments, the experimental intervention administered by a trained
clinician will result in at least 25% more patients entering treatment compared to
standard care, as measured by the numbers of patients who complete referrals to
3. Test the effect of the intervention on other substance-related outcomes. We hypothesize
that the intervention will result in similar reductions in alcohol use, as measured by
the TLFB, and in driving/riding while impaired (DRWI) risks as measured by the score of
a 4-item self-reported scale. Other outcomes of interest include readiness to change,
school performance, and experience of other harmful consequences of substance use and
associated risk behaviors.
4. Identify factors that moderate and/or mediate the effect of the experimental
intervention on our outcomes of interest (drug use, engagement in treatment), and
estimate their effect sizes. Identifying moderating variables will help us to identify
subgroups of optimal responders to the brief intervention. Based on our previous
experience, we theorize that girls may respond more strongly to the intervention than
boys, and that those who participate in other treatments (outpatient counseling) and/or
a laboratory drug testing program will also have greater response.
- 12-21 years old
- CRAFFT score of 1 or more
- Have used alcohol, cannabis or another substance 2 or more times in the past month or
6 or more times in the past 3 months
- Can read and understand English
- Requires immediate hospitalization
- Will not be available to complete the study visits over the next 9 months