The Effectiveness of Text Coaching on Substance Use Treatment Outcomes in Adolescence

The purpose of this study was to investigate the utility of text coaching on reducing substance use in adolescents participating in a school-based manualized intervention that utilizes Motivational Interviewing (MI) and motivational enhancement principles. A further aim of this study was to examine how perceived treatment satisfaction and self-efficacy mediate this relationship. Participants included 76 adolescents (62% male, 65% ethnic minority), ages 14-19 (M = 16), referred for substance use assessment and intervention by school administrators at large suburban public high schools. It was hypothesized that individuals who received the addition of text coaching would evidence a greater reduction in substance use compared to individuals who did not receive text coaching by the end of treatment and at post-treatment follow-up. Data was collected via an online survey tool. Substance use was measured using the Customary Drinking and Drug Use Record (Brown, et al., 1998). Treatment satisfaction was measured using the What I Got from Treatment scale (Miller & Brown, 1994). Self-efficacy was measured using the Situational Confidence Questionnaire (Annis & Graham, 1988). Multiple regression analyses were conducted for alcohol use and marijuana use separately. Text coaching predicted greater reduction in alcohol use at end of treatment (R2 = .11, F = 4.08 [2, 67], p \u3c .05), but not marijuana use (R2 = .04, F = 1.49 [2, 67], p = .233). Text coaching as a predictor of greater reduction in alcohol use at post-treatment follow-up was trending towards significance (R2 = .06, F = 2.70 [2, 48], p = .078); however, not for marijuana use (R2 = .05, F = 1.11 [2, 46], p = .337). Additionally, PROCESS Macro for SPSS 22 (Hayes, 2013) was used to determine the mediating effects of treatment satisfaction and self-efficacy. This mediation analysis failed to reach significance on any pathway. These results indicated text coaching was an effective adjunct intervention in decreasing alcohol use in high-risk substance using adolescence. This study provides a rationale for designing substance use interventions for adolescents with a text coaching component as a means of enhancing the gains made from treatment

The Relationship between Intrinsic Motivation, Motivational Interviewing and Physical Activity in an African American Church Population

African Americans carry a disproportionate amount of the health burden for chronic disease in the United States (Center for Disease Control and Prevention, 2007). Diabetes, heart disease and cancer, to name a few, are diseases which prematurely capture the lives of African Americans. While chronic, these diseases are preventable with the advent of behavioral change. Physical activity is a primary contributor to longer life expectancy and fewer health concerns (United States Department of Health and Human Services, 1996). While American society, as a whole, struggles to incorporate more physical activity in their lifestyles, African Americans exhibit higher levels of physical inactivity which correlates to higher instances of preventable and chronic health problems in this subgroup of the population. Thus intervention which addresses the specific needs of this community, the mechanisms by which to prompt behavior change and the most effective means to disseminate this information is needed to affect health behavior change in this population. The African American church provides an ideal vehicle by which to diminish these health issues as existing teaching, support and resource mechanisms can be utilized. The current paper explores the relationship between increasing intrinsic motivation through employing motivational interviewing as a strategy to increase physical activity among African Americans church members

Understanding Client Reactions in Online Mental Health Counseling

Communication success relies heavily on reading participants' reactions. Such feedback is especially important for mental health counselors, who must carefully consider the client's progress and adjust their approach accordingly. However, previous NLP research on counseling has mainly focused on studying counselors' intervention strategies rather than their clients' reactions to the intervention. This work aims to fill this gap by developing a theoretically grounded annotation framework that encompasses counselors' strategies and client reaction behaviors. The framework has been tested against a large-scale, high-quality text-based counseling dataset we collected over the past two years from an online welfare counseling platform. Our study shows how clients react to counselors' strategies, how such reactions affect the final counseling outcomes, and how counselors can adjust their strategies in response to these reactions. We also demonstrate that this study can help counselors automatically predict their clients' states.Comment: Accept to ACL 2023, oral. For code and data, see https://github.com/dll-wu/Client-Reac

Obesity and Cancer

Obesity has become the second leading preventable cause of disease and death in the United States, trailing only tobacco use. Weight control, dietary choices, and levels of physical activity are important modifiable determinants of cancer risk. If multi-factorial approaches to prevention and management are not implemented, obesity will likely become the leading modifiable cause of death in the coming years. Physicians have a key role in integrating these approaches into clinical care and advocating for systemic prevention efforts. This article provides: 1) an introduction to the epidemiology and magnitude of childhood and adult obesity; 2) the relationship of overweight/obesity to cancer and other chronic diseases, 3) potential mechanisms postulated to explain these relationships; 4) a review of recommended obesity treatment and assessment guidelines for adults, adolescents and children: 5) multi-level prevention strategies, and; 6) an approach to obesity management in adults utilizing the Chronic Care Model

"Because they made me come" : motivation and outcome in adolescent substance abuse treatment

Due to the fact that most research done on motivation and readiness to change as it applies to chemical dependency treatment has been done in the adult population, the present study was designed to assess how motivation and readiness to change impact adolescent chemical dependency treatment. The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) was implemented in the adolescent chemical dependency treatment program at Coastal Horizons Center. The sample consisted of 28 participants (13 females and 15 males) who were admitted to treatment at Coastal Horizons Center and administered the SOCRATES at least twice over a period of eight months. None of the hypotheses were confirmed due to a number of issues beyond the researcher’s control. SOCRATES subscale scores did not indicate movement to an advanced stage of change. Furthermore, higher SOCRATES subscale scores were not associated with more days spent in treatment, more treatment attendance, or a higher proportion of clean urine screens. The limitations of the study are discussed

The Impact of Shame on Medication-Assisted Therapy Treatment Outcomes for Individuals with a Severe Opiate Use Disorder

Shame has a significant impact on various psychopathologies including depression (Pinto et al., 2012), anxiety, and posttraumatic stress disorder (Bryan et al., 2013). The gap in this research is the quantitative impact of shame on the relapse cycle in individuals with a severe opioid use disorder. This research study will demonstrate the impact of shame on the expression of addictive behavior in patients that have a diagnosed opiate use disorder and are currently actively enrolled in a medication-assisted therapy treatment program. This research study will illustrate how the presence of increased therapeutic alliance strength can result in the reduction of addictive behavior and shame. This proposal seeks to establish shame as a predictor of addictive behavior. Showing how, even when the biological use cycle is considered with the use of well-established pharmaceutical therapies, the impact of shame is so great that addictive behaviors increase. This study will explore research surrounding the impact of shame on opiate use disorders, the development of therapeutic/working alliances, and the role that this relationship has on shame reduction and the reduction of addictive behaviors

Has Motivational Interviewing fallen into its own Premature Focus Trap?

Since the initial conception of the behaviour change method Motivational Interviewing, there has been a shift evident in epistemological, methodological and practical applications, from an inductive, process and practitioner-focussed approach to that which is more deductive, research-outcome, and confirmatory-focussed. This paper highlights the conceptual and practical problems of adopting this approach, including the consequences of assessing the what (deductive outcome-focussed) at the expense of the how (inductively process-focussed). We encourage a return to an inductive, practitioner and client-focussed MI approach and propose the use of Computer Assisted Qualitative Data Analysis Systems such as NVivo in research initiatives to support this aim