Behavioral Treatment of Adolescent Substance Use

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

59 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-11-30

Study Completion Date

2018-08-14

Brief Summary

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This study will continue research designed to improve treatment outcomes for adolescent substance use disorders by integrating neuroscience- and behaviorally-based treatments. In particular, this project will be the first to evaluate whether Working Memory Training can enhance cognitive function and reduce impulsive decision making to improve abstinence outcomes. In addition, an adaptive abstinence-based incentive program will be evaluated as a new method for intervening with those who do not respond to their first-line treatment.

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Detailed Description

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The study will test two novel strategies to enhance outcomes. Working Memory Training (WMT), an efficacious method for strengthening specific cognitive processes, aims to improve factors (e.g., delay discounting / impulsive decision-making) that have shown a strong relation to substance use and treatment response. Second, more intensive and higher magnitude CM (ICM) will be used to motivate abstinence among teens who are not abstinent by Week 4. The investigators hypothesize that these strategies will improve outcomes by modifying a fundamental cognitive system involved in making choices to engage in risky behavior and by increasing motivation to abstain in early nonresponders. Aim 1 will pilot and refine the new procedures in a community clinic in preparation for the randomized trial. A sequential, multiple assignment randomized trial (SMART) will allow the study to determine the most effective first-line treatment and the most effective adaptive strategy (Aim 2). All teens will begin treatment with CM or CM/WMT. After 4 weeks, responders will continue in their first-line treatments, while nonresponders will be randomized to ICM or to continue with first-line treatment. Aim 3 will conduct mechanistic analyses to assess whether cognitive changes related to WMT engender increased abstinence, and whether specific tailoring variables moderate treatment effects. Aim 4 will gather formative data on implementation factors to inform future large-scale studies and dissemination efforts. Primary hypotheses are: (1) first-line treatment with WMT will improve abstinence outcomes and reduce relapse; (2) strategies with ICM for nonresponders will result in better outcomes than those without; (3) WMT will reduce delay discounting, which will predict outcome. The unique approach holds promise for reducing multiple types of risky behaviors by affecting basic mechanisms that determine impulsive decision-making.

Conditions

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Substance Use Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intensive Outpatient Treatment (IOP) + Contingency Management (CM) + Working Memory Training (WMT)

IOP + CM + WMT

Group Type EXPERIMENTAL

Intensive Outpatient Treatment (IOP) + Contingency Management (CM)

Intervention Type BEHAVIORAL

Multiple group sessions weekly, one individual counseling session weekly with teen to review and discuss contingency management abstinence-based incentives

Working Memory Training

Intervention Type BEHAVIORAL

25 computer-delivered sessions of neurocognitive training

IOP + CM

Group Type ACTIVE_COMPARATOR

Intensive Outpatient Treatment (IOP) + Contingency Management (CM)

Intervention Type BEHAVIORAL

Multiple group sessions weekly, one individual counseling session weekly with teen to review and discuss contingency management abstinence-based incentives

Interventions

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Intensive Outpatient Treatment (IOP) + Contingency Management (CM)

Multiple group sessions weekly, one individual counseling session weekly with teen to review and discuss contingency management abstinence-based incentives

Intervention Type BEHAVIORAL

Working Memory Training

25 computer-delivered sessions of neurocognitive training

Intervention Type BEHAVIORAL

Other Intervention Names

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Cogmed, Inc

Eligibility Criteria

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Inclusion Criteria

Participants must be 12 to 26 years of age, must live at home with the parent who will participate, report using marijuana during the previous 30 days or provide a marijuana-positive urine test, meet criteria for cannabis abuse or dependence, and have a parent who can participate.

Minimum Eligible Age

12 Years

Maximum Eligible Age

26 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No