%0 Journal Article %J J Subst Abuse Treat %D 2015 %T Maintenance Check-ups Following Treatment for Cannabis Dependence. %A Walker, Denise D %A Stephens, Robert S %A Towe, Sheri %A Banes, Kelsey %A Roffman, Roger %K Adult %K Cognitive Therapy %K Continuity of Patient Care %K Female %K Follow-Up Studies %K Humans %K Male %K Marijuana Abuse %K Middle Aged %K Motivational Interviewing %K Random Allocation %K Treatment Outcome %X

Substance use disorders, including cannabis use disorders and associated negative consequences, are best considered chronic and in need of continuing care. In contrast, most treatment efficacy studies evaluate a fixed number of intervention sessions at a single point in time. The present study evaluated the efficacy of posttreatment maintenance check-ups (MCUs) in maintaining and improving outcomes following nine sessions of motivational enhancement treatment/cognitive behavioral treatment (MET/CBT). Adults dependent on cannabis (n=74) were randomly assigned to the MCU or a no check-up (NCU) condition and followed up at 3- and 9-months. MCU sessions occurred 1 and 4months following the completion of the base treatment. Additional MET/CBT sessions were available to participants throughout the follow-up period. The MCUs specifically encouraged treatment re-entry for those showing ongoing signs of disorder. Participants in the MCU condition reported significantly greater abstinent rates at both follow-ups and were using on fewer days at the 3-month but not the 9-month follow-up. Contrary to hypotheses, MCU participants did not attend more additional treatment and differences in rates of cannabis use emerged prior to the first MCU session. Future research with longer follow-up periods and longer monitoring of outcomes is needed to fully evaluate the utility of MCUs or other forms of continuing care.

%B J Subst Abuse Treat %V 56 %P 11-5 %8 2015 Sep %G eng %R 10.1016/j.jsat.2015.03.006 %0 Journal Article %J Addict Behav %D 2011 %T The influence of client behavior during motivational interviewing on marijuana treatment outcome. %A Walker, Denise %A Stephens, Robert %A Rowland, Jared %A Roffman, Roger %K Adult %K Behavior, Addictive %K Diagnostic and Statistical Manual of Mental Disorders %K Female %K Follow-Up Studies %K Humans %K Interview, Psychological %K Male %K Marijuana Abuse %K Motivation %K Patient Acceptance of Health Care %K Psychotherapy %K Treatment Outcome %X

Psychotherapy process research continues to be important in identifying within session client and therapist behaviors related to outcome. Motivational Interviewing (MI) assumes that the type of client language elicited within session is important. Client behavior was coded from 61 MI sessions with marijuana dependent adults. Sessions were coded for client language using the Client Language and Commitment Scale. Client statements indicating desire and reasons for change were significantly predictive of marijuana treatment outcome through the 34-month follow-up above and beyond baseline levels of marijuana use or motivation for change. Commitment language was not associated with outcomes. These findings suggest specific types of client language statements predict marijuana treatment outcome and are durable to a 34-month follow-up.

%B Addict Behav %V 36 %P 669-73 %8 2011 Jun %G eng %N 6 %R 10.1016/j.addbeh.2011.01.009 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Randomized controlled trial of motivational enhancement therapy with nontreatment-seeking adolescent cannabis users: a further test of the teen marijuana check-up. %A Walker, Denise D %A Stephens, Robert %A Roffman, Roger %A Demarce, Josephine %A Lozano, Brian %A Towe, Sheri %A Berg, Belinda %K Adolescent %K Behavior Therapy %K Female %K Humans %K Interview, Psychological %K Male %K Marijuana Abuse %K Marijuana Smoking %K Motivation %K Psychotherapy, Brief %K Treatment Outcome %X

Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC), or Delayed Feedback Control (DFC). Those who were assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to four optional individual treatment sessions aimed at cessation of cannabis use. The research was conducted in high schools in Seattle, Washington. The participant s included 310 self-referred adolescents who smoked cannabis regularly. The main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to those in the DFC. The frequency of cannabis use was less in MET relative to EFC at 3 months, but it did not translate to differences in negative consequences. Reductions in use and problems were sustained at 12 months, but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and did not differ by condition. Brief interventions can attract adolescent cannabis users and have positive impacts on them, but the mechanisms of the effects are yet to be identified.

%B Psychol Addict Behav %V 25 %P 474-84 %8 2011 Sep %G eng %N 3 %R 10.1037/a0024076