A randomized trial of contingency management for adolescent marijuana abuse and dependence.
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.
Stanger
Catherine
C
University of Arkansas for Medical Sciences, Center for Addiction Research, 4301 West Markham St. #843, Little Rock, AR 72205, United States. cstanger@uams.edu
Budney
Alan J
AJ
Kamon
Jody L
JL
Thostensen
Jeff
J
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