Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment. (February 2017)

• Record Type: Journal Article
• Authors: Esposito-Smythers, Christianne; Hadley, Wendy; Curby, Timothy W.; Brown, Larry K.
• Is Part Of: Behaviour research and therapy. Volume 89(2017)
• Page Start: 49
• Page End: 56
• Publication Date: 2017-02
• Subjects: Suicide -- Alcohol -- Sexual risk -- Family -- Prevention -- Adolescent -- Clinical trial; ASH-P Alcohol, Self-harm, and HIV Prevention program -- AO-C Assessment Only Control condition -- DSH Deliberate Self-Harm -- SCLT Social Cognitive Learning Theory -- CBT Cognitive Behavioral Therapy; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2016.11.005
• Languages: English
• ISSNs: 0005-7967

Abstract

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. Highlights: Evaluated an alcohol, self-harm and HIV prevention workshop for high-risk teens. Workshop was family-based and offered to teens in mental health treatment. Workshop was associated with improvement in family communication and norms. Workshop had medium-large effects on self-harm, binge drinking, and refusal of sex.