Skip to main content

Advertisement

SpringerLink
Log in

Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review

  • Published:
Clinical Child and Family Psychology Review Aims and scope Submit manuscript

Abstract

Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may, therefore, be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3–4 interventions significantly reduced youth internalizing symptoms; 3–5 reduced youth substance use; and 2–3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from ~ 15 to 240 min. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. One study team did not respond to email requests for more information, and therefore, we ultimately did not include this study in the review, though it may have met inclusion criteria (Arnaud et al., 2017).

  2. Except the text-based intervention, which was administered via 24 text messages.

  3. Per authors’ report, four intervention conditions were associated with significant decreases in anxiety symptoms across follow-ups (Andersson et al., 2017; both active conditions in Murphy et al., (2019), and O’Leary-Barrett et al. (2016), and one intervention condition was associated with consistent decreases in depression symptoms across follow-ups (O’Leary-Barrett et al., 2016).

  4. Per authors’ report, three intervention conditions were associated with significant decreases in substance use across follow-ups or as overall change scores (Brown et al., 2015; one active condition in Murphy et al., 2019; O’Leary-Barrett et al., 2016).

  5. In our preregistration, we had additionally planned to use established rating criteria to characterize the state of the evidence for each included intervention. However, because each included intervention was only assessed in a single study, we ultimately decided not to pursue this step.

References

  • Andersson, C., Öjehagen, A., Olsson, M. O., Brådvik, L., & Håkansson, A. (2017). Interactive voice response with feedback intervention in outpatient treatment of substance use problems in adolescents and young adults: A randomized controlled trial. International Journal of Behavioral Medicine, 24(5), 789–797.

    Article  PubMed  Google Scholar 

  • Arnaud, N., Diestelkamp, S., Wartberg, L., Sack, P. M., Daubmann, A., & Thomasius, R. (2017). Short-to midterm effectiveness of a brief motivational intervention to reduce alcohol use and related problems for alcohol intoxicated children and adolescents in pediatric emergency departments: A randomized controlled trial. Academic Emergency Medicine, 24(2), 186–200.

    Article  PubMed  Google Scholar 

  • Back, S. E., Waldrop, A. E., & Brady, K. T. (2009). Treatment challenges associated with comorbid substance use and posttraumatic stress disorder: Clinicians’ perspectives. The American Journal on Addictions, 18(1), 15–20.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brown, R. A., Abrantes, A. M., Minami, H., Prince, M. A., Bloom, E. L., Apodaca, T. R., Strong, D. R., Picotte, D. M., Monti, P. M., MacPherson, L., Matsko, S. V., & Hunt, J. I. (2015). Motivational interviewing to reduce substance use in adolescents with psychiatric comorbidity. Journal of Substance Abuse Treatment, 59, 20–29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brownlie, E., Beitchman, J. H., Chaim, G., Wolfe, D. A., Rush, B., & Henderson, J. (2019). Early adolescent substance use and mental health problems and service utilization in a school-based sample. The Canadian Journal of Psychiatry, 64(2), 116–125.

    Article  PubMed  Google Scholar 

  • Bukstein, O. G., & Horner, M. S. (2010). Management of the adolescent with substance use disorders and comorbid psychopathology. Child and Adolescent Psychiatric Clinics, 19(3), 609–623.

    Article  Google Scholar 

  • Castellanos, N., & Conrod, P. (2006). Brief interventions targeting personality risk factors for adolescent substance misuse reduce depression, panic and risk-taking behaviours. Journal of Mental Health, 15(6), 645–658.

    Article  Google Scholar 

  • Center for Behavioral Health Statistics and Quality. (2018). 2017 National Survey on Drug Use and Health: Methodological summary and definitions. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  • Creswell, C., Nauta, M. H., Hudson, J. L., March, S., Reardon, T., Arendt, K., Bodden, D., Cobham, V. E., Donovan, C., Halldorsson, B., In-Albon, T., Ishikawa, S.-I., Johnsen, D. B., Jolstedt, M., de Jong, R., Kreuze, L., Mobach, L., Rapee, R. M., Spence, S. H., & Kendall, P. C. (2021). Research review: Recommendations for reporting on treatment trials for child and adolescent anxiety disorders–an international consensus statement. Journal of Child Psychology and Psychiatry, 62(3), 255–269.

    Article  PubMed  Google Scholar 

  • Deady, M., Mills, K. L., Teesson, M., & Kay-Lambkin, F. (2016). An online intervention for co-occurring depression and problematic alcohol use in young people: Primary outcomes from a randomized controlled trial. Journal of Medical Internet Research, 18(3), e71.

    Article  PubMed  PubMed Central  Google Scholar 

  • Esmaeelzadeh, S., Moraros, J., Thorpe, L., & Bird, Y. (2018). Examining the association and directionality between mental health disorders and substance use among adolescents and young adults in the U.S. and canada—A systematic review and meta-analysis. Journal of Clinical Medicine, 7(12), 543.

    Article  PubMed Central  Google Scholar 

  • Fergusson, D. M., Boden, J. M., & Horwood, L. J. (2011). Structural models of the comorbidity of internalizing disorders and substance use disorders in a longitudinal birth cohort. Social Psychiatry and Psychiatric Epidemiology, 46(10), 933–942.

    Article  PubMed  Google Scholar 

  • Garey, L., Olofsson, H., Garza, T., Rogers, A. H., Kauffman, B. Y., & Zvolensky, M. J. (2020). Directional effects of anxiety and depressive disorders with substance use: A review of recent prospective research. Current Addiction Reports, 16, 1–12.

    Google Scholar 

  • Harpaz-Rotem, I., Leslie, D., & Rosenheck, R. A. (2004). Treatment retention among children entering a new episode of mental health care. Psychiatric Services, 55(9), 1022–1028.

    Article  PubMed  Google Scholar 

  • Herz, V., Franzin, N., Huemer, J., Mairhofer, D., Philipp, J., & Skala, K. (2018). Substance use and misuse among children and youth with mental illness. Neuropsychiatrie, 32(1), 18–25.

    Article  PubMed  Google Scholar 

  • Hilt, L. M., & Pollak, S. D. (2012). Getting out of rumination: Comparison of three brief interventions in a sample of youth. Journal of Abnormal Child Psychology, 40(7), 1157–1165.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hussong, A. M., Ennett, S. T., Cox, M. J., & Haroon, M. (2017). A systematic review of the unique prospective association of negative affect symptoms and adolescent substance use controlling for externalizing symptoms. Psychology of Addictive Behaviors, 31(2), 137.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnson, T. P., & Bowman, P. J. (2003). Cross-cultural sources of measurement error in substance use surveys. Substance Use & Misuse, 38(10), 1447–1490.

    Article  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005a). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005b). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lansford, J. E., Erath, S., Yu, T., Pettit, G. S., Dodge, K. A., & Bates, J. E. (2008). The developmental course of illicit substance use from age 12 to 22: Links with depressive, anxiety, and behavior disorders at age 18. Journal of Child Psychology and Psychiatry, 49(8), 877–885.

    Article  PubMed  Google Scholar 

  • Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1998). Major depressive disorder in older adolescents: Prevalence, risk factors, and clinical implications. Clinical Psychology Review, 18(7), 765–794.

    Article  PubMed  Google Scholar 

  • Lewinsohn, P. M., Zinbarg, R., Seeley, J. R., Lewinsohn, M., & Sack, W. H. (1997). Lifetime comorbidity among anxiety disorders and between anxiety disorders and other mental disorders in adolescents. Journal of Anxiety Disorders, 11(4), 377–394.

    Article  PubMed  Google Scholar 

  • Lubman, D. I., Allen, N. B., Rogers, N., Cementon, E., & Bonomo, Y. (2007). The impact of co-occurring mood and anxiety disorders among substance-abusing youth. Journal of Affective Disorders, 103(1–3), 105–112.

    Article  PubMed  Google Scholar 

  • Marmorstein, N. R. (2009). Longitudinal associations between alcohol problems and depressive symptoms: early adolescence through early adulthood. Alcoholism Clinical and Experimental Research, 33(1), 49–59.

    Article  PubMed  Google Scholar 

  • Mason, M., Mennis, J., Way, T., Zaharakis, N., Campbell, L. F., Benotsch, E. G., Keyser-Marcus, L., & King, L. (2016). Text message delivered peer network counseling for adolescent smokers: A randomized controlled trial. The Journal of Primary Prevention, 37(5), 403–420.

    Article  PubMed  Google Scholar 

  • McGorry, P. D., & Mei, C. (2020). Unmet needs in youth mental health: Transforming models of care to improve outcomes. New directions in psychiatry (pp. 181–191). Springer.

    Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989.

    Article  Google Scholar 

  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mullarkey, M. C., & Schleider, J. L. (2021). Embracing scientific humility and complexity: Learning “what works for whom” in youth psychotherapy research. Journal of Clinical Child & Adolescent Psychology, 1, 1–7.

    Google Scholar 

  • Murphy, J. G., Dennhardt, A. A., Martens, M. P., Borsari, B., Witkiewitz, K., & Meshesha, L. Z. (2019). A randomized clinical trial evaluating the efficacy of a brief alcohol intervention supplemented with a substance-free activity session or relaxation training. Journal of Consulting and Clinical Psychology, 87(7), 657.

    Article  PubMed  PubMed Central  Google Scholar 

  • National Institute of Mental Health (NIMH). (2021). Substance Use and Co-Occurring Mental Disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health/.

  • O'Brien, C. P., Oster, M., & Morden, E. (2013). Best practices in prevention, screening, diagnosis, and treatment of substance use disorders. Substance Use Disorders in the US Armed Forces.

  • O’Leary-Barrett, M., Castellanos-Ryan, N., Pihl, R. O., & Conrod, P. J. (2016). Mechanisms of personality-targeted intervention effects on adolescent alcohol misuse, internalizing and externalizing symptoms. Journal of Consulting and Clinical Psychology, 84(5), 438.

    Article  PubMed  Google Scholar 

  • O’Neil, K. A., Conner, B. T., & Kendall, P. C. (2011). Internalizing disorders and substance use disorders in youth: Comorbidity, risk, temporal order, and implications for intervention. Clinical Psychology Review, 31(1), 104–112.

    Article  PubMed  Google Scholar 

  • Ouimette, P., & Brown, P. J. (2003). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. American Psychological Association.

    Book  Google Scholar 

  • Roberts, N. P., Roberts, P. A., Jones, N., & Bisson, J. I. (2015). Psychological interventions for post-traumatic stress disorder and comorbid substance use disorder: A systematic review and meta-analysis. Clinical Psychology Review, 38, 25–38.

    Article  PubMed  Google Scholar 

  • Rohde, P., Lewinsohn, P. M., & Seeley, J. R. (1991). Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults. Journal of Abnormal Psychology, 100(2), 214.

    Article  PubMed  Google Scholar 

  • Ryan, R., Hill, S., Prictor, M., & McKenzie, J. (2013). Cochrane Consumers and Communication group Study Quality Guide. CCCG http://cccrg.cochrane.org/author-resources. La Trobe University, Melbourne.

  • Schleider, J. L., Dobias, M. L., Sung, J. Y., & Mullarkey, M. C. (2020a). Future directions in single-session youth mental health interventions. Journal of Clinical Child & Adolescent Psychology, 49(2), 264–278.

    Article  Google Scholar 

  • Schleider, J. L., Dobias, M. L., Sung, J. Y., Mumper, E., & Mullarkey, M. C. (2020b). Acceptability and utility of an open-access, online single-session intervention platform for adolescent mental health. JMIR Mental Health, 7(6), e20513.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schleider, J. L., Mullarkey, M. C., & Chacko, A. (2020c). Harnessing wise interventions to advance the potency and reach of youth mental health services. Clinical Child and Family Psychology Review, 23(1), 70–101.

    Article  PubMed  Google Scholar 

  • Schleider, J. L., & Weisz, J. R. (2017). Little treatments, promising effects? Meta-analysis of single-session interventions for youth psychiatric problems. Journal of the American Academy of Child & Adolescent Psychiatry, 56(2), 107–115.

    Article  Google Scholar 

  • Schleider, J. L., Ye, F., Wang, F., Hipwell, A. E., Chung, T., & Sartor, C. E. (2019). Longitudinal reciprocal associations between anxiety, depression, and alcohol use in adolescent girls. Alcoholism, Clinical and Experimental Research, 43(1), 98–107.

    Article  PubMed  Google Scholar 

  • Schmit, E. L., Schmit, M. K., & Lenz, A. S. (2016). Meta-analysis of solution-focused brief therapy for treating symptoms of internalizing disorders. Counseling Outcome Research and Evaluation, 7(1), 21–39.

    Article  Google Scholar 

  • Steele, D. W., Becker, S. J., Danko, K. J., Balk, E. M., Adam, G. P., Saldanha, I. J., & Trikalinos, T. A. (2020). Brief behavioral interventions for substance use in adolescents: A meta-analysis. Pediatrics, 146(4), 1.

    Article  Google Scholar 

  • Stein, L. A., Colby, S. M., Barnett, N. P., Monti, P. M., Golembeske, C., & Lebeau-Craven, R. (2006). Effects of motivational interviewing for incarcerated adolescents on driving under the influence after release. The American Journal on Addictions, 15, s50–s57.

    Article  Google Scholar 

  • Sterling, S., Kline-Simon, A. H., Jones, A., Hartman, L., Saba, K., Weisner, C., & Parthasarathy, S. (2019). Health care use over 3 years after adolescent SBIRT. Pediatrics, 143(5), 18.

    Article  Google Scholar 

  • Stoll, R. D., Pina, A. A., & Schleider, J. (2020). Brief, non-pharmacological, interventions for pediatric anxiety: Meta-analysis and evidence base status. Journal of Clinical Child & Adolescent Psychology, 49(4), 435–459.

    Article  Google Scholar 

  • Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15–4927, NSDUHSeries H-50).

  • Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Substance Use Disorder Treatment for People with Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series, No. 42. SAMHSA Publication No. PEP20–02–01–004. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  • Sugarman, D. E., Campbell, A. N., Iles, B. R., & Greenfield, S. F. (2017). Technology-based interventions for substance use and comorbid disorders: An examination of the emerging literature. Harvard Review of Psychiatry, 25(3), 123.

    Article  PubMed  PubMed Central  Google Scholar 

  • Swendsen, J., Burstein, M., Case, B., Conway, K. P., Dierker, L., He, J., & Merikangas, K. R. (2012). Use and abuse of alcohol and illicit drugs in US adolescents: Results of the National Comorbidity Survey-Adolescent Supplement. Archives of General Psychiatry, 69(4), 390–398.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tait, R. J., & Hulse, G. K. (2003). A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug. Drug and Alcohol Review, 22(3), 337–346.

    Article  PubMed  Google Scholar 

  • Tanner-Smith, E. E., & Lipsey, M. W. (2015). Brief alcohol interventions for adolescents and young adults: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 51, 1–18.

    Article  PubMed  Google Scholar 

  • Tanner-Smith, E. E., Steinka-Fry, K. T., Hennessy, E. A., Lipsey, M. W., & Winters, K. C. (2015). Can brief alcohol interventions for youth also address concurrent illicit drug use? Results from a meta-analysis. Journal of Youth and Adolescence, 44(5), 1011–1023.

    Article  PubMed  PubMed Central  Google Scholar 

  • van den Bosch, L. M. C., & Verheul, R. (2007). Patients with addiction and personality disorder: Treatment outcomes and clinical implications. Current Opinion in Psychiatry, 20(1), 67–71.

    Article  PubMed  Google Scholar 

  • Wisdom, J. P., Cavaleri, M., Gogel, L., & Nacht, M. (2010). Barriers and facilitators to adolescent drug treatment: Youth, family, and staff reports. Addiction Research & Theory, 19(2), 179–188.

    Article  Google Scholar 

  • Wittchen, H. U., Behrendt, S., Höfler, M., Perkonigg, A., Lieb, R., Bühringer, G. E. E. A., & Beesdo, K. (2008). What are the high risk periods for incident substance use and transitions to abuse and dependence? Implications for early intervention and prevention. International Journal of Methods in Psychiatric Research, 17(S1), S16–S29.

    Article  PubMed  Google Scholar 

  • Wolitzky-Taylor, K., Bobova, L., Zinbarg, R. E., Mineka, S., & Craske, M. G. (2012). Longitudinal investigation of the impact of anxiety and mood disorders in adolescence on subsequent substance use disorder onset and vice versa. Addictive Behaviors, 37(8), 982–985.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wu, L. T., Blazer, D. G., Li, T. K., & Woody, G. E. (2011). Treatment use and barriers among adolescents with prescription opioid use disorders. Addictive Behaviors, 36(12), 1233–1239.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was supported by the Office of the Director, National Institutes of Health, per awards DP5OD028123 (PI: Schleider) and DP5OD029636 (PI: Opara).

Author information

Author notes

  1. Ijeoma Opara and Jessica L. Schleider shares joint senior authorship.

Authors and Affiliations

  1. Department of Psychology, Stony Brook University, Psychology B Building, Stony Brook, NY, 11794-2500, USA

    Riley McDanal & Jessica L. Schleider

  2. Program of Public Health, Stony Brook University, Stony Brook, USA

    Deanna Parisi

  3. Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, USA

    Ijeoma Opara

Authors
  1. Riley McDanal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deanna Parisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ijeoma Opara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jessica L. Schleider
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Riley McDanal.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

As we do not collect any data for this systematic review, Institutional Review Board approval is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McDanal, R., Parisi, D., Opara, I. et al. Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review. Clin Child Fam Psychol Rev 25, 339–355 (2022). https://doi.org/10.1007/s10567-021-00372-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10567-021-00372-2

Keywords

Search

Navigation