title: A randomized trial of contingency management for adolescent marijuana abuse and dependence.
abstract: An initial efficacy test of an innovative behavioral outpatient treatment model for adolescents with problematic use of marijuana enrolled 69 adolescents, aged 14-18, and randomly assigned them to one of two treatment conditions. Both conditions received individualized Motivational Enhancement and Cognitive Behavioral Therapy (MET/CBT) and a twice-weekly drug-testing program. The experimental contingency management condition involved a clinic-delivered, abstinence-based incentive program, and weekly behavioral parent training sessions that included a parent-delivered, abstinence-based, substance monitoring contract. The comparison condition included an attendance-based incentive program, and weekly psychoeducational parent sessions. Follow-up assessments were performed at 3, 6, and 9 months post-treatment. The experimental condition showed greater marijuana abstinence during treatment, e.g., 7.6 vs. 5.1 continuous weeks and 50% vs. 18% achieved > or = 10 weeks of abstinence. Improvements were found in parenting and youth psychopathology across treatment conditions, and improvements in negative parenting uniquely predicted post-treatment abstinence. The outcomes observed in the experimental condition are consistent with adult substance-dependence treatment literature, and suggest that integrating CM abstinence-based approaches with other empirically based outpatient interventions provides an alternative and efficacious treatment model for adolescent substance abuse/dependence. Replication and continued development of more potent interventions remain needed to further advance the development of effective substance abuse treatments for adolescents.
authors.affiliation: University of Arkansas for Medical Sciences, Center for Addiction Research, 4301 West Markham St. #843, Little Rock, AR 72205, United States. cstanger@uams.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Stanger
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Budney
authors.forename: Jody L
authors.initials: JL
authors.lastname: Kamon
authors.forename: Jeff
authors.initials: J
authors.lastname: Thostensen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D016739:Behavior, Addictive / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000628:therapy*; D010349:Patient Compliance; D016896:Treatment Outcome