title: The impact of therapists' words on the adolescent brain: In the context of addiction treatment.
abstract: At this time, we still do not know how therapist behaviors influence adolescent brain response and related treatment outcomes. Therefore, we examined this question with 17 binge drinking youth (mean age=16.62 years; 64.3% female; 42.9% Hispanic; 28.6% bi-/multi-racial). In this within-subjects design, all youth completed a baseline assessment, two therapy sessions, an fMRI scan, and were re-evaluated for behavior change at one-month post-treatment. During the fMRI session, youth were presented with two types of responses from their treating therapist: higher-skill statements prescribed in an empirically-supported addiction treatment (complex reflections) vs. language standard within addiction treatment more broadly (closed questions). In terms of behavior change, at the one-month follow-up, youth showed significant reductions in number of drinking days and binge drinking days. Further, we found main effects for complex reflections and closed questions across the superior middle temporal gyrus and middle temporal gyrus (FWE-corrected, p<.05). Greater brain response was observed for complex reflections versus closed questions within the bilateral anterior cingulate gyrus. Greater BOLD response in the parietal lobe during closed questions was significantly associated with less post-treatment drinking. Lower BOLD response during complex reflections and closed questions in the precuneus were associated with greater post-treatment ratings of importance of changing. This study represents a first step in understanding how therapist behaviors influence the developing adolescent brain and how that neural response may be associated with youth treatment outcomes.
authors.affiliation: Oregon Health & Science University, Department of Psychiatry, 3314 SW US Veteran's Hospital Road, M/C DC7P, Portland, OR 97239, USA. Electronic address: feldstei@ohsu.edu.
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Feldstein Ewing
authors.affiliation: University of New Mexico Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions (UNM CASAA), 2650 Yale Blvd SE, MSC11 6280, Albuquerque, NM 87106, USA. Electronic address: jhouck@unm.edu.
authors.forename: Jon M
authors.initials: JM
authors.lastname: Houck
authors.affiliation: Advance MRI LLC, 8700 Stonebrook Parkway, #105, Frisco, TX 75034, USA. Electronic address: uma.yezhuvath@advancemri.com.
authors.forename: Uma
authors.initials: U
authors.lastname: Yezhuvath
authors.affiliation: Advance MRI LLC, 8700 Stonebrook Parkway, #105, Frisco, TX 75034, USA. Electronic address: eshoko@gmail.com.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Shokri-Kojori
authors.affiliation: University of New Mexico Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions (UNM CASAA), 2650 Yale Blvd SE, MSC11 6280, Albuquerque, NM 87106, USA. Electronic address: dtruitt@mrn.org.
authors.forename: Dustin
authors.initials: D
authors.lastname: Truitt
authors.affiliation: Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX 75235, USA. Electronic address: francesca.filbey@utdallas.edu.
authors.forename: Francesca M
authors.initials: FM
authors.lastname: Filbey
mesh_terms: D000293:Adolescent; D063425:Binge Drinking / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D011613:Psychotherapy / Q000379:methods*; D013067:Speech Perception / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Adolescent; Alcohol; Motivational interviewing; Therapist; fMRI