RANDOMIZED TREATMENT STUDY

A Randomized treatment study comparing the clinical effectiveness of Motivational Enhancement Therapy/Cognitive Behavioral Therapy intervention and Adolescent Community Reinforcement Approach in an outpatient setting

Talia M. Drummond

Capella University

Chapter 1: Introduction/Statement of the Problem

Cannabis (including hashish, marijuana, blunts, and other forms of tetrahydrocannabinol) is the most prevalent psychoactive substance used by adolescents in the U.S. Cannabis is the leading substance identified during adolescent treatment admissions. In addition, it is the leading substance found during drug screens following adolescent arrests, emergency room admissions and autopsies. There has been an increasing interest in developing effective outpatient treatments for adolescents with cannabis use disorders. The literature on the medical, social, and psychological consequences on cannabis abuse continues to increase (Fothergill & Ensminger, 2006).

During the past 10-12 years, there have been numerous randomized and quasi-experimental field studies conducted to evaluate a variety of outpatient treatment approaches for adolescents with alcohol or other drug use problems. The treatment approaches have included: cognitive behavior therapy alone and in combination with a motivational interviewing approach; family education and therapy approaches; group psychoeducational approaches; individual behavior therapy approaches, and 12-step based programs. These studies suggest that there may be a variety of effective types of treatment for this population (Substance Abuse and Mental Health Services, 2007).

As a Clinical doctoral learner, the researchers conduct a comparison study on two adolescent treatment approaches for cannabis use that are utilized in outpatient treatment settings. The purpose of the study will identify any differences in treatment models in terms of their effectiveness during and after treatment in terms of marijuana use, alcohol use, behavior/cognitive problems, school problems and illegal activity. A non-treatment control group can provide additional evidence about the efficacy; nevertheless it would be unethical based on previous research that demonstrated the lack of improvement in untreated samples. Code 8.04a Client/Patient, Student, and subordinates Research Participants in the 2002 APA code of ethics states, “when psychologist conduct research with clients/patients, students, or subordinates as participants, psychologist take steps to protect the prospective participants from adverse consequences of declining or withdrawing from participation (p.11).”

Background

Throughout the 1990s, substance use among adolescents increased nationwide while the age of initiation decreased, putting more youth at risk of developing long-term substance abuse and dependence. There are indications that the rates of substance use have declined, however they remain high. In 2007, the National Household Survey of Drug Use and Health (NSDUH) found that 16.5% of 12 to 17-year-old youth were current alcohol users and 9.9% reported use of marijuana, the most commonly used illicit drug. The survey also revealed that 8% of the youth ages 12 to 17 met criteria for substance abuse or dependence. However, less than one in ten (8.6%) identified with abuse or dependence had received substance abuse treatment at a facility, indicating a large gap between treatment need and service use (SAMHSA, 2007). Substance Abuse and Mental Health Services Administration (SAMHSA, 2007) reported that adolescents living in the Northeast and in socioeconomically disadvantaged urban centers are at particularly high risk for ...