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.
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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).
Except the text-based intervention, which was administered via 24 text messages.
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).
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.
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This study was supported by the Office of the Director, National Institutes of Health, per awards DP5OD028123 (PI: Schleider) and DP5OD029636 (PI: Opara).
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The authors declare that they have no conflict of interest.
As we do not collect any data for this systematic review, Institutional Review Board approval is not required.
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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