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The effects of treatment satisfaction and therapeutic dosage on adolescent drinking outcomes


The current study examined the impact of non-specific treatment factors, therapeutic dosage and treatment satisfaction, on drinking behaviors and consequences among adolescents participating in a voluntary, high school- based alcohol intervention (N = 94). Path analysis served to test the primary model in which satisfaction and dosage were predicted to influence severity of alcohol use (i.e., number of binge drinking episodes and alcohol-related problems within the past 30 days) three months after initial intervention participation. Student attempts to reduce or quit drinking alcohol were proposed as an intervening variable in the model, accounting for part of the relationship between treatment variables and changes in alcohol involvement. In addition, student estimates of peer frequency of alcohol use were included in the model as a covariate to account for previous findings of the current intervention, which demonstrated that reductions in perceived peer alcohol use were associated with decreased drinking. Two theoretically-sound alternative models were also tested to determine which model best fit the data. The model exhibiting the best relative fit included direct paths 1) from treatment satisfaction and peer drinking estimates to 1-month alcohol quit attempts, and 2) direct paths from quit attempts and peer drinking estimates to 3-month binge drinking episodes. Examination of path coefficients revealed three significant relationships. First, students reporting greater peer estimates of alcohol use at intake were more likely to report at least one quit attempt at 1-month follow-up. Next, students who had a reported quit attempt were more likely to report greater alcohol use severity two months later. Finally, greater baseline alcohol use severity was associated with greater follow-up alcohol use severity. Overall, it appears that adolescents self-selecting into an alcohol intervention are likely to make change efforts early in treatment, with little change in quit attempts between one and three months post-intake. Similarly, more did not mean better in terms of therapeutic dosage or treatment satisfaction and drinking outcomes. These findings suggest that adolescents voluntarily attending a school-based intervention are able to effectively optimize their therapeutic dose and quickly utilize strategies taught in session. Understanding how non-specific treatment factors affect change efforts and drinking patterns can help tailor secondary interventions for adolescents with moderate alcohol histories by maximizing engagement, motivation, and possibly future help-seeking behaviors.

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