Computerized Intervention for Teen Substance Abuse
(CARS Trial)
Recruiting in Palo Alto (17 mi)
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Medical University of South Carolina
No Placebo Group
Trial Summary
What is the purpose of this trial?The study will test a computerized treatment with subjects ages 13-17 years who are seeking treatment for alcohol and/or cannabis use. Follow-up assessments will be conducted at one- and three-months following treatment.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment modified Approach-Avoidance Task (mAAT) for teen substance abuse?
The research does not provide direct evidence for the effectiveness of the modified Approach-Avoidance Task (mAAT) for teen substance abuse. However, Motivational Interviewing (MI), a similar approach used in addiction treatment, shows promise in promoting behavior change, although results are mixed and further investigation is needed.
12345How is the modified Approach-Avoidance Task (mAAT) treatment for teen substance abuse different from other treatments?
The modified Approach-Avoidance Task (mAAT) is unique because it is a computerized intervention that aims to change automatic tendencies to approach substances, unlike traditional therapies that may focus on counseling or medication. This approach uses cognitive training to help teens avoid substance-related cues, potentially reducing cravings and use.
678910Eligibility Criteria
This trial is for young people aged 13-17 who are looking for help with alcohol or cannabis use and have used both in the past three months. They must be willing to seek treatment and have a caregiver who can consent to their participation. Pregnant or breastfeeding individuals cannot join.Inclusion Criteria
Patients must be seeking treatment for either cannabis or alcohol use
I am between 13 and 17 years old.
Patients must report co-occurring alcohol and cannabis use during the past three months
+1 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive a computerized intervention for reducing cannabis and alcohol use
1 week
Follow-up
Participants are monitored for safety and effectiveness after treatment
3 months
Follow-up assessments at one- and three-months
Participant Groups
The study tests a computerized task called modified Approach-Avoidance Task (mAAT) designed to change automatic tendencies towards substance use. Participants will either receive mAAT that aims to modify this bias or one that does not, assessing its effectiveness over time.
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Group A: Treatment GroupExperimental Treatment1 Intervention
Group II: Group B: Control GroupPlacebo Group1 Intervention
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Medical University of South CarolinaCharleston, SC
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Who Is Running the Clinical Trial?
Medical University of South CarolinaLead Sponsor
National Institute on Drug Abuse (NIDA)Collaborator
References
The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. [2022]Having good intentions to engage in healthy behaviours, to change our lives in a positive direction and make substantial, lasting changes may not always translate into actions or behaviour that is maintained. Motivational Interviewing is a directive person-centred approach designed to explore ambivalence and activate motivation for change [Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behaviour. London: Guilford Press, 1991]. A key component of a motivational interviewing conversation is to acknowledge that clients have every right to make no change. It uses a guiding communication style which invites people to consider their own situation and find their own solutions to situations that they identify as problematic that are preventing change. Motivational Interviewing was first introduced in adult health addiction services in the early 1980s. It has developed in the physical health specialties, and in the last 20 years or so attention has turned to the potential of Motivational Interviewing in the paediatric setting and the challenges of using it in families with children at differing ages and developmental stages. This article summarizes studies published from 2006 to 2011 of Motivational Interviewing in individuals across the lifespan with type 1 and type 2 diabetes and obesity.
Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol. [2023]Client discontinuation from outpatient addiction treatment programs is common, and the initial intake is the service delivery point with the highest attrition rate. Replacing the comprehensive intake assessment with a person-centered Motivational Interviewing (MI) intervention is a potential solution to address provider and client concerns about the disengaging, time-intensive nature of the typical initial intake. It remains unclear whether the use of an alternative to the standard intake at the initial visit can fit within typical organizational reporting requirements, whether it decreases attrition, and whether implementation of person-centered intake procedures within outpatient addiction treatment programs is feasible, acceptable, and can be sustained.
Effectiveness of motivational interviewing to improve chronic condition self-management: what does the research show us? [2019]Motivational interviewing (MI) as a strategy to promote behavior change has its roots in the addiction field. In recent years there is growing use of MI as an intervention to help patients with diet, physical activity, and other lifestyle changes. This counseling approach initially developed by clinical psychologists is a goal-oriented, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence (). MI is appealing because it is seen as a practical front-line intervention that is concordant with patient-centered care that is being called for in the health service environment.This column profiles four published research/synthesis articles describing experiences by different groups in implementing MI strategies. As you will read, results from trials evaluating MI on patient outcomes are mixed and there continues to be gaps in the evidence on how to best implement MI and on which patients will most likely benefit. Even with outstanding questions, MI shows promise in the very challenging area of promoting behavior change and warrants continued investigation. Interested readers are encouraged to read the original articles for more details.
Enhanced motivational interviewing versus brief advice for adolescent smoking cessation: results from a randomized clinical trial. [2022]Motivational interviewing (MI) is widely used for adolescent smoking cessation but empirical support for this approach is mixed.
A motivational intervention for adolescent smokers. [2022]Motivational interviewing (MI) is a brief psychotherapeutic intervention to increase the likelihood of a client's considering, initiating, and maintaining specific change strategies to reduce harmful behavior. MI is founded on principles of motivational psychology, client-centered therapy, and stages of change in natural recovery from addiction. Motivational Enhancement Therapy (MET) embeds MI within a structured format of standardized intake assessment, personalized feedback of testing results, and follow-up interview to facilitate treatment outcome evaluation. This paper presents research evidence for the efficacy of MET, a description of the methods and goals of MI counseling approach, and the rationale for MET as an appropriate brief intervention for adolescents. Specific recommendations for application of MI to adolescent smokers are offered.
Reaching out towards cannabis: approach-bias in heavy cannabis users predicts changes in cannabis use. [2021]Repeated drug exposure can lead to an approach-bias, i.e. the relatively automatically triggered tendencies to approach rather that avoid drug-related stimuli. Our main aim was to study this approach-bias in heavy cannabis users with the newly developed cannabis Approach Avoidance Task (cannabis-AAT) and to investigate the predictive relationship between an approach-bias for cannabis-related materials and levels of cannabis use, craving, and the course of cannabis use.
Approach-avoidance modification as an add-on in smoking cessation: A randomized-controlled study. [2020]Biases in information processing are attributed an important role in the maintenance of tobacco dependence. As these biases are not sufficiently taken into account in current treatments, the aim of the present study was to investigate whether clinical outcome can be improved by combining treatment-as-usual (TAU) with Approach-Avoidance Modification Training (AAMT). A two group parallel (1:1) randomized-controlled single-blind study with adult smokers (N = 105) was conducted (DRKS00011406). Participants received three sessions of TAU and either six sessions of AAMT or Sham training. During AAMT, participants were trained to implicitly avoid all smoking-related and to approach all smoking-unrelated pictures, while the contingency was 50:50 in Sham training. Participants were assessed after the intervention and 6 months later. Primary outcome was daily cigarette consumption at follow-up. Participants receiving TAU + AAMT did not show a significantly greater reduction of daily cigarette consumption at follow-up compared to TAU + Sham (per-protocol: 95% CI: -2.56-4.89, p = .608; intention-to-treat: 95% CI: -3.11-2.96, p = .968). Using an implicit AAMT (vs. Sham) as an add-on to TAU did not improve clinical outcome. However, no consistent evidence for a change of bias was found. It is important for future research to explore the effectiveness of optimized training versions (e.g., explicit instructions). PRE-REGISTRATION: German Clinical Trials Register (DRKS00011406).
Alcohol Avoidance Training as a Mobile App for Problem Drinkers: Longitudinal Feasibility Study. [2021]Alcohol use is associated with an automatic tendency to approach alcohol, and the retraining of this tendency (cognitive bias modification [CBM]) shows therapeutic promise in clinical settings. To improve access to training and to enhance participant engagement, a mobile version of alcohol avoidance training was developed.
Preliminary evidence that computerized approach avoidance training is not associated with changes in fMRI cannabis cue reactivity in non-treatment-seeking adolescent cannabis users. [2020]Cognitive Bias Modification (CBM) has garnered interest as a potential addiction treatment. CBM interventions such as Approach Avoidance Training (AAT) are designed to alter automatic tendencies to approach drugs or drug-related cues. In our previous work, the cannabis AAT (CAAT) reduced cannabis approach bias, which was related to reduced cannabis use, among 80 non-treatment-seeking cannabis-using youth (Jacobus et al., 2018). In this preliminary examination, a subsample of these youth underwent neuroimaging to explore CAAT's effect on cannabis cue-related neural activation.
Personalized Approach Bias Modification Smartphone App ("SWIPE") to Reduce Alcohol Use Among People Drinking at Hazardous or Harmful Levels: Protocol for an Open-Label Feasibility Study. [2020]Alcohol accounts for 5.1% of the global burden of disease and injury, and approximately 1 in 10 people worldwide develop an alcohol use disorder. Approach bias modification (ABM) is a computerized cognitive training intervention in which patients are trained to "avoid" alcohol-related images and "approach" neutral or positive images. ABM has been shown to reduce alcohol relapse rates when delivered in residential settings (eg, withdrawal management or rehabilitation). However, many people who drink at hazardous or harmful levels do not require residential treatment or choose not to access it (eg, owing to its cost, duration, inconvenience, or concerns about privacy). Smartphone app-delivered ABM could offer a free, convenient intervention to reduce cravings and consumption that is accessible regardless of time and place, and during periods when support is most needed. Importantly, an ABM app could also easily be personalized (eg, allowing participants to select personally relevant images as training stimuli) and gamified (eg, by rewarding participants for the speed and accuracy of responses) to encourage engagement and training completion.