Evidence map›Paper›PMID 28742932›Full record

Trial reportAddiction (Abingdon, England)2017

A pilot randomized clinical trial testing integrated 12-Step facilitation (iTSF) treatment for adolescent substance use disorder.

John F Kelly, Yifrah Kaminer, Christopher W Kahler, Bettina Hoeppner, Julie Yeterian, Julie V Cristello, Christine Timko

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Addiction (Abingdon, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06395467 (Integrated Treatment for Enhancing Growth in Recovery During Adolescence), which is not on this map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06395467 narecruitingnot on this mapstarted 2024, after this paper: background citation

Integrated Treatment for Enhancing Growth in Recovery During Adolescence (InTEGRA)

TypeinterventionalSponsorMassachusetts General HospitalRan2024 to 2028Enrolled294ConditionsAlcohol Use Disorder, Cannabis Use DisorderArmsInTEGRA, MET/CBT
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Contingency management for treatment attendance: A meta-analysis.Journal of substance abuse treatment · 2022
    Pooled it
  2. Pooled it
  3. Alcoholics Anonymous and other 12-step programs for alcohol use disorder.The Cochrane database of systematic reviews · 2020
    Pooled it
  4. Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use, 2014-2017: Outcomes, Treatment Delivery, and Promising Horizons.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
    Pooled it
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  17. The Twelve Steps and Adolescent Recovery: A Concise Review.Substance abuse : research and treatment · 2020
    Review
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  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

John F KellyRecovery Research Institute Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-6915-0750
Yifrah KaminerUniversity of Connecticut Health Sciences Center, Farmington, CT, USA.
Christopher W KahlerDepartment of Public Health, Brown University, Providence, RI, USA.
Bettina HoeppnerRecovery Research Institute Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Julie YeterianRecovery Research Institute Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Julie V CristelloRecovery Research Institute Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Christine TimkoVA Palo Alto Health Care System and Stanford University Medical School, Menlo Park, CA, USA.

Funding

Mentoring in Patient-Oriented Addiction ResearchK24AA022136 · NIAAA · MASSACHUSETTS GENERAL HOSPITAL · PI KELLY, JOHN F. · 2014 to 2023
$1.8M
Development and Testing of Adolescent Twelve-Step FacilitationR01AA019664 · NIAAA · MASSACHUSETTS GENERAL HOSPITAL · PI KELLY, JOHN F. · 2011 to 2013
$1.2M
NIAAA NIH HHS K24 AA022136NIAAA NIH HHS R01 AA019664
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe integration of 12-Step philosophy and practices is common in adolescent substance use disorder (SUD) treatment programs, particularly in North America. However, although numerous experimental studies have tested 12-Step facilitation (TSF) treatments among adults, no studies have tested TSF-specific treatments for adolescents. We tested the efficacy of a novel integrated TSF.

designExplanatory, parallel-group, randomized clinical trial comparing 10 sessions of either motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT; n = 30) or a novel integrated TSF (iTSF; n = 29), with follow-up assessments at 3, 6 and 9 months following treatment entry.

settingOut-patient addiction clinic in the United States.

participantsAdolescents [n = 59; mean age = 16.8 (1.7) years; range = 14-21; 27% female; 78% white]. INTERVENTION AND COMPARATOR: The iTSF integrated 12-Step with motivational and cognitive-behavioral strategies, and was compared with state-of-the-art MET/CBT for SUD. MEASUREMENTS: Primary outcome: percentage days abstinent (PDA); secondary outcomes: 12-Step attendance, substance-related consequences, longest period of abstinence, proportion abstinent/mostly abstinent, psychiatric symptoms.

findingsPrimary outcome: PDA was not significantly different across treatments [b = 0.08, 95% confidence interval (CI) = -0.08 to 0.24, P = 0.33; Bayes' factor = 0.28). SECONDARY OUTCOMES: during treatment, iTSF patients had substantially greater 12-Step attendance, but this advantage declined thereafter (b = -0.87; 95% CI = -1.67 to 0.07, P = 0.03). iTSF did show a significant advantage at all follow-up points for substance-related consequences (b = -0.42; 95% CI = -0.80 to -0.04, P < 0.05; effect size range d = 0.26-0.71). Other secondary outcomes did not differ significantly between treatments, but effect sizes tended to favor iTSF. Throughout the entire sample, greater 12-Step meeting attendance was associated significantly with longer abstinence during (r = 0.39, P = 0.008), and early following (r = 0.30, P = 0.049), treatment.

conclusionCompared with motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT), in terms of abstinence, a novel integrated 12-Step facilitation treatment for adolescent substance use disorder (iTSF) showed no greater benefits, but showed benefits in terms of 12-Step attendance and consequences. Given widespread use of combinations of 12-Step, MET and CBT in adolescent community out-patient settings in North America, iTSF may provide an integrated evidence-based option that is compatible with existing practices.

Indexed as

Self-Help GroupsAdolescentAdultCognitive Behavioral TherapyFemaleFollow-Up StudiesHumansMaleMotivational InterviewingOutpatientsPilot ProjectsSubstance-Related DisordersTreatment OutcomeYoung Adult12-Step12-Step facilitationaddictionadolescentsAlcoholics AnonymousMarijuana AnonymousNarcotics Anonymoussubstance use disordertreatmentyoung adults

Identifiers

PMID28742932
PMCPMC5673563

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.