The Cannabis Youth Treatment (CYT) Study: Main findings from two randomized trials

The Children's Hospital of Philadelphia, Filadelfia, Pennsylvania, United States
Journal of Substance Abuse Treatment (Impact Factor: 3.14). 11/2004; 27(3):197-213. DOI: 10.1016/j.jsat.2003.09.005
Source: PubMed


This article presents the main outcome findings from two inter-related randomized trials conducted at four sites to evaluate the effectiveness and cost-effectiveness of five short-term outpatient interventions for adolescents with cannabis use disorders. Trial 1 compared five sessions of Motivational Enhancement Therapy plus Cognitive Behavioral Therapy (MET/CBT) with a 12-session regimen of MET and CBT (MET/CBT12) and another that included family education and therapy components (Family Support Network [FSN]). Trial II compared the five-session MET/CBT with the Adolescent Community Reinforcement Approach (ACRA) and Multidimensional Family Therapy (MDFT). The 600 cannabis users were predominately white males, aged 15-16. All five CYT interventions demonstrated significant pre-post treatment during the 12 months after random assignment to a treatment intervention in the two main outcomes: days of abstinence and the percent of adolescents in recovery (no use or abuse/dependence problems and living in the community). Overall, the clinical outcomes were very similar across sites and conditions; however, after controlling for initial severity, the most cost-effective interventions were MET/CBT5 and MET/CBT12 in Trial 1 and ACRA and MET/CBT5 in Trial 2. It is possible that the similar results occurred because outcomes were driven more by general factors beyond the treatment approaches tested in this study; or because of shared, general helping factors across therapies that help these teens attend to and decrease their connection to cannabis and alcohol.

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    • "To facilitate clinical comparison with adolescents, Smith, Godley, Godley, and Dennis (2011) examined both emerging adult and adolescent response to the Adolescent Community Reinforcement Approach (A-CRA) provided at one of several SAMHSA-funded outpatient treatment programs, using propensity score matching to create groups that were roughly equivalent on key characteristics associated with positive outcomes (e.g., treatment retention). A-CRA is a CB intervention for SUD, shown to be effective in the treatment of cannabis use disorders among adolescents (Dennis et al., 2004; Godley et al., 2001). Authors found that although both groups improved from intake to follow-up (3 or 6 months post-intake), emerging adults had significantly worse treatment response. "
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    • "Current outpatient treatment practices for adolescent substance abusers utilize cognitive-behavioral (CB)-based therapies for relapse prevention (Dennis et al., 2002, 2004; Kaminer, 2001). During group therapy, youth are taught to self-monitor and identify affect, cognitions, and situational factors that make them vulnerable to relapse. "
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    • "The mood module featured behavioral activation strategies, which have shown promise as easily understood and efficacious in the treatment of depression (Hopko, Lejuez, Ruggiero, et al., 2003; Jacobson et al., 1996; Ruggiero et al., 2007). The tobacco and alcohol modules used brief motivational-enhancement and cognitive– behavioral strategies (Dennis et al., 2004; Waldron & Kaminer, 2004). These strategies are evidence based and were intended to address the needs of adolescent populations, such as teaching skills to (a) refuse substance abuse offers from peers; (b) establish a positive family and peer network that is supportive of abstention from use; (c) develop a plan for positive, enjoyable activities to replace substance use– related activities; and (d) cope with stressful and/or high-risk situations (Sampl & Kadden, 2001). "
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