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. 2012 Sep;43(2):211-20.
doi: 10.1016/j.jsat.2011.11.003. Epub 2011 Dec 29.

The effectiveness of community-based delivery of an evidence-based treatment for adolescent substance use

Sarah B Hunter  1 , Rajeev Ramchand, Beth Ann Griffin, Marika J Suttorp, Daniel McCaffrey, Andrew Morral
Affiliations

The effectiveness of community-based delivery of an evidence-based treatment for adolescent substance use

Sarah B Hunter et al. J Subst Abuse Treat. 2012 Sep.

Erratum in

  • J Subst Abuse Treat. 2013 Jan;44(1):143

Abstract

This study evaluates the effectiveness of motivational enhancement therapy/cognitive behavioral therapy-5 (MET/CBT-5) when delivered in community practice settings relative to standard community-based adolescent treatment. A quasi-experimental strategy was used to adjust for pretreatment differences between the MET/CBT-5 sample (n = 2,293) and those who received standard care (n = 458). Results suggest that youth who received MET/CBT-5 fared better than comparable youth in the control group on five of six 12-month outcomes. A low follow-up rate (54%) in the MET/CBT-5 sample raised concerns about nonresponse bias in the treatment effect estimates. Sensitivity analyses suggest that although modest differences in outcomes between the MET/CBT-5 nonrespondents and respondents would yield no significant differences between the two groups on two of the six outcomes, very large differences in outcomes between responders and nonresponders would be required for youth receiving MET/CBT-5 to have fared better had they received standard outpatient care.

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Figures

Figure 1
Figure 1
12-month dichotomous outcomes (recovery and institutionalization) for the EAT (MET/CBT-5) and ATM (control group) samples, after propensity score weighting.
Figure 2
Figure 2
12-month continuous outcomes (emotional problem, substance frequency, substance problem, and illegal activities scales) for the EAT (MET/CBT-5) and ATM (control group) samples, after propensity score weighting.
Figure 3
Figure 3
Bolded lines show the range of effect size differences on outcomes that would be required between simulated ATM responders and non-responders for the 95% simulation bands to contain zero as a possible mean difference between the ATM and EAT (MET/CBT-5) groups (note that for Recovery and IAS, the simulation band extends beyond 2, which represents a very large effect size). The circles denote the exact effect size difference on an outcome for which the mean treatment effect estimate comparing the ATM and EAT (MET/CBT-5) groups across the 100 simulations is zero (i.e, null or no treatment effect). Note: SPS=Substance Problem Scale; SFS=Substance Frequency Scale; EPS=Emotional Problem Scale, IAS=Illegal Activity Scale 38
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