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Effectiveness of a Theoretically-Based Judgment and Decision Making Intervention for Adolescents

Abstract

Although adolescents demonstrate capacity for rational decision making, their tendency to be impulsive, place emphasis on peers, and ignore potential consequences of their actions often translates into higher risk-taking including drug use, illegal activity, and physical harm. Problems with judgment and decision making contribute to risky behavior and are core issues for youth in treatment. Based on theoretical and empirical advances in cognitive science, the Treatment Readiness and Induction Program (TRIP) represents a curriculum-based decision making intervention that can be easily inserted into a variety of content-oriented modalities as well as administered as a separate therapeutic course. The current study examined the effectiveness of TRIP for promoting better judgment among 519 adolescents (37 % female; primarily Hispanic and Caucasian) in residential substance abuse treatment. Change over time in decision making and premeditation (i.e., thinking before acting) was compared among youth receiving standard operating practice (n = 281) versus those receiving standard practice plus TRIP (n = 238). Change in TRIP-specific content knowledge was examined among clients receiving TRIP. Premeditation improved among youth in both groups; TRIP clients showed greater improvement in decision making. TRIP clients also reported significant increases over time in self-awareness, positive-focused thinking (e.g., positive self-talk, goal setting), and recognition of the negative effects of drug use. While both genders showed significant improvement, males showed greater gains in metacognitive strategies (i.e., awareness of one’s own cognitive process) and recognition of the negative effects of drug use. These results suggest that efforts to teach core thinking strategies and apply/practice them through independent intervention modules may benefit adolescents when used in conjunction with content-based programs designed to change problematic behaviors.

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References

  • Albert, D., & Steinberg, L. (2011). Judgment and decision making in adolescence. Journal of Research on Adolescence, 21(1), 211–224.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.

  • Bartholomew, N. G., Dansereau, D. F., Knight, D. K., Becan, J. E., & Flynn, P. M. (2012). Treatment Readiness and Induction Program (TRIP). Fort Worth: Texas Christian University, Institute of Behavioral Research.

    Google Scholar 

  • Bates, M. E., Voelbel, G. T., Buckman, J. F., Labouvie, E. W., & Barry, D. (2005). Short-term neuropsychological recovery in clients with substance use disorders. Alcoholism, Clinical and Experimental Research, 29(3), 367–377.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cantwell, D. P. (1996). Attention deficit disorder: A review of the past 10 years. Journal of the American Academy of Child Adolescent Psychiatry, 35, 978–987.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum.

    Google Scholar 

  • Crick, N. R., & Dodge, K. A. (1996). Social information-processing mechanisms in reactive and proactive aggression. Child Development, 67, 993–1002.

    Article  PubMed  Google Scholar 

  • Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.

    Article  Google Scholar 

  • Cross, C. P., Copping, L. T., & Campbell, A. (2011). Sex differences in impulsivity: A meta-analysis. Psychological Bulletin, 137(1), 97–130.

    Article  PubMed  Google Scholar 

  • Czuchry, M., & Dansereau, D. F. (2004). The importance of need for cognition and educational experience in enhanced and standard substance abuse treatment. Journal of Psychoactive Drugs, 36(2), 243–251.

    Article  PubMed  Google Scholar 

  • Czuchry, M., & Dansereau, D. F. (2005). Using motivational activities to facilitate treatment involvement and reduce risk. Journal of Psychoactive Drugs, 37(1), 7–13.

    Article  PubMed  Google Scholar 

  • Czuchry, M., Dansereau, D. F., Dees, S. M., & Simpson, D. D. (1995). The use of node-link mapping in drug abuse counseling: The role of attentional factors. Journal of Psychoactive Drugs, 27(2), 161–166.

    Article  PubMed  Google Scholar 

  • Czuchry, M., Sia, T. L., & Dansereau, D. F. (2006). Improving early engagement and treatment readiness of probationers: Gender differences. The Prison Journal, 86(1), 56–74.

    Article  Google Scholar 

  • Czuchry, M., Sia, T. L., Dansereau, D. F., & Dees, S. M. (1997). Downward Spiral: A pedagogical game depicting the dangers of substance abuse. Journal of Drug Education, 27(4), 373–387.

    Article  PubMed  Google Scholar 

  • Dansereau, D. F. (2005). Node-link mapping principles for visualizing knowledge and information. In S. O. Tergan & T. Keller (Eds.), Knowledge visualization and information visualization: Searching for synergies. Heidelberg: Springer.

    Google Scholar 

  • Dansereau, D. F., Joe, G. W., & Simpson, D. D. (1995). Attentional difficulties and the effectiveness of a visual representation strategy for counseling drug-addicted clients. International Journal of the Addictions, 30(4), 371–386.

    PubMed  Google Scholar 

  • Dansereau, D. F., Knight, D. K., & Flynn, P. M. (2013). Improving adolescent judgment and decision making. Professional Psychology Research and Practice, 44(4), 274–282.

    Article  Google Scholar 

  • Dansereau, D. F., & Simpson, D. D. (2009). A picture is worth a thousand words: The case for graphic representations. Professional Psychology: Research & Practice, 40(1), 104–110.

    Article  Google Scholar 

  • De Leon, G. (1997). Therapeutic communities: Is there an essential model? In G. De Leon (Ed.), Community as methods: Therapeutic communities for special populations and special settings (pp. 3–18). Westport, CT: Praeger.

    Google Scholar 

  • De Leon, G. (2000). The therapeutic community: Theory, model and method. New York: Springer Publishing Company.

    Google Scholar 

  • Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39(2), 349–371.

    Article  PubMed Central  PubMed  Google Scholar 

  • Drug Strategies. (2005). Bridging the gap: A guide to drug treatment in the juvenile justice system. Washington, DC: Author.

    Google Scholar 

  • Etheridge, R. M., Smith, J. C., Rounds-Bryant, J. L., & Hubbard, R. L. (2001). Drug abuse treatment and comprehensive services for adolescents. Journal of Adolescent Research, 16, 563–589.

    Article  Google Scholar 

  • Garner, B. R., Knight, K., Flynn, P. M., Morey, J. T., & Simpson, D. D. (2007). Measuring offender attributes and engagement in treatment using the Client Evaluation of Self and Treatment. Criminal Justice and Behavior, 34(9), 1113–1130.

    Article  Google Scholar 

  • Gladwell, M. (2005). Blink: The power of thinking without thinking. New York: Little, Brown, & Company.

    Google Scholar 

  • Greenfield, S. F., Brooks, A. J., Gordon, S. M., Green, C. A., Kropp, F., McHugh, R., et al. (2007). Substance abuse treatment entry, retention, and outcome in women: A review of the literature. Drug and Alcohol Dependence, 86(1), 1–21.

    Article  PubMed Central  PubMed  Google Scholar 

  • Joe, G. W., Broome, K. M., Rowan-Szal, G. A., & Simpson, D. D. (2002). Measuring patient attributes and engagement in treatment. Journal of Substance Abuse Treatment, 22(4), 183–196.

    Article  PubMed  Google Scholar 

  • Joe, G. W., Knight, D. K., Becan, J. E., & Flynn, P. M. (2014). Recovery among adolescents: Models for post-treatment gains in drug abuse treatments. Journal of Substance Abuse Treatment, 46, 362–373.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kahneman, D. (2011). Thinking fast and slow. New York: Farrar, Straus, Giroux.

    Google Scholar 

  • Klaczynski, P. A. (2005). Metacognition and cognitive variability: A dual-process model of decision making and its development. In J. E. Jacobs & P. A. Klaczynski (Eds.), The development of judgment and decision-making in children and adolescents (pp. 39–76). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Knight, D. K., Becan, J. E., Landrum, B., Joe, G. W., & Flynn, P. M. (in press). Screening and assessment tools for measuring adolescent client needs and functioning in substance use treatment. Substance Use and Misuse.

  • Knight, K., Simpson, D. D., & Hiller, M. L. (2002). Screening and referral for substance-abuse treatment in the criminal justice system. In C. G. Leukefeld, F. Tims, & D. Farabee (Eds.), Treatment of drug offenders: Policies and issues (pp. 259–272). New York: Springer.

    Google Scholar 

  • Kreitler, C. M., Dansereau, D. F., Barth, T. M., Repasky, G. T., & Miller, J. (2012). Evaluation of a cognitive tool for enhanced decision-making and personal change among college students. Journal of the National Academic Advising Association, 32(1), 18–29.

    Google Scholar 

  • Landrum, B., Knight, D. K., Becan, J. E., & Flynn, P. M. (in press). To stay or not to stay: Adolescent client, parent, and counselor perspectives on leaving substance abuse treatment early. Journal of Child and Adolescent Substance Abuse.

  • McWhirter, P. T. (2008). Enhancing adolescent substance abuse treatment engagement. Journal of Psychoactive Drugs, 40(2), 173–182.

    Article  PubMed  Google Scholar 

  • Millstein, S. G., & Halpern-Felsher, B. L. (2002). Judgment about risks and perceived invulnerability in adolescents and young adults. Journal of Research in Adolescence, 12(4), 399–422.

    Article  Google Scholar 

  • Morey, J. T., & Dansereau, D. F. (2010). Decision-making strategies for college students. Journal of College Counseling, 13(2), 155–168.

    Article  Google Scholar 

  • Morral, A. R., McCaffrey, D. F., & Ridgeway, G. (2004). Effectiveness of community-based treatment for substance-abusing adolescents: 12-Month outcomes of youths entering Phoenix Academy or alternative probation dispositions. Psychology of Addictive Behaviors, 18(3), 257–268.

    Article  PubMed  Google Scholar 

  • National Institute on Drug Abuse. (2014). Principles of adolescent substance use disorder treatment: A research-based guide (NIH Publication No. 14-7953). Retrieved from http://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide.

  • Newbern, D., Dansereau, D. F., Czuchry, M., & Simpson, D. D. (2005). Node-link mapping in individual counseling: Treatment impact on clients with ADHD-related behaviors. Journal of Psychoactive Drugs, 37(1), 93–103.

    Article  PubMed  Google Scholar 

  • O’Donnell, A. M., & King, A. (1999). Cognitive perspectives on peer learning. Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Perry, J. L., Joseph, J. E., Jiang, Y., Zimmerman, R. S., Kelly, T. H., Darna, M., et al. (2011). Prefrontal cortex and drug abuse vulnerability: Translation to prevention and treatment interventions. Brain Research Reviews, 65, 124–149.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pompi, K. F., & Resnick, J. (1987). Retention of court-referred adolescents and young adults in the therapeutic community. American Journal of Drug and Alcohol Abuse, 13(3), 309–325.

    Article  PubMed  Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the traditional boundaries of therapy. Malabar, FL: Krieger.

    Google Scholar 

  • Prochaska, J. O., DiClemente, C. C., & Norcross, J. (1992). In search of how people change. American Psychologist, 47, 1101–1114.

    Article  Google Scholar 

  • Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed.). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Reyna, V. F., & Farley, F. (2006). Risk and rationality in adolescent decision making: Implications for theory, practice, and public policy. Psychological Science in the Public Interest, 7(1), 1–44.

    Google Scholar 

  • SAS Institute. (2003). SAS/STAT user’s guide. Cary, NC:Author

  • Silverman, I. W. (2003). Gender differences in delay of gratification: A meta-analysis. Sex Roles, 49, 451–463.

    Article  Google Scholar 

  • Steinberg, R. J. (2007). Wisdom, intelligence, and creativity synthesized. Cambridge, NY: Cambridge University Press.

    Google Scholar 

  • Stevens, S. J., Estrada, B., Murphy, B. S., McKnight, K. M., & Tims, F. (2004). Gender differences in substance use, mental health, and criminal justice involvement of adolescents at treatment entry and at three, six, twelve and thirty month follow-up. Journal of Psychoactive Drugs, 36(1), 13–25.

    Article  PubMed  Google Scholar 

  • Stevens, S. J., Murphy, B. S., & McKnight, K. (2003). Traumatic stress and gender differences in relationship to substance abuse, mental health, physical health, and HIV risk behavior in a sample of adolescents enrolled in drug treatment. The Journal of Child Maltreatment, 8, 46–57.

    Article  Google Scholar 

  • Titus, J. C., & Dennis, M. L. (2006). Cannabis youth treatment intervention: Preliminary findings and implications. In H. A. Liddle & C. L. Rowe (Eds.), Adolescent substance abuse: Research and clinical advances (pp. 104–126). Cambridge, NY: Cambridge University Press.

    Chapter  Google Scholar 

  • Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669–689.

    Article  Google Scholar 

  • Williams, R. J., Chang, S. Y., & Addiction Centre Adolescent Research Group. (2000). A comprehensive and comparative review of adolescent substance abuse treatment outcome. Clinical Psychology: Science and Practice, 7(2), 138–166.

    Google Scholar 

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Acknowledgments

This work was funded by the National Institute on Drug Abuse (NIDA; Grant R01DA013093). The interpretations and conclusions, however, do not necessarily represent the position of the NIDA, National Institutes of Health, or Department of Health and Human Services. The authors would like to acknowledge the contributions of administrators and clinical staff at participating programs who worked diligently to insure that assessment and curriculum protocols were implemented with fidelity.

Author contributions

DK conceived the study, participated in its design, conducted statistical analyses, and drafted the manuscript. DD developed the intervention, participated in study design and rationale, and wrote sections of the introduction and discussion. JB participated in the coordination of the study, wrote sections of the methods, and edited the full manuscript. GR participated in the statistical analysis and interpretation of the data and contributed to the results section. PF was the Principal Investigator, contributed to the conceptualization of the original research, contributed to the study design and editing of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Danica K. Knight.

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Knight, D.K., Dansereau, D.F., Becan, J.E. et al. Effectiveness of a Theoretically-Based Judgment and Decision Making Intervention for Adolescents. J Youth Adolescence 44, 1024–1038 (2015). https://doi.org/10.1007/s10964-014-0127-6

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  • DOI: https://doi.org/10.1007/s10964-014-0127-6

Keywords

  • Judgment and decision making
  • Thinking
  • Adolescents
  • Substance use
  • Treatment
  • Intervention