Ambivalence: Prerequisite for success in motivational interviewing with adolescents?

The exploration and resolution of ambivalence play an essential role in motivational interviewing (MI) theory. However, most adolescent MI studies have not examined ambivalence as a contributor to behaviour change. This paper reviewed research findings on the role of ambivalence in the adolescent change process. We undertook a narrative review of the published empirical and theoretical literature on ambivalence and mechanisms of change in MI for adolescents and found that current MI evaluations appear not to have access to reliable and valid measures of ambivalence in adolescence or neuroimaging methods to evaluate the mechanisms of treatment response. Improved instrumentation is needed to assess adolescents' ambivalence in clinical and research settings. Innovative methodology, including neuroimaging, may help identify factors mediating relationships between adolescents' ambivalence and treatment response

Do therapist behaviors differ with Hispanic youth? A brief look at within-session therapist behaviors and youth treatment response.

Brief addiction treatments, including motivational interviewing (MI), have shown promise with youth. One underexamined factor in this equation is the role of therapist behaviors. We therefore sought to assess whether and how therapist behaviors differ for Hispanic versus non-Hispanic youth and how that may be related to treatment outcome. With 80 substance-using adolescents (M age = 16 years; 65% male; 59% Hispanic; 41% non-Hispanic), we examined the relationship between youth ethnicity and therapist behaviors across two brief treatments (MI and alcohol/marijuana education [AME]). We then explored relationships to youth 3-month treatment response across four target outcomes: binge drinking days, alcohol-related problems, marijuana use days, and marijuana-related problems. In this study, therapists showed significantly more MI skills within the MI condition and more didactic skills in the AME condition. With respect to youth ethnicity, across both conditions (MI and AME), therapists used less MI skills with Hispanic youth. Contrary to expectations, therapists' use of MI skills was not connected to poorer outcomes for Hispanic youth across the board (e.g., for binge drinking days, marijuana use days, or marijuana-related problems). Rather, for Hispanic youth, therapists' use of lower MI skills was related only to poorer treatment outcomes in the context of alcohol-related problems. The observed relationships highlight the importance of investigating salient treatment interactions between therapist factors and youth ethnicity to guide improvements in youth treatment response

Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data.

Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9-10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9-10 year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated

Measurement invariance of alcohol instruments with Hispanic youth

INTRODUCTION: Despite their widespread use across clinical and research settings, no study has yet investigated the fit of several standard alcohol measures for Hispanic youth, including those used to assess motivation to change, self-efficacy, peer norms, and problem drinking. This study thus served to address this gap by evaluating measurement invariance with substance-using youth. METHODS: We enrolled a large sample of regular substance-using youth who were involved with the justice system (N=368; 72.9% male; 76.9% Hispanic; M age=16.17years). Similar to the broader Hispanic population of the southwest United States (U.S.), Hispanic youth in the sample were on average 3.5th generation (with at least 1 foreign-born grand-parent). Following standard administration and scoring procedures, all youth completed measures of motivation to change (e.g., readiness rulers, intentions to change), self-efficacy (e.g., drink refusal in social situations), peer norms (e.g., peer norms for substance use), and problem drinking (e.g., substance use quantity/frequency; Alcohol Use Disorders Identification Test; Rutgers Alcohol Problems Index; Timeline FollowBack). Measurement equivalence was evaluated via multiple group confirmatory factor analysis. RESULTS: Our results indicated that each measure evaluated herein worked equally well for Hispanic and Caucasian youth. We found measurement invariance at every level tested. CONCLUSIONS: This study supports the validity and future use of these important and widely-used alcohol use measures for high-risk substance-using Hispanic youth. Further, given the representativeness of this sample within the southwestern U.S., these results show promise for generalizability to U.S.-born Hispanic youth within this geographic region

Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods.

One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States

Understanding and Defining Addiction in an Honors Context

Exploration and development of identity, autonomy, sexuality, academic functioning, and peer relationships are important age-appropriate tasks of adolescence and emerging adulthood (Baer & Peterson; Cicchetti & Rogosch; Erikson). During college, this developmental stage may manifest as questioning prior beliefs and assumptions and exploring fresh philosophies and behaviors (Schulenberg & Maggs). Many emerging adults try out what they believe are different facets of adult life. Some of the requisite experimentation may include risk-taking behavior, including experimentation with alcohol, cigarettes, and marijuana (Baer & Peterson; Shedler & Block; Winters). College provides opportunities to experiment with potentially addictive substances at peer-run social events that often include alcohol and other substances (Schulenberg & Maggs). The combination of a mindset poised for exploration and a developmental period with enhanced opportunity for experimental behavior makes college a unique time to explore the high-risk behaviors that are prevalent within emerging adult communities. While large courses may usher university students through the research about what constitutes addictions, honors programs offer an invaluable resource for exploring more fully these value-laden, highrisk, and timely questions. In small, discussion-based honors classes, emerging adults are able to actively explore their questions, thoughts, and previous conceptions about addiction in a manner that would not be possible in larger classes. The students emerge from my 300-level honors class—titled “Yeah, I Like It, but I’m Not Addicted”: Exploring the Meanings and Consequences of Addiction—with a more thorough understanding of addiction as well as analytical skills that will help them navigate both academic and personal contexts in college

Training primary care providers in motivational interviewing for youth behavior change.

Presented at: 8th Biennial Childhood Obesity Conference; June 29-July 2, 2015; San Diego, CA.https://digitalrepository.unm.edu/prc-posters-presentations/1049/thumbnail.jp

Primary care provider’s use of motivational interviewing to support youth nutrition and physical activity behavior change.

Presented at: International Society of Behavioral Nutrition and Physical Activity; June 8-11, 2016; Cape Town, South Africa.https://digitalrepository.unm.edu/prc-posters-presentations/1034/thumbnail.jp

Two approaches to tailoring treatment for cultural minority adolescents

At this time, compared with mainstream (Caucasian) youth, cultural minority adolescents experience more severe substance-related consequences and are less likely to receive treatment. Although several empirically supported interventions (ESIs), such as motivational interviewing (MI), have been evaluated with mainstream adolescents, fewer published studies have investigated the fit and efficacy of these interventions with cultural minority adolescents. In addition, many empirical evaluations of ESIs have not explicitly attended to issues of culture, race, and socioeconomic background in their analyses. As a result, there is some question about the external validity of ESIs, particularly in disadvantaged cultural minority populations. This review seeks to take a step toward filling this gap, by addressing how to improve the fit and efficacy of ESIs like MI with cultural minority youth. Specifically, this review presents the existing literature on MI with cultural minority groups (adult and adolescent), proposes two approaches for evaluating and adapting this (or other) behavioral interventions, and elucidates the rationale, strengths, and potential liabilities of each tailoring approach