Researchers at Dalhousie and the University of Montreal have found that brief cognitive behavioural interventions that help young people manage such things as impulsivity, sensation seeking, sensitivity to anxiety and negative thinking can reduce teen substance use disorders.
The findings, published in the American Journal of Psychiatry, outlined results of the cluster randomised trial involving 31 Canadian high schools and 3,800 students. The study showed that when such interventions are delivered to students in Grade 7, they are associated with reduced risk for substance use disorders by Grade 11.
"By providing adaptive coping skills training to youth that is specific to their unique needs, we can delay early onset substance use to cope and thereby help protect our youth from developing full-blown substance use disorders in the longer term," says Dalhousie psychiatry professor Dr. Sherry Stewart, director of the Mood, Anxiety and Addiction Comorbidity (MAAC) Lab at Dal and a Tier 1 Canada Research Chair in Addiction and Mental Health.
Building positive behaviour
The team used PreVenture, a school-based preventative mental health intervention program co-developed by Dr. Stewart and Dr. Patricia Conrod at the University of Montreal, which is already used in schools in five Canadian provinces and 12 U.S. states. The interventions help young people explore individual differences in personality traits and the coping strategies they are using to manage their personality. They are also taught cognitive and behavioural strategies that are specific to their personalities that will help them channel key personality traits towards long-term goals.
The trial showed that intervention delivered in Grade 7 was associated with reduced growth in substance use disorder by as much as 80 per cent compared to schools that did not use the interventions.
Individual differences in personality are essential to a healthy society. However, when certain personality traits are mismanaged, young people may turn to substances to reduce the stress brought about by certain traits.
The team collaborated with high schools in the Greater Montreal Area as part of the CoVenture trial, funded by the Canadian Institutes of Health Research and aimed at testing whether the PreVenture program could reduce risk for substance use disorder over a five-year period in adolescence. Students completed a brief personality questionnaire in Grade 7 that assesses impulsivity, sensation seeking, anxiety sensitivity and negative thinking. Schools helped in delivering personality-targeted brief cognitive behavioural interventions to students who reported elevated scores on one of the four traits. All students were followed every year for five years on school-based digital assessments.
"Given the ongoing addiction crisis in Canada and across North America, this trial provides crucial evidence of the importance of governments investing in school-based prevention as part of the tools we should be using to combat addiction in our youth," says Dr. Stewart.
Scaling supports
The team is conducting another trial, called the Canadian Underage Substance Prevention (CUSP) Trial, in schools in three Canadian provinces including Nova Scotia, to study the best ways to put this effective program into practice.
"Our experience implementing and scaling PreVenture in schools, Integrated Youth Services and other community-based settings in Ontario has been exceptional. By prioritizing prevention, PreVenture supports creating environments for youth that foster healthy decision-making and reduces the likelihood of substance use. There isn't any other program with the evidence base like it," says Deb Chiodo, director of Data Management and Evaluation at Youth Wellness Hubs Ontario.
It is also being used in Indiana by a group helping people and communities affected by addiction and substance use disorder.
"Overdose Lifeline, Inc. is a proud partner of the PreVenture team expanding access to this evidence-based, easy to implement program," says CEO Justin K. Phillips.
