title: Multidimensional family therapy lowers the rate of cannabis dependence in adolescents: a randomised controlled trial in Western European outpatient settings.
abstract: BACKGROUND
  Noticing a lack of evidence-based programmes for treating adolescents heavily using cannabis in Europe, government representatives from Belgium, France, Germany, The Netherlands, and Switzerland decided to have U.S.-developed multidimensional family therapy (MDFT) tested in their countries in a trans-national trial, called the International Need for Cannabis Treatment (INCANT) study.
  
  
  METHODS
  INCANT was a 2 (treatment condition)×5 (time) repeated measures intent-to-treat randomised effectiveness trial comparing MDFT to Individual Psychotherapy (IP). Data were gathered at baseline and 3, 6, 9 and 12 months thereafter. Study participants were recruited at outpatient secondary level addiction, youth, and forensic care clinics in Brussels, Berlin, Paris, The Hague, and Geneva. Participants were adolescents from 13 through 18 years of age with a recent cannabis use disorder. 85% were boys; 40% were of foreign descent. One-third had been arrested for a criminal offence in the past 3 months. Three primary outcomes were assessed: (1) treatment retention, (2) prevalence of cannabis use disorder and (3) 90-day frequency of cannabis consumption.
  
  
  RESULTS
  Positive outcomes were found in both the MDFT and IP conditions. MDFT outperformed IP on the measures of treatment retention (p<0.001) and prevalence of cannabis dependence (p=0.015). MDFT reduced the number of cannabis consumption days more than IP in a subgroup of adolescents reporting more frequent cannabis use (p=0.002).
  
  
  CONCLUSIONS
  Cannabis use disorder was responsive to treatment. MDFT exceeded IP in decreasing the prevalence of cannabis dependence. MDFT is applicable in Western European outpatient settings, and may show moderately greater benefits than IP in youth with more severe substance use.
authors.affiliation: Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands. rigter.h@kpnmail.nl
authors.forename: Henk
authors.initials: H
authors.lastname: Rigter
authors.forename: Craig E
authors.initials: CE
authors.lastname: Henderson
authors.forename: Isidore
authors.initials: I
authors.lastname: Pelc
authors.forename: Peter
authors.initials: P
authors.lastname: Tossmann
authors.forename: Olivier
authors.initials: O
authors.lastname: Phan
authors.forename: Vincent
authors.initials: V
authors.lastname: Hendriks
authors.forename: Michael
authors.initials: M
authors.lastname: Schaub
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Rowe
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000379:methods* / Q000639:trends; D005060:Europe / Q000453:epidemiology; D005196:Family Therapy / Q000379:methods* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D010865:Pilot Projects; D016320:Substance Abuse Treatment Centers / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome