Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment

• Published in: Behaviour research and therapy Vol. 89; pp. 49 - 56
• Main Authors: Esposito-Smythers, Christianne, Hadley, Wendy, Curby, Timothy W., Brown, Larry K.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2017; Elsevier Science Ltd
• Subjects: Adolescent; Adolescent Behavior - psychology; Adolescents; Alcohol; Alcohol abuse; Alcohol Drinking - prevention & control; Alcohol use; Behavior; Behavior problems; Binge Drinking - prevention & control; Clinical trial; Cognition; Cognitive ability; Cognitive aspects; Cognitive Therapy; Disease prevention; Drinking behavior; Evaluation; Families & family life; Family; Family Therapy; Female; Health behavior; Health problems; High risk; HIV; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infections; Male; Mental disorders; Mental health; Mental health services; Perceptions; Pilot Projects; Prevention; Prevention programs; Preventive medicine; Refusal; Risk assessment; Risk behavior; Risk factors; Risk groups; Self destructive behavior; Self injury; Self-Injurious Behavior - prevention & control; Sex; Sex education; Sexual behavior; Sexual intercourse; Sexual risk; Sexually transmitted diseases; STD; Substance abuse; Substance use; Suicidal Ideation; Suicide; Teenagers; Unsafe Sex - prevention & control; Prevention; ASH-P; CBT; Adolescent; Sexual risk; DSH; Alcohol; Family; Clinical trial; AO-C; Suicide; SCLT
• ISSN: 0005-7967; 1873-622X
• DOI: 10.1016/j.brat.2016.11.005

Adolescents with mental health conditions represent a high-risk group for substance use, deliberate self-harm (DSH), and risky sexual behavior. Mental health treatment does not uniformly decrease these risks. Effective prevention efforts are needed to offset the developmental trajectory from mental health problems to these behaviors. This study tested an adjunctive cognitive-behavioral family-based alcohol, DSH, and HIV prevention program (ASH-P) for adolescents in mental healthcare. A two group randomized design was used to compare ASH-P to an assessment only control (AO-C). Participants included 81 adolescents and a parent. Assessments were completed at pre-intervention as well as 1, 6, and 12-months post-enrollment, and included measures of family-based mechanisms and high-risk behaviors. ASH-P relative to AO-C was associated with greater improvements in most family process variables (perceptions of communication and parental disapproval of alcohol use and sexual behavior) as well as less DSH and greater refusal of sex to avoid a sexually transmitted infection. It also had a moderate (but non-significant) effect on odds of binge drinking. No differences were found in suicidal ideation, alcohol use, or sexual intercourse. ASH-P showed initial promise in preventing multiple high-risk behaviors. Further testing of prevention protocols that target multiple high-risk behaviors in clinical samples is warranted. •Evaluated an alcohol, self-harm and HIV prevention workshop for high-risk teens.•Workshop was family-based and offered to teens in mental health treatment.•Workshop was associated with improvement in family communication and norms.•Workshop had medium-large effects on self-harm, binge drinking, and refusal of sex.