Intervention delivered by school staff successfully lowers drinking rates in 'at risk' children
24 August 2010
In the September 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry Principal Investigator Dr Patricia Conrod and colleagues, Institute of Psychiatry, King’s College London, report findings from Adventure - a successful personality-based intervention for substance abuse delivered by teachers.
In the past ten years alcohol consumption in 12-17 years olds has doubled. In 2009 17.42% of 3.1 million 11-15 year olds sampled in England, had drunk alcohol in the previous week. Before publication of data from the Preventure trial* no programme had been shown to be effective in the UK at reducing substance abuse in young people.
Preventure is a school-based drug and alcohol prevention programme that helps teenagers learn coping skills to better manage personality traits associated with risk for addiction. Adventure is a training model which teaches school staff to deliver the programme in their school. An effectiveness trial was conducted to determine whether the programme was just as effective when delivered by members of school staff.
In Personality-Targeted Interventions Delay Uptake of Drinking and Decrease Risk of Alcohol-Related Problems When Delivered by Teachers, Dr Patricia Conrod and colleagues evaluated 2,506 adolescents, with a mean age of 13.7, using the Substance Use Risk Profile scale; a 23-item questionnaire which assesses personality risk for substance abuse along four dimensions including sensation-seeking, impulsivity, anxiety-sensitivity, and hopelessness.
Of the 1159 students identified by researchers as being at high risk for substance abuse, 624 received intervention as part of the Adventure trial and a matched high risk group of 384 received no intervention. School based interventions consisted of two 90 minute group sessions conducted by a trained educational professional. In order to adequately evaluate the students, the teachers attended a 3-day rigorous workshop, followed by 4 hour supervision and feedback session. An 18 point checklist was used to determine whether the teachers demonstrated a good understanding of the aims and components of the programmes.
Although the trial is designed to evaluate mental health symptoms, academic achievement, and substance use uptake over a 2 year period, the authors have focused their findings on the six month outcomes of drinking and binge-drinking rates, quantity by frequency of alcohol use, and drinking-related problems.
Reporting on the efficacy of the intervention at six months, author and Trial Co-ordinator Maeve O’Leary-Barrett said 'Receiving an intervention significantly decreased the likelihood of drinking in the six months following - there was a 40% reduction in drinking rates in the intervention group, relative to the control group, and a 55% reduction in binge-drinking rates. In addition, high-risk intervention-school students reported lower quantity by frequency of alcohol use and drinking-related problems compared with the non-treatment group at follow-up.'
Dr Patricia Conrod commented, 'The findings at six months suggest that this approach may provide a sustainable school-based prevention program for youth at risk for substance abuse. In-house personality-targeted interventions allow schools to implement early prevention strategies with youth most at risk for developing future alcohol-related problems and provide the potential for follow-up of the neediest individuals.'
Nick Barton, Chief Executive of Action on Addiction who commissioned the trials, said 'Large numbers of those we treat for addiction say that their relationship with substances began in their school years. So the development of a programme for young people that may help them reduce their chances of developing an addiction in the future is exciting.'
Trisha Jaffe, Headteacher, Kidbrooke School who took part in the trials said: 'The work with King's College London has been a powerful addition to the work we have been doing with students to support them to be successful. It helps to identify young people at risk of impetuous or destructive behaviours. Having done so, we can work with them to support them to manage life and their choices more effectively. We have been really grateful for the support that King's has given us and to the skills it has added to our staff who have now taken over the running of both the assessment and the interventions. This is an approach that can make a difference.'
O’Leary-Barrett M, Mackie CJ, Castellanos-Ryan N, Al-Khudhairy N, Conrod PJ. Personality-Targeted Interventions Delay Uptake of Drinking and Decrease Risk of Alcohol-Related Problems When Delivered by Teachers. J. Am. Acad. Child Adolesc.Psychiatry, 2010;49(9):954 –963 can be viewed online at Journal of the American Academy of Child and Adolescent Psychiatry www.jaacap.com.
* Personality-targeted interventions delay the growth of adolescent drinking and binge drinking - Authors: Conrod, Patricia J.; Castellanos, Natalie; Mackie, Clare Journal of Child Psychology and Psychiatry and Allied Disciplines, Volume 49, Number 2, February 2008 , pp. 181-190(10) Wiley-Blackwell. Brief, Personality-Targeted Coping Skills Interventions and Survival as a Non–Drug User Over a 2-Year Period During Adolescence Patricia J. Conrod, PhD, CPsychol; Natalie Castellanos-Ryan, PhD; John Strang, MBBS, FRCPsych, MD Arch Gen Psychiatry. 2010;67(1):85-93.