The impact of motivational interviewing on relapse to substance use among women in Iran: a randomized clinical trial

Background: Women in Iran are in great need of effective substance abuse services. The current study was conducted to investigate the effectiveness of motivational interviewing (MI) for women in treatment for drug use in Iran. Method: The sample (N = 60) included women in a drug treatment center in Qazvin (Iran) from August to December of 2017. The research sample included 60 female drug users randomly assigned to MI or Standard Care (SC). Prior to randomization women completed a baseline questionnaire and the Relapse Prediction Scale (RPS), which measures desire (urge) to use and probability of using/not using in risky situations (self-efficacy). MI consisted of eight 60-min group sessions over a 1-month period, twice weekly. At 2-months follow-up, data were gathered using a questionnaire similar to baseline. Mixed Model Analysis were used to determine group differences. Results: Mean age of participants was 30 years and average addiction duration was 7 years. Although the scores of the desire to use and the probability of drug use were not significant before the intervention, after the intervention, scores on desire to use and probability of use improved about 81.1% (F: 2230.15, P \u3c 0.001, degrees of freedom: 63, 15) and 81.9%, (F: 749.39, P \u3c 0.001, degrees of freedom: 79, 77), respectively, compared to those of control group. Conclusion: The results showed that motivational interviewing could decrease desire to use and probability of use among female drug users. Motivational interviewing could play an important role in improving women’s health in Iran

All Might Have Won, But Not All Have the Prize: Optimal Treatment for Substance Abuse Among Adolescents with Conduct Problems

Considerable evidence from the literature on treatment outcomes indicates that substance abuse treatment among adolescents with conduct problems varies widely. Treatments commonly used among this population are cognitive-behavioral therapy (CBT), 12-step facilitation, multisystemic therapy (MST), psychoeducation (PE), and motivational interviewing (MI). This manuscript thoroughly and systematically reviews the available literature to determine which treatment is optimal for substance-abusing adolescents with conduct problems. Results suggest that although there are several evidence-based and empirically supported treatments, those that incorporate family-based intervention consistently provide the most positive treatment outcomes. In particular, this review further reveals that although many interventions have gained empirical support over the years, only one holds the prize as being the optimal treatment of choice for substance abuse treatment among adolescents with conduct problems

Validation of the delinquent activities scale for incarcerated adolescents

Purpose: This study examined the validity of the Delinquent Activities Scale (DAS), based in part on the Self Reported Delinquency (SRD) scale. Method: Participants were 190 incarcerated adolescents (85.8% male; average age 17 years) at a juvenile correctional facility in the Northeast. While incarcerated, they were asked about substance use and delinquent activities in the 1 year prior to incarceration, as well as parental, peer, and demographic information. They were tracked at three months post-release, given the DAS, and assessed for post-release substance use. Results: Three factors of the DAS assess general, alcohol-involved, and marijuana-involved delinquent activities. Principal components analysis was used to develop subscales within each factor. Support was found for concurrent and predictive incremental validities of these factors and their subscales in predicting substance use, with stronger findings for the general and the alcohol-involved factors. Subscales related to stealing showed lower validity than those related to more aggressive behaviors. Conclusions: These analyses suggest that the factors and empirically derived subscales offer researchers and clinicians a psychometrically sound approach for the assessment of adolescent misbehaviors

Effectiveness of message-framing to improve oral health behaviors and dental plaque among pregnant women

Background: Oral health is considered a prominent factor that contributes to quality of life. Hormonal changes during pregnancy can influence oral health. Message framing can play an important role in oral health. The aim of the present study was to investigate the effect of message framing on oral health and dental plaque among pregnant women. Methods: The study was conducted in 2017 on 108 pregnant women in Izeh county, Iran. Participants were randomly assigned to gain-framed, loss-framed, and control groups. The research instrument included a two part questionnaire containing demographic information and oral health knowledge, attitude, behavioral intention, self-efficacy, practice, and dental plaque index. Gain-and loss-framed messages were sent to the intervention groups via cell phone texts, but the control group did not receive any messages. Participant dental plaque was clinically assessed. Analysis of covariance with follow-up tests were performed using SPSS version, 23.0 with p-value set at 0.01 for significance. Results: Intervention groups had better oral health (knowledge, atttitude, intention, efficacy, practices and plaque) scores compared to the control group (p \u3c 0.001), but intervention (gain- vs loss-framed) groups did not differ on outcomes. Conclusion: Text message intervention improved knowledge, attitude, behavioral intention, self-efficacy, practice, and dental plaque among pregnant women. While differences between control and both intervention groups indicated text messaging had an impact on oral health outcomes, message framing (i.e., gain vs loss) had no discernable impact on oral health outcomes

Evaluating Measures of Fidelity for Substance Abuse Group Treatment With Incarcerated Adolescents

The evaluation of treatment fidelity has become increasingly important as the demand for evidence-based practice grows. The purpose of the present study is to describe the psychometric properties of two measures of treatment fidelity that can be used by therapists and supervisors - one for group-based cognitive–behavioral therapy (CBT) and one for combined Substance Education and Twelve-Step Introduction (SET) for adolescent substance use. At the end of group sessions (CBT n = 307; SET n = 279), therapists and supervisors completed an evaluation measure assessing adherence to certain core components of the intervention. The supervisor version of the fidelity measure also included items for rating the level of competency the therapist demonstrated when providing each component of the intervention. Results from split-half cross-validation analyses provide strong support for an 11-item, three-factor CBT fidelity measure. Somewhat less consistent but adequate support for a nine-item, two-factor SET fidelity measure was found. Internal consistencies ranged from acceptable to good for both the CBT and SET adherence scales and from acceptable to good for the CBT and SET competency scales, with the exception of the CBT practices competency scale. Preliminary validation of the measures suggests that both measures have adequate to strong factor structure, reliability, and concurrent and discriminant validity. The results of this study have implications for research and clinical settings, including the supervision process

Prevalence and factors associated with disruptive behavior among Iranian students during 2015: a cross-sectional study

Background: Disruptive behavior can have lifetime consequences for youth. Prevention, early identification and treatment of disruptive behavior can improve outcomes for these youth. The purpose of the present study was to assess the prevalence of disruptive behavior among a sample of Iranian youth, and the relationship of disruptive behavior to other psychological phenomena that may be targeted for prevention, early identification and treatment. Method: The sample consisted of 600 high school students (300 boys and 300 girls; ages 15 to 18 years old) selected through multi-stage random sampling in Saveh city, of Iran, in 2015. Questionnaires assessed several phenomena including demographics, life satisfaction, social support, depression, stress, smoking and hopefulness. The Disruptive Behavior Scale was also utilized. Univariate analyses were followed by multiple logistic regressions to examine relations among disruptive behavior and other constructs. Results: Prevalence of disruptive behavior was 7.5%, in boys and 3.1%, in girls. Mean scores were 22.97 ± 1.17 for boys and 19.15 ± 1.06 for girls, with a significant difference between them (P \u3c 0.05). The results of regression revealed low life satisfaction (OR = 3.75; 95% CI: (2.37–5.91), social support (OR = 0.72; 95% CI: (0.56–0.82) and hopefulness (OR = 0.85; 95% CI: (0.62–0.92); and smoking (OR = 3.65; 95% CI: (2.19–6.06), being male (OR = 2.55; 95% CI: (1.54–4.22), and higher stress (OR = 1.92; 95% CI: (1.60–2.91) and depression (OR = 2.76; 95% CI: (1.82–4.88) were significant factors in predicting disruptive behavior. Conclusion: Disruptive behavior was associted with life satisfaction, smoking, being a boy, social support, hopefulness, stress, and depression. Targeting constructs (e.g., support, stress) associated with disruptive behavior may assist in prevention, early identification and treatment of problem behavior. For example, health promotion programs to increase hopefulness, satisfaction and support, and reduce stress, depression and smoking might be of importance for prevention and treatment of disruptive behavior

Ethnicity as a moderator of motivational interviewing for incarcerated adolescents after release

Motivational interviewing (MI) has been found to be an effective treatment for substance using populations, including incarcerated adolescents. Although some studies suggest MI is more successful with individuals from minority backgrounds, the research remains mixed. The current study investigated the impact of ethnicity on treatment in reducing alcohol and marijuana use among incarcerated adolescents. Adolescents (14–19 years of age) were recruited from a state juvenile correctional facility and randomly assigned to receive MI or relaxation therapy (RT) (N = 147; 48 White, 51 Hispanic, and 48 African American; 126 male; 21 female). Interviews were conducted at admission to the facility and 3 months after release. Results suggest that the effects of MI on treatment outcomes are moderated by ethnicity. Hispanic adolescents who received MI significantly decreased total number of drinks on heavy drinking days (NDHD) and percentage of heavy drinking days (PHDD) as compared to Hispanic adolescents who received RT. These findings suggest that MI is an efficacious treatment for an ethnic minority juvenile justice-involved population in need of evidence-based treatments

Motivational Interviewing with Computer Assistance as an Intervention to Empower Women to Make Contraceptive Choices while Incarcerated: Study Protocol for Randomized Controlled Trial

Background: Unplanned pregnancies and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual intercourse. Risk factors for unplanned pregnancies and STIs (poverty, low educational attainment, homelessness, substance abuse, lack of health insurance, history of an abusive environment, and practice of commercial sex work) are especially high among women with a history of incarceration. Project CARE (Contraceptive Awareness and Reproductive Education) is designed to evaluate an innovative intervention, Motivational Interviewing with Computer Assistance (MICA), aimed at enhancing contraceptive initiation and maintenance among incarcerated women who do not want a pregnancy within the next year and who are anticipated to be released back to the community. This study aims to: (1) increase the initiation of highly effective contraceptives while incarcerated; (2) increase the continuation of highly effective contraceptive use at 3, 6, 9, and 12 months after release; and (3) decrease unsafe sexual activity. Methods/Design: This randomized controlled trial will recruit 400 women from the Rhode Island Department of Corrections (RI DOC) women’s jail at risk for an unplanned pregnancy (that is, sexually active with men and not planning/wanting to become pregnant in the next year). They will be randomized to two interventions: a control group who receive two educational videos (on contraception, STIs, and pre-conception counseling) or a treatment group who receive two sessions of personalized MICA. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. Women will be followed at 3, 6, 9, and 12 months post release and assessed for STIs, pregnancy, and reported condom use. Discussion: Results from this study are expected to enhance our understanding of the efficacy of MICA to enhance contraceptive initiation and maintenance and reduce sexual risk-taking behaviors among incarcerated women who have re-entered the community

Validation of a Measure to Assess Alcohol- and Marijuana-Related Risks and Consequences Among Incarcerated Adolescents

Few measures exist to assess risky behaviors and consequences as they relate to substance use in juvenile delinquents. This study sought to validate such a measure on a racially and ethnically diverse sample (N = 175). Results indicate that alcohol-related risky behaviors and consequences comprise a single scale as do marijuana-related risky behaviors and consequences. Furthermore, results suggest that the retention of common items for both scales produces reliable and valid scales and maintains parsimony. Internal consistencies were more than adequate (0.72 – 0.83) and test-retest stabilities, even across several months were acceptable (0.52 - 0.50). The scales evidenced a high degree of concurrent and predictive incremental validity in predicting conduct disorder, dependence symptoms, and consumption patterns. Researchers can use these scales to measure a generalized construct tapping risks and consequences as related to alcohol and marijuana use. Ease of use may make these scales appealing to clinicians who can provide feedback to clients regarding risky behaviors involving alcohol and marijuana

Offender Assessment, Case Planning, and Referral to Community-Based Treatment: Effects of a Structured Process Improvement Initiative

This article is part of the supplement: Abstracts from the 2014 Addiction Health Services Research (AHSR) Conferenc