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16. Predicting Response to Services for Homeless Adolescents and Transition Age Youth (TAY) with Substance Use And/Or Mental Health Disorders: Implications for Youth Treatment and Recovery.

Author

Passetti, Lora, Smith Ramey, Jennifer, Hunter, Brooke, and Godley, Mark

Subjects
SUBSTANCE abuse treatment, MENTAL illness treatment, TRANSITION to adulthood, ANALYSIS of variance, CONVALESCENCE, CRIME, TREATMENT effectiveness, HEALTH care teams, INTERPERSONAL relations, EMPLOYMENT, QUALITY of life, RESEARCH funding, MENTAL depression, CHI-squared test, HOMELESSNESS, INTEGRATED health care delivery, CLUSTER analysis (Statistics), SOCIAL skills, WORKING hours, ANXIETY, DATA analysis software, UNSAFE sex, EDUCATIONAL attainment, COGNITIVE therapy, ADOLESCENCE
Abstract

This paper examines patterns of response to a multi-disciplinary wrap-around program for homeless adolescents and transition-aged youth with substance use and/or mental health disorders. A cluster analysis of outcome data from 148 youth was conducted. Cluster 1 (n = 67) demonstrated significant decreases in risky behavior (e.g., engaging in unprotected sex, crime, and substance use) and poor interpersonal relationships (e.g. more interaction with family and friends and lower rates of violence) but experienced relatively fewer interactions with family and friends. Cluster 2 (n = 57) demonstrated a significant decrease in poor life functioning (e.g., lower rates of employment/education, better quality of life, and less symptoms of internalizing disorders). Cluster 3 (n = 24) experienced significant increases in risky behavior, poor life functioning, and poor interpersonal relationships. Clusters 1 and 2 improved over six months of care. Cluster 3 deteriorated despite receiving similar services and used more opioids and stimulants. Peer engagement in programs for this population are important. Recommendations for cluster 3 include targeted outreach, medication assisted treatment, and additional research-supported treatments. Further research is needed to test these interventions over longer periods of time. [ABSTRACT FROM AUTHOR]

Published
2023
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18. Feasibility of Implementing the Adolescent Community Reinforcement Approach in School Settings for Adolescents with Substance Use Disorders

Author

Hunter, Brooke D., Godley, Mark D., and Godley, Susan H.

Abstract

Nationally, approximately 10% of adolescents in need of treatment for a substance use (SU) disorder receive treatment. School-based treatment may provide an important opportunity to reduce the treatment gap by facilitating access to services. While some school-based SU treatment exists, little is known about whether newer, evidence-based treatments (e.g. Adolescent Community Reinforcement Approach [A-CRA]) can be well implemented in schools. The objectives of this study were to compare adolescents receiving A-CRA services in school-based versus clinic-based settings in regard to (1) intake characteristics, (2) treatment implementation quality, and (3) clinical outcomes. Results suggest that A-CRA in school-based settings was more likely to reach girls and youth with shorter SU histories; A-CRA was well implemented within school-based settings and the school-based group had equivalent or better outcomes than the clinic-based group.

Published
2014
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21. A tutorial for using propensity score weighting for moderation analysis: an application to smoking disparities among sexual minority adults

Author

Griffin, Beth Ann, Schuler, Megan S., Cefalu, Matt, Ayer, Lynsay, Godley, Mark, Greifer, Noah, Coffman, Donna L., and McCaffrey, Daniel

Subjects
Methodology (stat.ME), FOS: Computer and information sciences, Applications (stat.AP), Statistics - Applications, Statistics - Methodology
Abstract

Objective. To provide step-by-step guidance and STATA and R code for using propensity score (PS) weighting to estimate moderation effects. Research Design. Tutorial illustrating the key steps for estimating and testing moderation using observational data. Steps include (1) examining covariate overlap across treatment groups within levels of the moderator, (2) estimating the PS weights, (3) evaluating whether PS weights improved covariate balance, (4) estimating moderated treatment effects, and (5) assessing sensitivity of findings to unobserved confounding. Our illustrative case study uses data from 41,832 adults from the 2019 National Survey on Drug Use and Health to examine if gender moderates the association between sexual minority status (e.g., lesbian, gay, or bisexual [LGB] identity) and adult smoking prevalence. Results. For our case study, there were no noted concerns about covariate overlap and we were able to successfully estimate the PS weights within each level of the moderator. Moreover, balance criteria indicated that PS weights successfully achieved covariate balance for both moderator groups. PS weighted results indicated there was significant evidence of moderation for the case study and sensitivity analyses demonstrated that results were highly robust for one level of the moderator but not the other. Conclusions. When conducting moderation analyses, covariate imbalances across levels of the moderator can cause biased estimates. As demonstrated in this tutorial, PS weighting within each level of the moderator can improve the estimated moderation effects by minimizing bias from imbalance within the moderator subgroups.

Published
2022

23. The Role of Pre-Treatment Traumatic Stress Symptoms in Adolescent Substance Use Treatment Outcomes.

Author

Coffman, Donna L., Ayer, Lynsay, Schuler, Megan S., Godley, Mark D., and Griffin, Beth Ann

Subjects
SUBSTANCE abuse treatment, TREATMENT of post-traumatic stress disorder, RESEARCH, POST-traumatic stress disorder, COMMUNITY health services, VIOLENCE, TREATMENT effectiveness, CRIME victims, RESEARCH funding, STATISTICAL correlation, SOCIODEMOGRAPHIC factors, WOUNDS & injuries, OUTPATIENT services in hospitals, PROBABILITY theory, EVALUATION, ADOLESCENCE
Abstract

Background: Prominent theories suggest that individuals with co-occurring traumatic stress symptoms (TSS) and substance use (SU) may be less responsive to SU treatment compared to those with SU only. However, empirical findings in adult samples are mixed, and there has been limited work among adolescents. This study assesses the association between TSS and SU treatment outcomes among trauma-exposed adolescents, using statistical methods to reduce potential confounding from important factors such as baseline SU severity. Method: 2,963 adolescents with lifetime history of victimization received evidence-based SU treatment in outpatient community settings. At baseline, 3- and 6-months, youth were assessed using the Global Appraisal of Individual Needs Traumatic Stress Scale and the Substance Frequency Scale. Propensity score weighting was used to mitigate potential confounding due to baseline differences in sociodemographic characteristics and SU across youth with varying levels of TSS. Results: Propensity score weighting successfully balanced baseline differences in sociodemographic factors and baseline SU across youth. Among all youth, mean SU was lower at both 3- and 6- month follow-up relative to baseline, indicating declining use. After adjusting for potential confounders, we observed no statistically significant relationship between TSS and SU at either 3- or 6-month follow-up. Conclusions: Based on this investigation, conducted among a large sample of trauma-exposed youth receiving evidence-based outpatient SU treatment, baseline TSS do not appear to be negatively associated with SU treatment outcomes. However, future research should examine whether youth with TSS achieve better outcomes through integrative treatment for both SU and TSS. The results of this study provide keenly needed evidence that, among youth with prior victimization, presence and level of traumatic stress symptoms at substance use treatment initiation does not lead to significantly worse treatment outcomes for youth in outpatient treatment. This suggests that evidence-based outpatient substance use treatment modalities may be effective at improving substance use outcomes even when co-existing traumatic stress symptoms are present. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Adolescent Substance Abuse Disorders: From Acute Treatment to Recovery Management.

Author

White, William L., Dennis, Michael L., and Godley, Mark D.

Abstract

A surge in adolescent alcohol and illicit drug use during the 1990s triggered renewed calls for evidence-based intervention programs and sparked an unprecedented federal investment in treatment-related adolescent research. This article discusses some of the major findings of this research with particular reference to their implications for the design of community-based services for substance-involved youth and families. (Contains 25 references.) (GCP)

Published
2002

29. Discharge Status as a Performance Indicator: Can It Predict Adolescent Substance Abuse Treatment Outcome?

Author

Godley, Mark D., Godley, Susan H., Funk, Rodney R., Dennis, Michael L., and Loveland, David

Abstract

Assesses the relationship between discharge status and therapeutic outcomes after discharge from a residential treatment program for adolescents. Results of this study did not indicate superior outcomes for the planned discharge group. Several issues are raised regarding the use of discharge status as a performance indicator and recommendations are made for further research in this area. (Contains 44 references and 2 tables.) (GCP)

Published
2001

38. Attitudes and beliefs among Georgia addiction treatment staff about medication for opioid use disorder in adolescents, young adults, and adults: a multi-mixed methods study.

Author

Welsh, Justine W., Mataczynski, Maggie J., Passetti, Lora L., Hunter, Brooke D., and Godley, Mark D.

Subjects
OPIOID abuse, YOUNG adults, ADULTS, OPIOIDS, ADOLESCENCE, TREATMENT of addictions, TEENAGERS, DRUG abuse treatment
Abstract

Background: Adverse consequences, including non-fatal overdose and death, are prevalent in adolescents and young adults with opioid use disorder (OUD). Barriers toward medication for opioid use disorder (MOUD) have been identified in adult populations but are poorly understood in youth. Objective: This exploratory multi-mixed methods study examines beliefs and attitudes of addiction treatment program staff about the use of MOUD in youth. Methods: A 40-item survey was distributed electronically to 299 addiction treatment programs in Georgia from May 2020 to January 2021. Participant (N = 215; 74% female) attitudes regarding the use of MOUD in three age groups (adolescents (aged 16–17), young adults (aged 18–25), and adults (aged 26+) on a 6-point Likert scale were compared using paired samples t-tests. A series of one-way ANOVA analyses examined differences in attitudes and beliefs across participant characteristics. Verbatim responses to qualitative survey questions were analyzed using a coding reliability approach to thematic analysis. Results: Participants were less likely to support MOUD in adolescents (M = 3.68, SD 1.5) compared with young (M = 4.38, SD 1.36, t = 8.19, p <.001, d =.51) and older adults (M = 4.64, SD 1.3, t = 9.83, p <.001 d =.74). Participants endorsed higher response rates for the use of both naltrexone and buprenorphine over methadone in young adults. A total of 1,412 text responses were reviewed. Participants highlighted barriers to acceptance and use of MOUD in adolescents including safety concerns and impact on brain development. Conclusions: The results support a comprehensive approach to reducing the barriers to using medications to treat OUDs in adolescent populations. Formal and focused continuing education to correct attitudes and beliefs about MOUD treatment for adolescents is necessary. [ABSTRACT FROM AUTHOR]

Published
2022
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39. Contingency management for attendance to group substance abuse treatment administered by clinicians in community clinics

Author

Ledgerwood, David M., Alessi, Sheila M., Hanson, Tressa, Godley, Mark D., and Petry, Nancy M.

Subjects
Group counseling -- Methods, Group counseling -- Management, Contingency theory (Management) -- Research, Substance abuse -- Care and treatment, Substance abuse -- Methods, Company business management, Psychology and mental health
Abstract

Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were enrolled in the clinics when the CM treatment phase was in effect attended a significantly greater percentage of therapy sessions than patients who were enrolled in treatment when CM was not in effect. This study is one of the first to investigate CM in community settings implemented entirely by community clinicians, and results suggest that CM is effective in improving therapy attendance. DESCRIPTORS: attendance, community settings, contingency management, substance abuse treatment

Published
2008

47. Abstract

Author

van der Wal, Mike, Lang, Scott A., Yip, Ray W., Chow, Frances L., Duncan, Peter G., Perverseff, Robert A., Crone, Lesley-Ann L., Verity, Robert A., Flath, Jim, Twist, David L., Code, William E., Thornhill, Jim, Wang, Louie, Hong, Murray, Milne, Brian, Jhamandas, Khem, Shannon, Janet L., Gerard, Martin, Takeuchi, Larry, Puchalski, Stephen A., Roberts, Robin, Law, Victor, Bell, Roger, Dunn, Geoffrey L., Eger Robert P., McLeod B. A., Asenjo, Francisco, Blaise, Gilbert, Normandin, Denise, Naguib, Mohamed, Abdulatif, Mohamed, Hung, Orlando R., Mezei, Michael, Varvel, John R., Whynot, Sara C., McKenzie, Wileena, Bands, Colin, Shafer, Steven L., Neumeister, Michael W., Hall, Richard I., Li, Gefeng, Dawe, Gwen, O’Regan, Noel, Hall, Richard, Gardner, Martin, El-Beheiry, H., Shelley, E. S., Frcpc, Sharpe, Freeman, D. J., Gelb, A. W., Orser, Beverley A., Wang, Lu-Yang, MacDonald, John F., Derdemezi, Jeanette, Britt, Beverley A., Hyperthermia, Malignant, Doyle, D. John, Chau, Thomas C. Y., Guay, Joanne, Crochètiere, Chantal, Gaudreault, Pierre, Lortie, Louise, Varin, France, Bevan, David R., Plourde, R. Gilles, Zaharia, Francoise, Knox, J. W. Donald, Belo, Susan, Warriner, C. Brian, Cannon, John E., Watson, John B., Byrick, R. J., Mullen, J. B. M., Wigglesworth, D. F., Klinck, J. R., Ortiz, F., Pedersen, J., Smith, M. F., Hayman, G. A., Buckingham, C., Nebbia, Stephan P., Un, Victor, Chung, Frances F., Theodorou-Michaloliakou, Christina, Baylon, Godofredo J., Chua, Jose G., Sharma, Sharad, Cruise, Charles, McGuire, Glenn, Chan, Vincent W. S., Patel, Nilesh, Pinchak, Alfred C., Smith, Charles E., Hancock, Donald E., Tessler, Michael J., Grillas, Bobby H., Gioseffini, Sonia, Grillas, B., Desparmet, J. F., MacArthur, C., MacArthur, A., Carpenter, Robert D., Bissonnette, Bruno, Fear, David W., Lerman, J., Spahr-Schopfer, I. A., Sikich, N., Hagen, Joan F., Fuller, John G., Taylor, Michael, Fisgus, John, Petz, Colleen, Hagen, Joan, Forrest, J. B., Buckley, D. N., Beattie, W. S., Beattie, A. E., Clairoux, M., Katz, J., Kavanagh, B., Roger, S., Nierenberg, H., Sandler, A., Baxter, Alan D., Samson, Benolt, Laganière, Sylvie, Stewart, John, Hull, Kathryn A., Goernart, Lynne, Sosis, Mitchel B., Braverman, Berton, Toppses, Anthony, Lipov, Eugene, Ivankovich, Anthony D., Rose, D. Keith, Cohen, Marsha M., Cheng, Davy C. H., Asokumar, Buvanendran, Caballero, Antonio C., Wong, David, Maltby, J. Roger, Eagle, Chris J., Müller, Hermann G., Teasdale, Sallie J., Karski, Jacek M., Carroll, Jo A., Van Luven, Sue, Zulys, Vytas J., Davies, Ann, Norman, Peter N., Cuddihy, Pamela, Kavanagh, Brian, Caballero, Antonio, Sandier, Alan, Peniston, Charlie, Sandler, Alan N., Boylan, John F., Feindel, Christopher M., Sandier, Alan N., Boylen, Patricia, Ries, Craig R., Puil, Ernie, Hickey, Donald R., Scott, Andrew, Doblar, Dennis D., Frenette, Luc, Boyo, Gwendolyn, Poplawski, Steven, Ranjan, Dinesh, Godley, Mark B., Saprunoff, Sam, Vincent, D., Yee, Doreen, Goodall, Deborah, Zawacki, John, Withington, Davinia E., Davis, Michael, Vallinis, Peter, Bevan, Joan C., Sapin-Leduc A., Plourde G., Fosset N., Symes J. F., Morin J. E., De Varennes B., Latter D., Kantor, Gareth S., Smyth, Robert J., Glynn, Michael, McLean, Richard F., Phillips, Andrew A., Fremes, Stephen E., Bunting, Peter, Joy, Lance, Hamilton, Carol, Searle, Norman R., Roy, Micheline, Perrault, Jean, Roof, Jeanne, Hermanns, Cory C., Courtemanche, Micheline, Demers, Christine, Cartier, Raymond, Boudreault, Daniel, Couture, Pierre, To, Quy, Parent, Martin, Badner, Neal H., Komar, Wendy E., Murkin, J. M., Martzke, J. B., Buchan, A. M., Bentley, C., Mazer, C. David, Byrick, Robert J., Tong, Jeff, Carroll, Jo A., Van Kessel, Karl, Glynn, Michael F., Martin, René, Jourdain, S., Tétrault, J. P., Javery, Keith B., Colclough, George W., Sutterlin, John, Witt, William O., Rolbin, Steve, Levinton, Carey, Sayeed, Yousuf G., Ward, Marlene E., Campbell, David, Douglas, M. Joanne, Merrick, Pamela, Sandier, Alan, Baxter, Alan, Samson, Benoit, Katz, Joel, Friedlander, Mark, Donnelly, Maria, Pagenkopf, Derrick S., Bagdan, Bonnie L., Davies, Jan M., Parsons, Louise M., Roth, Leah, Garnett, R. Lawre, MacIntyre, Annette, Lindsay, M. Patrice, Yogendran, Suntheralingham, Little, D’Arcy, Lena, Joseph, Halpern, Stephen H., Lin, Susan, Bell, Dean D., Ostryzniuk, Patricia, Roberts, Edward, Roberts, Dan, Gauthier, Jean E., Perreault, C., Tomasa, Grace, Sosis, Nitchel B., Matta, Basil F., Eng, Calvin C., Mayberg, Teresa S., Lam, Arthur M., Mathisen, Terri L., Kitts, John, Martineau, Raymond, Miller, Donald, Lindsay, Patrice, Curran, Michael, Betcher, Jeffrey G., Kirpalani, Haresh, Gray, Shari, Lung, Kevin E., Multari, Joseph, Stewart, Ronald D., Forward, S. Paula, McGrath, Patrick J., Finley, G. Allen, McNeill, Gillian, Biddle, Nancy L., Gelb, Adrian W., Hamilton, John T., Sharpe, M. D., Vanelli, T., Craen, R. A., Brodkin, I., Le, D., Lok, P., Rose, D. K., Yee, D. A., Layon, A. Joseph, White, Sno E., Gibby, Gordon L., Greig, Paul D., Nierenberg, Hilary, Sheiner, Patricia A., Levytam, S., Arellano, R., Glynn, Michael F. X., Purday, Jonathan P., Reichert, Clayton C., Reimer, Eleanor J., Bevan, Joan C., Montgomery, Carolyne J., Blackstock, Derek, Reichert, Clayton, Byers, G. F., Muir, J. G., Levine, M. F., Kleinman, S., Sarner, J., Davis, P., Motoyaraa, E., Cook, D. R., Sessler, Daniel I., Foster, J. M. T., Burrows, F. A., Haig, Margaret, Poitras, Benoit, Reid, Craig W., Slinger, Peter, Lenis, Serge, Wilkes, P., Henderson, S. M., Zhang, C., Zulys, Vytas, Bradwell, John, Mabuchi, Norifumi, Carroll, Jo, Harley, Pat, Doblar, Dennis, Boyd, Gwen, Singer, Dan, Gelman, Simon, Devitt, J. Hugh, Wenstone, R., Noel, Alva G., O’Donnell, Michael P., Pytka, Saul, Murphy, Michael F., Launcelott, Gordon O., Morris, Ian R., Stevens, Sarah C., Cooper, Richard M., Irish, John C., Brown, Dale H., Donen, Neil, White, Ian W. C., Snidal, Lisa, Sanmartin, Claudia, Knox, Margot G., Roper, Fiona, Gornall, Wayne, Fisk, John D., Ritvo, Paul, and Stanish, W.

Published
1993
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