title: Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment.
abstract: Adolescents with mental health conditions represent a high-risk group for substance use, deliberate self-harm (DSH), and risky sexual behavior. Mental health treatment does not uniformly decrease these risks. Effective prevention efforts are needed to offset the developmental trajectory from mental health problems to these behaviors. This study tested an adjunctive cognitive-behavioral family-based alcohol, DSH, and HIV prevention program (ASH-P) for adolescents in mental healthcare. A two group randomized design was used to compare ASH-P to an assessment only control (AO-C). Participants included 81 adolescents and a parent. Assessments were completed at pre-intervention as well as 1, 6, and 12-months post-enrollment, and included measures of family-based mechanisms and high-risk behaviors. ASH-P relative to AO-C was associated with greater improvements in most family process variables (perceptions of communication and parental disapproval of alcohol use and sexual behavior) as well as less DSH and greater refusal of sex to avoid a sexually transmitted infection. It also had a moderate (but non-significant) effect on odds of binge drinking. No differences were found in suicidal ideation, alcohol use, or sexual intercourse. ASH-P showed initial promise in preventing multiple high-risk behaviors. Further testing of prevention protocols that target multiple high-risk behaviors in clinical samples is warranted.
authors.affiliation: George Mason University, Department of Psychology, MSN 35F, Fairfax, VA, USA. Electronic address: cesposi1@gmu.edu.
authors.forename: Christianne
authors.initials: C
authors.lastname: Esposito-Smythers
authors.affiliation: Rhode Island Hospital & Alpert Medical School of Brown University, Bradley/Hasbro Children's Research Center, One Hoppin Street, Suite 204, Providence, RI, 02903, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Hadley
authors.affiliation: George Mason University, Department of Psychology, MSN 35F, Fairfax, VA, USA.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Curby
authors.affiliation: Rhode Island Hospital & Alpert Medical School of Brown University, Bradley/Hasbro Children's Research Center, One Hoppin Street, Suite 204, Providence, RI, 02903, USA.
authors.forename: Larry K
authors.initials: LK
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000517:prevention & control*; D063425:Binge Drinking / Q000517:prevention & control; D015928:Cognitive Behavioral Therapy; D005196:Family Therapy; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016728:Self-Injurious Behavior / Q000517:prevention & control*; D059020:Suicidal Ideation; D047568:Unsafe Sex / Q000517:prevention & control
keywords: Adolescent; Alcohol; Clinical trial; Family; Prevention; Sexual risk; Suicide