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Table 1 Australian evidence on therapeutic interventions with adolescents with alcohol and other drug issues

From: Effective therapeutic interventions for Australian adolescents using alcohol and/or other drugs: a scoping review

First author, year of publication

Study design, year of study

Intervention(s), length of treatment

Sample

Eligibility

Age range, years (%m male)

Data collection

Outcome/effect

Risk of bias

Albertella et al. (2012)

Before-after study with no control group

January 2002-July 2010

Residential substance use program

Individual counselling, family counselling, living skills training, vocational/educational training, journaling and recreational activities

Continuing care in the community

Up to 3 month stay

Sample size: 132

14–18 years old

Cannabis primary drug

Completed ≥ 30 days of treatment

14–18 years

(77%m)

Pre-treatment

3-month follow-up

Reduced anxiety, paranoia and interpersonal sensitivity associated with reduced cannabis use on follow-up

Low

Bushmob (2014)

Observational study/Case study/Evaluation

2009

Bush adventure therapy,

counselling, individual therapy and continuing care

5-day horse trek

Sample size: 65

6–80 years old

young people with substance abuse issues, family and community members

6–80 years

(%m not stated)

Observations during trek

Reduced substance use and self-harm, and improved wellbeing

High

Calabria et al. (2011)

Systematic review

2005–2009

Individual intervention studies on young people experiencing alcohol-related harm

9 studies

Published in English

Intervention studies

Across studies:

11–25 years,

(17–90%m)

10 electronic databases, reference lists

None of the included studies had consistently strong methodology

Cognitive behaviour therapy (CBT), family therapy and community reinforcement appeared to be the more successful approaches

Moderate

Calabria et al. (2012)

Systematic review

2003–2010

Family-based interventions for alcohol misuse and alcohol-related harm in Indigenous communities

19 studies

Published in English

Family-based interventions

Across studies:

12–78 years

Targeting problem drinkers:

(17–100%m)

Targeting family members

(0–31%m)

11 electronic databases, reference lists

18 family-based interventions yielded a positive effect in

Decreased alcohol consumption

Improved individual and family coping and functioning

High

Doran et al. (2017)

Evidence check rapid literature review

January 2007-March 2017

Community, school-based and therapeutic interventions targeted at Aboriginal youth at risk of AOD-related harm

52 studies

Published in English

Indigenous young people

Alcohol and other drugs (AOD) interventions

Across studies:

Participant age range and %m not stated

9 electronic databases, consultation with experts

Successful AOD interventions for Indigenous young people require strong community and cultural engagement and support that is multi-faceted and flexible, addressing both individual, community and systemic issues

Moderate

Foster et al. (2010)

Participant observation/ ethnographic study

2006

Residential therapeutic community: journaling

encounter groups,

vocational education

Average length of stay: 40 days

Program length: 3 months

Sample size: 19

14–18 years old

substance dependence

14–18 years

(68%m)

4 months participant observation and informal interviews

Tailored recreation, art therapy and vocational education preferred

Negative reactions to journaling and encounter group sessions

Moderate

Green et al. (2013)

Qualitative study

2009–2010

The function of relationships in youth-focused AOD service: outreach, day programs, residential withdrawal and residential rehabilitation

Primary drugs of concern: cannabis alcohol, and heroin

Length of treatment: Residential withdrawal: up

to 2 weeks)

Residential rehabilitation: up to 6 months

Sample size: 42

Young people aged 15–22 years who were clients

Stable in AOD use and mental health

Ability to reflect on experiences

Excluded if recent experience of traumatic events or in emotional distress

15–22 years

(52.4%m)

Semi-structured interviews

Validating relationships with family, peers and service providers are key to success

Low

Hides et al. (2010)

Before-after study with no control group

Year not stated

Self-help for alcohol/other drug use and depression – for young people

10 sessions of individual integrated CBT treatment (incorporating motivational interviewing (MI) and mindfulness)

Intervention: Up to 20 weeks

Sample size: 60

15–25 years old

Diagnosis of Major Depressive Disorder and Substance Use Disorder or risky alcohol/drug use

English speaking

Excluded if using antidepressants within the past 30 days and/or a current/past history of psychosis

15–25 years

(56.7%m)

Assessment at baseline, mid-treatment (10 weeks), post-treatment (20 weeks) and 6 months follow-up (44 weeks)

Integrated CBT treatment associated with significant improvements in depression, anxiety, cognition, substance use and coping skills at follow-up

Moderate

Hides et al. (2011)

Non-RCT (parallel group)

2006–2008

Standard care (SC): Case management and brief MI

Intervention: SC plus CBT and MI

Timeframe: Up to 12 weeks

Substance misuse: mainly alcohol and cannabis

Sample size: 106

SC (n = 28)

SC + CBT/MI (n = 60)

16–25 years old

Comorbid depression and substance misuse

Accessing treatment at youth AOD service

English speaking

No past/current psychosis

16–25 years

(63%m)

Assessment at baseline, 3 months and 6 months

SC + CBT/MI group showed significant reductions in depression and cannabis use and increased social contact and motivation to change at 3-month follow-up compared to the SC group

Both groups achieved significant improvements in functioning and quality of life at 6 months follow-up

Moderate

Hides et al. (2013)

RCT (parallel group),

Year not stated

Assessment/Feedback Information (AFI) group: 1 session brief assessment, general assessment feedback

Brief Motivational Interviewing (BMI) intervention group: 2–3 sessions of BMI with personalised assessment feedback, psychoeducation and brief coping skills training

Sample size: 61

16–25 years old

Accessing a specialist youth mental health primary care service using cannabis and/or alcohol

English speaking

No past/current psychosis

16–25 years

(55.7%m)

Assessment at

baseline, 1, 3 and 6 months

BMI more effective in reducing alcohol use and psychological distress and achieving a more rapid reduction in cannabis use than AFI. No significant differences in both groups for psychological distress at 3 months. Reduced levels of psychological distress in BMI group at 6 months

Low

Hides et al. (2018)

RCT (parallel group),

Year not stated

Mobile app informed by motivational interviewing that creates a virtual experience to increase alcohol knowledge and reduce alcohol use in young app users

Duration of intervention: not specified

Sample size: 197

Immediate access group (n = 96)

1-month delayed access control group (n = 101)

16–25 years old

Australian residents

Consume alcohol at least monthly

Own an iPhone

16–25 years

(22.3%m)

Assessment at baseline, 1,2,3, and 6 months

No significant differences between the immediate and delayed access groups in alcohol use and alcohol related harm

Low

Hilferty et al. (2015)

Mixed-methods evaluation

2013 to 2014

Primary intervention:

focused psychological strategies provided by headspace

Comparison groups for binge drinking and cannabis use:

12–17 year-olds (n = 1,686) via survey

Intervention: 5 sessions average

headspace datasets (n = 45,000)

Survey participants:

headspace treatment (n = 1515)

No treatment (n = 4774)

12–25 years old

receiving headspace services

12–25 years

(%m not stated)

Comparison of young people attending headspace and young people not attending headspace

Significant small positive improvement in reduced psychological distress for the headspace group compared with the other treatment and no treatment groups over time. Reduced binge drinking highest in other treatment group. No significant differences between groups in cannabis use

Moderate

Knight et al. (2017)

Systematic review

2009–2014

Interventions including education, mentoring, recreation, information provision and counselling

targeting multiple risk factors

13 studies

12–24 years with multiple risk factors

Across studies:

12–24 years

(0–94%m)

7 electronic databases and grey literature

Most studies on single risk factors. Half of the studies were methodologically weak

High

Maclean et al. (2012)

Systematic review

1980–2010

Psychosocial therapeutic interventions for volatile substance use (VSU)

19 studies

Published in English

Substance use, health or welfare outcome data for therapeutic interventions addressing volatile substance use

Across studies:

10–32 years

(%m not stated)

Electronic databases and grey literature

Clear conclusions for VSU psychological treatment are not supported

High

Mission Australia (2011)

Before-after study with no control group

2005–2009

Residential rehabilitation: Counselling, case management, vocational education and training, sport and recreation, support for family communication and aftercare

Length of treatment:

Residential treatment: up to 3 months

Aftercare: up to 6 months

Sample size: 399 participants in program

Aftercare cohort: n = 160

16–24 years

Experiencing co-morbid conditions of drug addiction and mental illness

16–24 years

(72%m)

Assessment at baseline, 3 months and 6 months and post-treatment

Sustained reduction in chronic alcohol and/or cannabis use and increased abstinence

Sustained improvement in psychological health

Positive education, training, employment and accommodation outcomes

Moderate

Murphy (2011)

Case study

2007–2011

Koori youth residential AOD rehabilitation (Healing Service): Primary health counselling/mentoring, group work, aftercare, links to key adults in Koori community

Average length of stay: 69 days

Sample size: 7 case studies, number of participants interviewed not specified

Koori residential program participant

15–20 years

Problems relating to AOD use

15–20 years

(68%m)

7 case studies based on oral story-telling and

observations

Interviews with young people, staff and stakeholders

Increased safety and pride in cultural background

Improvements in communicating with adults, emotional regulation and relationships

Appropriate aftercare essential

Low

Norberg et al. (2013)

RCT (parallel group)

Year not stated

Brief CBT and motivational interviewing

Immediate treatment (IT) group and a 3-month delayed treatment control (DTC) group

Length of treatment: 3 sessions over 3 weeks (1 session per week)

Sample size: 33

IT (n = 18)

DTC (n = 11)

14–30 years old

 ≥ weekly cannabis use in month prior to assessment

Diagnosis of cannabis dependence

English speaking

14–30 years

(56.7%m)

Numerous clinical measures and scales for substance use and psychological distress

No significant improvements in the IT group compared with the DTC group for any of the outcome measures

High

Simpson et al. (2010)

Before-after study with no control group

2007–2009

Counselling clients of youth cannabis service received a median number of 3 treatment sessions over the course of a 2-year period

Sample size: 50 (counselling clients)

16–25 years

cannabis dependence

counselling clients

16–25 years

(80%m)

Service outcome statistics dataset and the National Minimum Data Set for the years 2007–2009 (for comparison)

Significant decrease in frequency and amount of cannabis use

Significant increase in life satisfaction

Low

Tait et al. (2010)

Systematic review and meta-analysis

2009

Internet-based attitudinal change and substance reduction interventions for young people with problematic substance use

16 studies

RCT

Published in English

Study outcome included a measure of consumption of the target substance

Across studies:

Participant age range and %m not stated for all studies

Search of 3 electronic databases and reference lists

Web-based interventions targeting alcohol use by young adults appear effective in reducing alcohol problems in current drinkers

Low

Tait et al. (2016)

RCT (parallel group)

1999–2002

RCT conducted across 4 public hospital emergency departments (ED) in Perth. Comparison of treatment costs following an AOD-related presentation to ED. Usual care compared with brief counselling, advice and referral to link adolescents with external AOD services

Length of treatment: 1 × 1 h session + referral and follow-up phone call

Sample size: 127

Control (n = 67)

Intervention (n = 60)

12–19 years

AOD-related presentation to ED

12–19 years

(%m not stated)

Health data linkage used for 10 years following the brief intervention

Those who received the intervention had lower costs of ED mental health AOD presentations

Injecting drug use was a significant baseline predictor of subsequent costs

Low

Wachtel et al. (2010)

Literature review

1998–2008

Brief clinical interventions including motivational interviewing and harm minimisation

aimed at reducing alcohol misuse and binge drinking

14 RCTs

RCT

Published in English

Brief intervention studies specific to alcohol reduction

Participant age: 12– 25 years

Across studies:

Participant age range and %m not stated for all studies

6 online databases and reference lists

No single intervention recommended due to confounding evidence

Moderate